assessment of respiratory system with normal and adventitous sounds and anatomical abnormalities . Diagnostic evaluations and tests performed in respiratory assessment.
Respiratory physiology.pptx by DR Girish JainGirish jain
The document provides information on respiratory physiology. It discusses:
1. The process of respiration which includes ventilation, gas exchange, and oxygen utilization. Gas exchange occurs via diffusion in the lungs and tissues.
2. The types of respiration - external respiration which is the exchange of gases between the lungs and environment, and internal respiration which is the exchange between tissues and blood.
3. The anatomy of the respiratory system including the upper airways, conducting airways, respiratory airways, and the terminal respiratory unit where gas exchange occurs.
4. The muscles of respiration including the diaphragm and intercostal muscles which are involved in inhalation, and abdominal muscles which can aid exhalation
The document summarizes key aspects of the respiratory system, including:
1. The trachea divides into the right and left bronchi, which further divide into smaller bronchioles before terminating in alveoli where gas exchange occurs.
2. The lungs are enclosed in the pleural cavity and surrounded by pleura. Contraction of the diaphragm and intercostal muscles increases the thoracic cavity volume during inspiration.
3. Expiration is a passive process involving relaxation of the respiratory muscles, while inspiration requires active contraction of muscles like the diaphragm and intercostals to decrease thoracic pressure and draw in air.
This document provides an overview of respiratory disorders and the clinical evaluation of thoracic surgical patients. It describes the anatomy and physiology of the respiratory system, including ventilation, respiration, and the structures involved like the chest wall, trachea, lungs, bronchi, and pleura. It also outlines the clinical assessment process, noting important details to observe like breathing rate and character, lymph node examination, chest inspection, percussion, auscultation, and cardiovascular and abdominal evaluation. The goal is to gather relevant information on presenting symptoms and medical history to accurately diagnose respiratory conditions.
'Physiology' of Respiratory System .pptxadarshka244
The respiratory system consists of the nose, pharynx, larynx, trachea, bronchi, bronchioles and lungs. Air enters through the nose where it is warmed, filtered and humidified. It then passes through the pharynx and larynx before entering the trachea which divides into bronchi and further into bronchioles and alveoli in the lungs. In the alveoli, gas exchange occurs as oxygen passes into the blood and carbon dioxide passes out. Breathing is facilitated by the contraction of the diaphragm and intercostal muscles which expand the lungs to draw in air during inspiration and relax to expel air during expiration.
The respiratory system has several functions:
1. The nose warms, moistens, and filters air entering the body through nasal hairs and mucus.
2. The pharynx is a passageway shared by the respiratory and digestive systems that leads to the larynx.
3. The larynx, or voice box, prevents food from entering the lungs and produces sounds. It leads to the trachea.
4. The trachea, or windpipe, divides into the left and right bronchi and transports air to the lungs.
The respiratory system provides oxygen to the body's cells through respiration and removes carbon dioxide. It includes the nose, pharynx, larynx, trachea, bronchi, lungs, and muscles of respiration. Oxygen and carbon dioxide are exchanged between the alveoli and blood in the lungs through diffusion. Respiration is regulated by the respiratory center in the brainstem and chemoreceptors that detect changes in blood gases. Artificial respiration can prevent deaths by reopening the airway and exchanging gases until natural breathing resumes.
The chest cavity contains the lungs and heart and is bounded by the chest wall and diaphragm. It can be divided into the mediastinum and pleural cavities. The pleura is a membrane that covers the lungs and lines the chest wall. It has parietal and visceral layers separated by a pleural space. Ultrasonography allows visualization of the pleura and underlying lung parenchyma. Key findings include the pleural line, A-lines, B-lines, lung sliding, and consolidations. It is useful for evaluating pleural effusions, pneumothorax, and infiltrates and has advantages over chest radiography of being radiation-free, portable, and allowing real-time
Respiratory physiology.pptx by DR Girish JainGirish jain
The document provides information on respiratory physiology. It discusses:
1. The process of respiration which includes ventilation, gas exchange, and oxygen utilization. Gas exchange occurs via diffusion in the lungs and tissues.
2. The types of respiration - external respiration which is the exchange of gases between the lungs and environment, and internal respiration which is the exchange between tissues and blood.
