.
Observation, inspection
Palpation
Tapping
Percussion
Auscultation
Well or unwell
Altertness and conscious level
Body Habitus
Absconcess
Signs of Respiratory Distress: Trachea, Tripod position, Use of Accessory Muscles, Pursed Lips, Flared Nostrils
Ability to whistle
Breathing Pattern
Added Breathing Sounds
Cough: Dry or Productive
Sternocleidomast
Scalene Trapezius
Brachials
Pectorialis Major
Internal Inter-costals
Abdominal Muscles
COPD
Asthma in exacerbation
Secretion Retention
Indicates Severe Respiratory distress and Hypoxemia
Yellow or Cyanotic skin
Fast or slow rate; Irregular Rhythm
Abnormal Lung Sounds
Reduced Tidal Volumes
Use of Accessory Muscles
Canary shaped ribs
Cool, damp, pale or cyanotic skin
Laboured Respiration (Assess for the use of Accessory muscles f)
Belly breathing
Retraction of intercostal spaces during inspiration
Long expiratory phase of respiration
Laughing while exhaling
Use of abdominal muscles to aid in expiration
Funnel Chest
Pigeon Chest
Canary Chest
Harrison's Sulcus
Cyanosis of the nails
Nail Bed Fluctuation (the first sign in clubbing)
Hair on fingers
Clubbing Nails
CO2 Retention Flap Sign of Hypercapnia (due to abnormally elevated Carbon Dioxide levels)
Yellow hands
Salbutamol induced tremor (Side effects of using Salbutamol as a treatment)
Anterior Wall - Upper Lobe
Anterior Wall - Lower Lobe
Posterior Wall - Upper Lobe
Posterior Wall - Lower Lobe
Right Lateral Wall - Middle Lobe
Left Lateral Wall - Lingula
Ask patient to take slow, deep breaths (increases duration, intensity-thus detestability of abnormal breath sounds)
Have patient cough DURING auscultation (clears airway secretions and opens small atelactatic areas at lung bases).
Have patient cough BEFORE beginning auscultation (clears airway secretions and opens small atelactatic areas at lung bases).
If patient cannot sit up - auscultation can be performed while patient is lying on their side.
Request patient exhale forcibly - can sometimes help to accentuate abnormal breath sounds (esp.wheezing)
If patient needs to remain supine - a minimal examination can be performed by listening laterally/posteriorly.
Some forms of Bronchiectasis
Emphysema
Chronic Bronchitis
Refractory (non-reversible) asthma
All forms of Bronchiectasis
Permanent enlargement of parts of the airways of the lung.
Typical symptoms: Chronic Cough with mucous production
Other Symptoms: Shortness of breath, coughing up blood and chest pain.
Typical symptoms: Chronic Cough with mucous production; coughing up blood.
Caused by damage to bronchial root.
Chronic Lung disease
Caused by damage to the alveoli
Damage to Alveoli results in fluid becoming trapped, causing them to expand and rupture.
Damage to Alveoli results in air becoming trapped, causing them to expand and rupture.
Congestion within first 24 hours; characterized by vascular engorgement, intra-alveolar fluid, small numbers of neutrophils, often numerous bacteria. Grossly, the lung is heavy and hyperaemic.
Red hepatization or consolidation; vascular congestion persists, with intravasation of red cells into alveolar spaces, along with increased #s of neutrophils and fibrin. The filling of airspaces by the exudate leads to a gross appearance of solidification, or consolidation of the alveolar parenchyma. This appearance has been likened to that of the liver, hence the term "hepatization".
Red hepatization or consolidation; vascular congestion persists, with extravasation of red cells into alveolar spaces, along with increased #s of neutrophils and fibrin. The filling of airspaces by the exudate leads to a gross appearance of solidification, or consolidation of the alveolar parenchyma. This appearance has been likened to that of the liver, hence the term "hepatization".
Grey Hepatization: Red cells disintegrate, with persistence of the neutrophils and fibrin. The alveoli still appear consolidated, but grossly the colour is paler and the cut surface is drier.
Resolution (complete recovery): The exudate is doubled by enzymatic activity, and cleared by macrophages or by cough mechanism. Enzymes produced by neutrophils will liquify exudates, and this will either be coughed up in sputum or be drained via lymph.
Resolution (complete recovery): The exudate is digested by enzymatic activity, and cleared by macrophages or by cough mechanism. Enzymes produced by neutrophils will liquify exudates, and this will either be coughed up in sputum or be drained via lymph.
An abnormal collection of air in the pleural space // the lung and chest wall.
Symptoms: Typically include a sudden onset of sharp, one-sided chest pain and shortness of breath.
Symptoms: Typically include a sudden onset of sharp, one-sided chest pain and sneezing.
Symptoms: Typically include a sudden onset of dull, one-sided chest pain and shortness of breath.