During the physical examination of COPD, the thorax is often inspected for which classic shape?

• A. Normal shape
• B. Barrel-chest shape
• C. Pectus excavatum
• D. Asymmetric chest expansion

Answer: (B)

Barrel-shaped chest is the classic finding in COPD due to hyperinflation from air trapping, especially with emphysema. When air gets trapped, the lungs stay expanded and push the ribs outward, increasing the anteroposterior diameter of the chest. This makes the chest wall appear round and enlarged, with a more prominent AP dimension and flattened diaphragms. In contrast, a normal chest has a balanced shape, pectus excavatum would show a sunken sternum, and asymmetric chest expansion points to localized problems rather than diffuse hyperinflation seen in COPD. So the exam often reveals a rounded, barrel-shaped thorax reflecting chronic lung hyperinflation.