3. The anatomy of the respiratory system including the upper airways, conducting airways, respiratory airways, and the terminal respiratory unit where gas exchange occurs.
4. The muscles of respiration including the diaphragm and intercostal muscles which are involved in inhalation, and abdominal muscles which can aid exhalation
The document summarizes key aspects of the respiratory system, including:
1. The trachea divides into the right and left bronchi, which further divide into smaller bronchioles before terminating in alveoli where gas exchange occurs.
2. The lungs are enclosed in the pleural cavity and surrounded by pleura. Contraction of the diaphragm and intercostal muscles increases the thoracic cavity volume during inspiration.
3. Expiration is a passive process involving relaxation of the respiratory muscles, while inspiration requires active contraction of muscles like the diaphragm and intercostals to decrease thoracic pressure and draw in air.
This document provides an overview of respiratory disorders and the clinical evaluation of thoracic surgical patients. It describes the anatomy and physiology of the respiratory system, including ventilation, respiration, and the structures involved like the chest wall, trachea, lungs, bronchi, and pleura. It also outlines the clinical assessment process, noting important details to observe like breathing rate and character, lymph node examination, chest inspection, percussion, auscultation, and cardiovascular and abdominal evaluation. The goal is to gather relevant information on presenting symptoms and medical history to accurately diagnose respiratory conditions.
'Physiology' of Respiratory System .pptxadarshka244
The respiratory system consists of the nose, pharynx, larynx, trachea, bronchi, bronchioles and lungs. Air enters through the nose where it is warmed, filtered and humidified. It then passes through the pharynx and larynx before entering the trachea which divides into bronchi and further into bronchioles and alveoli in the lungs. In the alveoli, gas exchange occurs as oxygen passes into the blood and carbon dioxide passes out. Breathing is facilitated by the contraction of the diaphragm and intercostal muscles which expand the lungs to draw in air during inspiration and relax to expel air during expiration.
The respiratory system has several functions:
1. The nose warms, moistens, and filters air entering the body through nasal hairs and mucus.
2. The pharynx is a passageway shared by the respiratory and digestive systems that leads to the larynx.
3. The larynx, or voice box, prevents food from entering the lungs and produces sounds. It leads to the trachea.
4. The trachea, or windpipe, divides into the left and right bronchi and transports air to the lungs.
The respiratory system provides oxygen to the body's cells through respiration and removes carbon dioxide. It includes the nose, pharynx, larynx, trachea, bronchi, lungs, and muscles of respiration. Oxygen and carbon dioxide are exchanged between the alveoli and blood in the lungs through diffusion. Respiration is regulated by the respiratory center in the brainstem and chemoreceptors that detect changes in blood gases. Artificial respiration can prevent deaths by reopening the airway and exchanging gases until natural breathing resumes.
The chest cavity contains the lungs and heart and is bounded by the chest wall and diaphragm. It can be divided into the mediastinum and pleural cavities. The pleura is a membrane that covers the lungs and lines the chest wall. It has parietal and visceral layers separated by a pleural space. Ultrasonography allows visualization of the pleura and underlying lung parenchyma. Key findings include the pleural line, A-lines, B-lines, lung sliding, and consolidations. It is useful for evaluating pleural effusions, pneumothorax, and infiltrates and has advantages over chest radiography of being radiation-free, portable, and allowing real-time
The document provides an overview of the respiratory system, including its anatomy and physiology. It discusses the upper and lower respiratory tract, the structures involved like the nose, pharynx, larynx, trachea, lungs and their functions. It explains the mechanics of breathing, gas exchange that occurs in the lungs and tissues, and the transport of oxygen and carbon dioxide in the blood and body. It also discusses the neural control of respiration and factors that can affect breathing and gas transport.
The respiratory system consists of organs and structures involved in gas exchange. It includes the nose, pharynx, larynx, trachea, bronchi, bronchioles and lungs. The nose warms and filters air before it reaches the lungs. In the lungs, oxygen diffuses into the bloodstream and carbon dioxide diffuses out in the alveoli. Breathing is driven by the diaphragm and intercostal muscles. The lungs have capacities including tidal volume, inspiratory reserve volume, and residual volume that contribute to gas exchange.
