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Patient crosses arms, places hands on opposite shoulders, breathes normally. Examiner inspects posterior thorax for contour, symmetry, deformities, and skin condition. Palpates chest wall for pain, tenderness, lesions. Assesses lung expansion by placing thumbs near spine at T10, spreads fingers across lateral thorax, asks patient to inhale/exhale deeply. Observes thumb divergence and movement symmetry. Palpates for tactile fremitus by asking patient to say "ninety nine" while touching chest.