Signs of Respiratory Disease

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Signs of Respiratory Disease

Auscultation

Crackles
- air space opening
- early inspiration
  - bronchitis
  - bronchiectasis
- late inspiration
  - fibrosis
  - pneumonia
  - oedema
Wheeze
- monophonic = single bronchus
  - carcinoma
  - stricture
- polyphonic = expiration, multiple bronchi
  - COAD
  - Bronchitis
  - Asthma
Bronchial Breathing
- harsh, long expiration
- always with
  - increased tactile vocal fremitus
  - bronchophony
  - whispering pectoriloquy
- cause
  - pleural effusion
  - lung cavity
  - lung fibrosis
  - lung consoloidation
Decreased breath sounds
- ventilation
  - emphysema
- pleura
  - pneumothorax
  - pleural effusion

Percussion

Increased resonance
- pneumothorax
- emphysema
Decreased resonance
- Pleural
  - effusion
  - thickening
- Lung
  - fibrosis
  - collapse
  - consolidation

Palpation

Tactile vocal fremitus increased
- pleural effusion
- lung cavity
- lung fibrosis
- lung consolidation
Tactile vocal fremitus decreased
- lung collapse
- pleural effusion
- pneumothorax

Inspection

Movements
- Unilateral reduced
  - surgery
  - pleural effusion
  - pneumothorax
  - fibrosis
  - consolidation
  - lung collapse
- bilateral reduced
  - brain tumour
  - drugs
Flattening
- fibrosis on one side
Hyperinflation
- increased AP diameter
- high shoulders
Pectus excavatum
Kyphoscoliosis

Clubbing

Cardiac
- endocarditis
- cyanotic congenital heart disease
Respiratory
- chronic suppuration
- carcinoma
- fibrosis

Respiration

rapid / shallow
- pneumonia
- pleurisy
deep = air hunger
- ketoacidosis
- uraemia
- aspirin overdose
Cheyne-Stokes
- rapid - blows off CO₂ leading to
- apnoea - leading to rise in CO₂ leading to rapid again
- Causes
  - central respiratory depression
  - left ventricular failure
  - sleep apnoea
  - cerebrovascular accident
hyperventilation
- anxiety
- panic states
- chest pain

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