The document provides an overview of the respiratory system and control of respiration. It describes the key organs involved, including the nose, pharynx, larynx, trachea, bronchi, lungs and alveoli. It explains the mechanics of breathing through inspiration and expiration. Gas exchange occurs as oxygen passes from the alveoli into the blood and carbon dioxide passes from the blood into the alveoli to be exhaled. The lungs, diaphragm, ribs and autonomic nervous system work together to regulate breathing and ventilation.
The respiratory system consists of upper and lower respiratory tracts. The upper tract includes the nose, nasal cavity and pharynx while the lower tract includes the larynx, trachea, bronchi and lungs. The respiratory tract transports air to the gas exchange surfaces in the lungs. It divides into a conducting portion from the nose to terminal bronchioles and a respiratory portion where gas exchange occurs in alveoli. The lungs have lobes and are made of branching bronchial tubes that terminate in alveoli where oxygen and carbon dioxide are exchanged with blood through thin epithelial walls.
The respiratory system has several key functions: supplying oxygen to the body, eliminating carbon dioxide, facilitating gas exchange between the blood and air, and warming/humidifying incoming air. It is divided into the upper respiratory tract (nose, sinuses, pharynx, larynx) and lower tract (trachea, bronchi, lungs). The lungs contain bronchioles and alveoli where gas exchange occurs between inhaled oxygen and exhaled carbon dioxide via thin membranes. The diaphragm and rib cage work together to inhale and exhale air by expanding and contracting the thoracic cavity.
Unit-III, Chapter-1- Respiratory System.pptAudumbar Mali
B. Pharm. First Year, Sem:II,
Unit III
Respiratory system 10 hours
Anatomy of respiratory system with special reference to anatomy of lungs,
mechanism of respiration, regulation of respiration
Lung Volumes and capacities transport of respiratory gases, artificial respiration,
and resuscitation methods.
The document summarizes the anatomy and physiology of the respiratory system. It describes the major components of the respiratory tract including the nose, pharynx, larynx, trachea, bronchi, bronchioles and lungs. It explains the functions of these structures in conducting air, warming, humidifying, and filtering air as well as the gas exchange that occurs in the alveoli. It also discusses the muscles involved in breathing and the process of inhalation and exhalation.
The respiratory system functions to provide oxygen to tissues and remove carbon dioxide through gas exchange that occurs in the alveoli of the lungs. It includes both conducting zones that transport air, and respiratory zones involved in gas exchange. Key structures are the nasal cavity, pharynx, larynx, trachea, bronchi, lungs, and pleurae. Breathing occurs through changes in pressure between the atmosphere and lungs, driven by the diaphragm and intercostal muscles, with inspiration occurring when the thoracic cavity volume increases and expiration when it decreases.
The document provides an overview of the respiratory system, including its main functions and components. It describes the lungs' role in gas exchange, their anatomy, and the upper and lower airway divisions. It also outlines the stages of respiration from ventilation to gas exchange in tissues. Key parts like the pleura, alveoli, conducting and respiratory zones are defined. Respiratory protective reflexes such as coughing and swallowing are summarized as well.
The respiratory system consists of the nose, pharynx, larynx, trachea, bronchi, bronchioles and lungs. Air enters through the nose where it is warmed, filtered and humidified. It then passes through the pharynx, larynx and trachea before reaching the bronchi and bronchioles which divide into smaller passages and terminate in alveoli in the lungs. Gas exchange takes place in the alveoli as oxygen diffuses into the blood and carbon dioxide diffuses out. The lungs and chest wall muscles work in coordination to inhale and exhale air in breathing.
respiratory system and related organs anatomy physiologyCharutaKunjeer1
The respiratory system consists of the nose, pharynx, larynx, trachea, bronchi, lungs and diaphragm. The nose warms, filters and humidifies inhaled air. The pharynx is a passageway for air and food and helps warm and humidify air. The larynx produces sound and protects the lungs. The trachea, bronchi and bronchioles branch within the lungs and contain cilia and mucus to warm, filter and protect the lungs. Gas exchange takes place in the alveoli of the lungs and oxygen is delivered and carbon dioxide removed via respiration.
