ABC Medical Notes.com |
|
---|---|
Free Open Access Medical Information | |
MEDICAL DISCLAIMER:The contents are under continuing development and improvements and despite all efforts may contain errors of omission or fact. This is not to be used for the assessment, diagnosis or management of patients. It should not be regarded as medical advice by healthcare workers or laypeople. It is for educational purposes only. Please adhere to your local protocols. Use the BNF for drug information. If you are unwell please seek urgent healthcare advice. If you do not accept this then please do not use the website. Makindo Ltd |
Resp exam: Overall plan |
---|
|
Ask the patient to cough first to remove any phlegm that can add noises to the auscultatory findings. Ask the patient to breathe through an open mouth as less resistance pathway and more air shifted and so more to hear normal breathing pattern expiration more prolonged than inspiration 2:1
Pathology | Aetiology | History/Inspection | Mediastinum | Palpation/Percussion | Auscultation |
---|---|---|---|---|---|
Consolidation | Lobar Pneumonia | Dyspnoea, Cough, fever, Pleurisy | Central and reduced movement same side | Dull to percussion, Increased Tactile fremitus and reduced expansion | Bronchial breathing, Added sounds, wheeze and creps and increased vocal resonance (whispering pectoriloquy) |
Collapse of lobe or lung | Occluded bronchus | No shift | Dull over pathology | Bronchial | Reduced same side |
Pleural Effusion | Fluid in pleural space | Progressive breathlessness, fever, weight loss | Central or away from pathology if > 1 L. Reduced movement affected side | Stony Dull over pathology, Reduced Tactile fremitus, | Reduced vesicular breath sounds. Crackles at upper edge with pleural friction rub |
Asthma | Bronchospasm and mucus plugs | Central | Resonant | Exp Wheeze | Reduced Vesicular breath sounds bilateral, Ominous silent chest |
COPD | Chronic cough, wheeze, smoker, distressed | Central | Resonant | Exp Wheeze | Decreased vesicular sounds, exp wheeze |
Pneumothorax | Air in Pleural space | Dyspnoea, wheeze, distressed | Central or towards PTX and reduce movement same side | Hyper/Resonant, Reduced Tactile fremitus | Reduced Vesicular breaths, added sounds |
Tension Pneumothorax | Air under pressure in Pleural space | Dyspnoea, wheeze, distressed, hypotenisve, cardiac arrest | Hyper/Resonant | Reduced | Reduced vesicular breath sounds, affected side |
Pulmonary Fibrosis | Air under pressure in Pleural space | Away from PTX | Hyper/Resonant | Reduced | Reduced affected side |