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Assessment of respiratory system

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Assessment of respiratory system

  1. 1. ASSESSMENT OFRESPIRATORY SYSTEM
  2. 2. RESPIRATORY SYMPTOMS Chest pain Dyspnoea Wheeze Cough hemoptysis
  3. 3. Chest pain QUESTIONS TO ASK SITE NATURE OR QUALITY INTENSITY RADIATION DURATION ONSET RELIEVING AND AGGRAVATING FACTORS ASSOCIATED MANIFESTATIONS
  4. 4. CAUSES CARDIOVASCULAR Angina MI PERCARDITIS DISSECTING AORTIC ANEURYSM
  5. 5. PULMONARY TRACHEO BRONCHITIS PLEURAL PNEUMONIA, PE,NEOPLASM
  6. 6. GI REFLUX ESOPHAGITIS DIFFUSE ESOPHAGEAL SPASM OTHER CAUSES CHEST WALL PAIN ANXIETY
  7. 7. DYSPNEA NON PAINFUL UNCOMFORTABLE AWARENESS OF BRETHING
  8. 8. QUESTIONS ONSET sudden or gradual Occurs on rest or exertion Interefere with daily activities Has dysnea altered the life style of patient Timing and setting of dysnea Associated symptoms Relieving and aggravating factors
  9. 9. CAUSES LVF CHRONIC BRONCHITIS COPD ASTHMA ILD PNEUMONIA PNEUMOTHORAX ACUTE PE ANXIETY
  10. 10. COUGH REFLEX RESPONSE TO STIMULI THAT IRRITATES RECEPTORS IN LARYNX ,TRACHEA, AND LARGE BRONCHI
  11. 11. QUESTIONS SINCE WHEN ONSET OCCURS AT WHAT TIME OF DAY INTENSITY AGGRAVATING OR RELIEVING FACTORS DRY OR PRODUCTIVE
  12. 12. SPUTUM AMOUNT COLOUR ODOUR CONSISTENCY BLOOD STREAKED
  13. 13. HEMOPTYSIS COUGHING UP BLOOD IN SPUTUM IS HEMOPTYSIS
  14. 14. QUESTIONS SINCE WHEN? PRECEDED WITH COUGH ? QUANTIFY COLOUR OF BLOOD FRESH OR ALTERED SETTING AND ACTIVITY ASSOCIATED SYMTOMS
  15. 15. DIFFERENTIATE FROMHEMETEMESIS PRECEDED WITH NAUSEA ASSOCIATEED GI SYMPTOMS FOOD PARTICLES IN VOMITUS ACIDIC PH
  16. 16. CAUSES LARYNGITIS TRACHEOBRONCHITIS PNEUMONIA POST NASAL DRIP CHRONIC BRONCHITIS BRONCHIECTASIS TB LUNG ABCESS
  17. 17. CONT….. ASTHMA GERD CA LVF MS PE INHALATION OF FUMES PARTICLES CHEMICLES OR GASES
  18. 18. CHEST CONTOUR ANDSYMMMETRY NORMALLLY LATERAL DIAMETER IS MORE THAN AP DIAMETER
  19. 19. DEFORMITIES BARREL FLAIL FUNNEL PIGEON KYPHOSCOLIOSIS
  20. 20. RESPIRATORY RATE 14 TO 20 BREATHS PER MINUTE THORACO ABDOMINAL IN FEMALES ABDOMEN PROTRUDES OUT DURING INSPIRATION ABDOMENOTHORACIC IN MALES
  21. 21. TACTILE FREMITUS WHEN SOUND WAVES TRAVEL THRU BRONCHOPULMONARY TREE THERE IS PALPABLE VIBRATIONS TRNSMITTED THRU CHEST WALL
  22. 22. HOW TO CHECK? PLACE ULNAR BORDER OF YOUR HAND ON THE CHEST WHILE ASKING PT TO SPEAK NINTYNINE. COMP;ARE BOTH SIDES ANTERIORLY AND POSTERIORLY.
  23. 23. CAUSES OF DECREASEDFREMITUS WHEN TRANSMISSION OF VIBRATION FROM LARYNX TO THE SURFACE OF THE CHEST IS IMPEDED. OBSTRUCTED BRONCHUS COPD PLEURAL EFFUSION PLEURAL THICKENING PNEUMOTHORAX INFILTRATING TUMOUR
  24. 24. CHEST EXPANSION 5 TO 7 CM CAUSES OF UNILATERAL REDUCED CHEST EXPANSION FIBROSIS EFFUSION PNEUMONIA BRONCHIAL OBSTRUCTION
  25. 25. PERCUSSION SETS THE CHEST WALL AND UNDERLYING TISSUR IONTO MOTION PRODUCING AUDIBLE SOND AND PALPABLE VIBRATION PENETRATES ONLY 5 TO 7 CM INTO THE CHEST
  26. 26. PERCUSSION NOTES STONY DULL DULL RESONANT HYPERRESONANT TYMPANITIC
  27. 27. CAUSES DULLNESS LOBAR PNEUMONIA STONY DULL ,PLEURAL EFFUSION ,HEMOTHORAX,EMPYEMA. HYPER RESONANCE , PNEUMOTHORAX AIR CONTAINING BULLA TYPANITIC GASTRIC AIR BUBBLE
  28. 28. DIAPHRAGMATICEXCURSION DESCENT OF DIAPHRAGM CHECKED THRU PERCUSSION NORMALLY WITH FULL INSPIRATION 5 TO 6 CM.
  29. 29. AUSCULTATION INTENSITY TYPE ADDED VOCAL RESONANANCE
  30. 30. TYPES OF BREATHSOUNDS VESICULAR BRONCHO VESICULAR BRONCHIAL AS IN PNEUMONIA,COLLASE WITH PATENT BRONCHUS,CAVITATION UPPER PART OF PLEURAL EFFUSION.
  31. 31. ADDED SOUNDS CRACKLES FINE AND COARSE WHEEZES RONCHI PLEURAL RUB
  32. 32. CRACKLES WHEN DEFLATED SMALL AIRWAYS OPEN UP DURING INSPIRATION. ILD,CCF. AIR BUBBLES FLOWING THRU SECRETIONSCHRONIC BRONCHITIS.
  33. 33. WHEEZES WHEN AIRFLOW THRU NARROIWED BRONCHI WHISTLING SOUNDS PRODUCED. ASTHMA, COPD,CCF. LOALISED WHEEZE SIGNIFIES PARTIOAL OBSTRUCTION OF BRONCHUS BY TUMOUR OR FOREIGN BODY
  34. 34. STRIDOR MUSICAL SOUND ENTIRELY INSPIRATORY. OBSTRUCTION OF LARYNX AND TRACHEA
  35. 35. PLEURAL RUB WHEN ROUGHENED PLEURAL SURFACES RUB AGAINST EACH OTHER.
  36. 36. TRNSMITTED SOUNDS. BRONCHOPHONY LODER AND CLEARER VOICE SOUNDS EGOPHONY QUALITY OF SOUNDS TURNED TP NASAL “EE” TO “AY” WHISPERED PECTORILOQUY LODER CLEARE WHISPERED SOUNDS. ALL ABOVE ARE FOUND IN CONSOLIDATION
  37. 37. THANK YOU

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