the beautiful thing about learning is that no one can take it away from you...so study and hard .....i hope it is helpful to you and its useful for study...best of luck
The human respiratory system allows for gas exchange between the blood and air through breathing. Air enters through the nasal cavity and is warmed and moistened before passing into the trachea and branching bronchi and bronchioles that lead to millions of tiny alveoli in the lungs. The alveoli are adapted for efficient gas exchange with very thin walls, a large surface area, and moist inner surfaces surrounded by blood capillaries. During inhalation, the diaphragm and intercostal muscles expand the ribcage to decrease pressure and allow air into the lungs. Exhalation is a passive process where the muscles relax and pressure increases to force air back out.
The human respiratory system allows for gas exchange between the blood and air through breathing. Air enters through the nasal cavity and is warmed and moistened before passing into the trachea and branching bronchi and bronchioles that lead to millions of tiny alveoli in the lungs. The alveoli are adapted for efficient gas exchange with very thin walls, a large surface area, and moist interiors surrounded by blood capillaries. Breathing is driven by the contraction and relaxation of the diaphragm and intercostal muscles, inhaling when they contract to decrease thoracic pressure and exhale when they relax.
The respiratory system supplies oxygen to tissues and removes carbon dioxide. It includes the nose, pharynx, larynx, trachea, bronchi, lungs and alveoli. The nose warms and filters air before it reaches the lungs. Gas exchange occurs in the alveoli between air and blood. Oxygen diffuses into blood and carbon dioxide diffuses out. The respiratory system regulates gas exchange and protects the lungs.
Techniques of chest physiotherapy and it's importanceKemzyEkam
This document provides an overview of chest physiotherapy for pre- and post-surgical patients. It discusses how surgery can negatively impact pulmonary function and increase the risk of postoperative pulmonary complications. Chest physiotherapy techniques like breathing exercises and chest wall mobilization are recommended both before and after surgery to improve lung function and clearance of secretions, thereby reducing complications. The document reviews the goals, indications, contraindications and relevant anatomy for chest physiotherapy. It focuses on techniques used to drain secretions, improve ventilation and strengthen respiratory muscles in surgical patients.
The respiratory system has three main functions: (1) to provide oxygen to cells, (2) to remove carbon dioxide from cells, and (3) to remove water from cells. Air passes through the nose, pharynx, trachea, bronchi, and into tiny sacs called alveoli in the lungs where gas exchange occurs between the blood and air. The diaphragm and rib muscles expand the chest during inhalation, allowing air to rush into the lungs due to the created vacuum. During exhalation, the muscles relax and the chest contracts, pushing air back out.
The respiratory system consists of organs and structures used for gas exchange. The major organs are the nose, pharynx, larynx, trachea, bronchi, bronchioles and lungs. Respiration is the process of oxygen intake and carbon dioxide output. The lungs are divided into lobes and receive air via the trachea which branches into bronchi and bronchioles. Gas exchange occurs in the alveoli via diffusion across the respiratory membrane. The pleura surrounds each lung and allows for lung movement during breathing.
This document provides an overview of respiratory physiology and acute respiratory failure. It discusses:
1. The functions of the respiratory system including gas exchange, acid-base balance, phonation, pulmonary defense, and metabolism.
2. The three components of respiration - ventilation, gas exchange, and oxygen utilization. It describes the mechanics of ventilation and gas exchange via diffusion.
3. The conducting and respiratory zones of the lungs and structures involved in gas exchange like alveoli and surfactant.
4. Control of respiration via brainstem centers that regulate rhythmic breathing and chemoreceptors that sense blood gases and pH to modulate breathing rate and depth.
This document provides an overview of respiratory physiology and acute respiratory failure. It discusses:
1. The functions of the respiratory system including gas exchange, acid-base balance, phonation, pulmonary defense, and metabolism.
2. The three components of respiration - ventilation, gas exchange, and oxygen utilization. It describes the mechanics of ventilation and gas exchange via diffusion.
3. The conducting and respiratory zones of the lungs and structures involved in gas exchange like alveoli and surfactant.
4. Control of respiration via brainstem centers that regulate breathing rhythm and respond to chemoreceptors monitoring blood gases.
Importance and purposes of Literature Reviewvaibhavpaul9
Literature review means a “re” view or “look again” at what has already been written about the topic. Literature review compiles various research projects published by recognized scholars and researchers.
This slide includes the introduction about the literature review and definition of literature review and what are the importance and purposes of literature review , is presented here in very concise way, it includes some pictures that will help you for easily understand the topic and it is more interesting.
definition According to University of Toronto(2001):-
“A literature review is an account of what has been already established or published on a particular research topic by accredited scholars and researchers.”
According to Creswell (2005):-
A review of literature “is a written summary of journal articles, books and other documents that describes the past and current state of information , organizes the literature into topics and documents a need for a proposed study.”
Importance of literature review are-
Identification of a research problem and development or refinement of research questions.
Generation of useful research questions or projects for the discipline.
Orientation to what is known and not known about an area of enquiry to ascertain to what research can best contribute to knowledge.
Determination of any gaps or inconsistencies in a body of knowledge.
Discovery of unanswered questions about subjects , concepts or problems.
Determination of a need to replicate a prior study in different study settings or different samples or size or different study populations.
Purposes of literature review:
To explore the area of interests in view of narrowing down the topic.
The purpose of literature review is to convey to the reader previous knowledge and facts established on a topic and their strengths and weakness.
The literature review allows the reader to be updated with the state of research in a field and any contraindications that may exist with challenges findings of other research studies.
4. It also provide the knowledge about the problems faced by the previous reseachers while studying same topic.
The literature review allows the reader to be updated with the state of research in a field and any contraindications that may exist with challenges findings of other research studies.
4. It also provide the knowledge about the problems faced by the previous reseachers while studying same topic.
The literature review allows the reader to be updated with the state of research in a field and any contraindications that may exist with challenges findings of other research studies.
4. It also provide the knowledge about the problems faced by the previous reseachers while studying same topic.
Review of literature# Literature review # definition of review of literature# importance of literature review# purposes of literature review#
ROLE OF RESEARCH, LEADERSHIP AND MANAGEMENT.pptxvaibhavpaul9
Role of research, leadership and management plays a vital role in field of Nursing. So here the definition of nursing ,definition of research, meaning of research, definition of nursing research, development of nursing research from nightingale to present, importance of research in nursing, role of research in nursing ,nurses responsibility in relation to research ,level of participation in nursing research is explained through diagram and gif animations .Definition of leader, characteristics and qualities of leader is explained, Leadership theories include trait theory, contigency theory, greatman theory, situational theory, leader member exchange theory, transformational theory etc. Leadership style includes Autocratic, democratic, pace setting, coaching, laissez faire etc. Role of nursing leaders. Definition of management ,functions of management, need of management in nursing, current research in nursing is also added .
The document provides an overview of the respiratory system, including its anatomy and physiology. It discusses the upper and lower respiratory tract, the structures involved like the nose, pharynx, larynx, trachea, lungs and their functions. It explains the mechanics of breathing, gas exchange that occurs in the lungs and tissues, and the transport of oxygen and carbon dioxide in the blood and body. It also discusses the neural control of respiration and factors that can affect breathing and gas transport.
The respiratory system consists of organs and structures involved in gas exchange. It includes the nose, pharynx, larynx, trachea, bronchi, bronchioles and lungs. The nose warms and filters air before it reaches the lungs. In the lungs, oxygen diffuses into the bloodstream and carbon dioxide diffuses out in the alveoli. Breathing is driven by the diaphragm and intercostal muscles. The lungs have capacities including tidal volume, inspiratory reserve volume, and residual volume that contribute to gas exchange.
The document provides an overview of the respiratory system and control of respiration. It describes the key organs involved, including the nose, pharynx, larynx, trachea, bronchi, lungs and alveoli. It explains the mechanics of breathing through inspiration and expiration. Gas exchange occurs as oxygen passes from the alveoli into the blood and carbon dioxide passes from the blood into the alveoli to be exhaled. The lungs, diaphragm, ribs and autonomic nervous system work together to regulate breathing and ventilation.
The respiratory system consists of upper and lower respiratory tracts. The upper tract includes the nose, nasal cavity and pharynx while the lower tract includes the larynx, trachea, bronchi and lungs. The respiratory tract transports air to the gas exchange surfaces in the lungs. It divides into a conducting portion from the nose to terminal bronchioles and a respiratory portion where gas exchange occurs in alveoli. The lungs have lobes and are made of branching bronchial tubes that terminate in alveoli where oxygen and carbon dioxide are exchanged with blood through thin epithelial walls.
The respiratory system has several key functions: supplying oxygen to the body, eliminating carbon dioxide, facilitating gas exchange between the blood and air, and warming/humidifying incoming air. It is divided into the upper respiratory tract (nose, sinuses, pharynx, larynx) and lower tract (trachea, bronchi, lungs). The lungs contain bronchioles and alveoli where gas exchange occurs between inhaled oxygen and exhaled carbon dioxide via thin membranes. The diaphragm and rib cage work together to inhale and exhale air by expanding and contracting the thoracic cavity.
Unit-III, Chapter-1- Respiratory System.pptAudumbar Mali
B. Pharm. First Year, Sem:II,
Unit III
Respiratory system 10 hours
Anatomy of respiratory system with special reference to anatomy of lungs,
mechanism of respiration, regulation of respiration
Lung Volumes and capacities transport of respiratory gases, artificial respiration,
and resuscitation methods.
The document summarizes the anatomy and physiology of the respiratory system. It describes the major components of the respiratory tract including the nose, pharynx, larynx, trachea, bronchi, bronchioles and lungs. It explains the functions of these structures in conducting air, warming, humidifying, and filtering air as well as the gas exchange that occurs in the alveoli. It also discusses the muscles involved in breathing and the process of inhalation and exhalation.
The respiratory system functions to provide oxygen to tissues and remove carbon dioxide through gas exchange that occurs in the alveoli of the lungs. It includes both conducting zones that transport air, and respiratory zones involved in gas exchange. Key structures are the nasal cavity, pharynx, larynx, trachea, bronchi, lungs, and pleurae. Breathing occurs through changes in pressure between the atmosphere and lungs, driven by the diaphragm and intercostal muscles, with inspiration occurring when the thoracic cavity volume increases and expiration when it decreases.
The document provides an overview of the respiratory system, including its main functions and components. It describes the lungs' role in gas exchange, their anatomy, and the upper and lower airway divisions. It also outlines the stages of respiration from ventilation to gas exchange in tissues. Key parts like the pleura, alveoli, conducting and respiratory zones are defined. Respiratory protective reflexes such as coughing and swallowing are summarized as well.
The respiratory system consists of the nose, pharynx, larynx, trachea, bronchi, bronchioles and lungs. Air enters through the nose where it is warmed, filtered and humidified. It then passes through the pharynx, larynx and trachea before reaching the bronchi and bronchioles which divide into smaller passages and terminate in alveoli in the lungs. Gas exchange takes place in the alveoli as oxygen diffuses into the blood and carbon dioxide diffuses out. The lungs and chest wall muscles work in coordination to inhale and exhale air in breathing.
respiratory system and related organs anatomy physiologyCharutaKunjeer1
The respiratory system consists of the nose, pharynx, larynx, trachea, bronchi, lungs and diaphragm. The nose warms, filters and humidifies inhaled air. The pharynx is a passageway for air and food and helps warm and humidify air. The larynx produces sound and protects the lungs. The trachea, bronchi and bronchioles branch within the lungs and contain cilia and mucus to warm, filter and protect the lungs. Gas exchange takes place in the alveoli of the lungs and oxygen is delivered and carbon dioxide removed via respiration.
the beautiful thing about learning is that no one can take it away from you...so study and hard .....i hope it is helpful to you and its useful for study...best of luck
The human respiratory system allows for gas exchange between the blood and air through breathing. Air enters through the nasal cavity and is warmed and moistened before passing into the trachea and branching bronchi and bronchioles that lead to millions of tiny alveoli in the lungs. The alveoli are adapted for efficient gas exchange with very thin walls, a large surface area, and moist inner surfaces surrounded by blood capillaries. During inhalation, the diaphragm and intercostal muscles expand the ribcage to decrease pressure and allow air into the lungs. Exhalation is a passive process where the muscles relax and pressure increases to force air back out.
The human respiratory system allows for gas exchange between the blood and air through breathing. Air enters through the nasal cavity and is warmed and moistened before passing into the trachea and branching bronchi and bronchioles that lead to millions of tiny alveoli in the lungs. The alveoli are adapted for efficient gas exchange with very thin walls, a large surface area, and moist interiors surrounded by blood capillaries. Breathing is driven by the contraction and relaxation of the diaphragm and intercostal muscles, inhaling when they contract to decrease thoracic pressure and exhale when they relax.
The respiratory system supplies oxygen to tissues and removes carbon dioxide. It includes the nose, pharynx, larynx, trachea, bronchi, lungs and alveoli. The nose warms and filters air before it reaches the lungs. Gas exchange occurs in the alveoli between air and blood. Oxygen diffuses into blood and carbon dioxide diffuses out. The respiratory system regulates gas exchange and protects the lungs.
Techniques of chest physiotherapy and it's importanceKemzyEkam
This document provides an overview of chest physiotherapy for pre- and post-surgical patients. It discusses how surgery can negatively impact pulmonary function and increase the risk of postoperative pulmonary complications. Chest physiotherapy techniques like breathing exercises and chest wall mobilization are recommended both before and after surgery to improve lung function and clearance of secretions, thereby reducing complications. The document reviews the goals, indications, contraindications and relevant anatomy for chest physiotherapy. It focuses on techniques used to drain secretions, improve ventilation and strengthen respiratory muscles in surgical patients.
The respiratory system has three main functions: (1) to provide oxygen to cells, (2) to remove carbon dioxide from cells, and (3) to remove water from cells. Air passes through the nose, pharynx, trachea, bronchi, and into tiny sacs called alveoli in the lungs where gas exchange occurs between the blood and air. The diaphragm and rib muscles expand the chest during inhalation, allowing air to rush into the lungs due to the created vacuum. During exhalation, the muscles relax and the chest contracts, pushing air back out.
The respiratory system consists of organs and structures used for gas exchange. The major organs are the nose, pharynx, larynx, trachea, bronchi, bronchioles and lungs. Respiration is the process of oxygen intake and carbon dioxide output. The lungs are divided into lobes and receive air via the trachea which branches into bronchi and bronchioles. Gas exchange occurs in the alveoli via diffusion across the respiratory membrane. The pleura surrounds each lung and allows for lung movement during breathing.
This document provides an overview of respiratory physiology and acute respiratory failure. It discusses:
1. The functions of the respiratory system including gas exchange, acid-base balance, phonation, pulmonary defense, and metabolism.
2. The three components of respiration - ventilation, gas exchange, and oxygen utilization. It describes the mechanics of ventilation and gas exchange via diffusion.
3. The conducting and respiratory zones of the lungs and structures involved in gas exchange like alveoli and surfactant.
4. Control of respiration via brainstem centers that regulate rhythmic breathing and chemoreceptors that sense blood gases and pH to modulate breathing rate and depth.
This document provides an overview of respiratory physiology and acute respiratory failure. It discusses:
1. The functions of the respiratory system including gas exchange, acid-base balance, phonation, pulmonary defense, and metabolism.
2. The three components of respiration - ventilation, gas exchange, and oxygen utilization. It describes the mechanics of ventilation and gas exchange via diffusion.
3. The conducting and respiratory zones of the lungs and structures involved in gas exchange like alveoli and surfactant.
4. Control of respiration via brainstem centers that regulate breathing rhythm and respond to chemoreceptors monitoring blood gases.
Similar to Assessment of respiratory system ptx (20)
Importance and purposes of Literature Reviewvaibhavpaul9
Literature review means a “re” view or “look again” at what has already been written about the topic. Literature review compiles various research projects published by recognized scholars and researchers.
This slide includes the introduction about the literature review and definition of literature review and what are the importance and purposes of literature review , is presented here in very concise way, it includes some pictures that will help you for easily understand the topic and it is more interesting.
definition According to University of Toronto(2001):-
“A literature review is an account of what has been already established or published on a particular research topic by accredited scholars and researchers.”
According to Creswell (2005):-
A review of literature “is a written summary of journal articles, books and other documents that describes the past and current state of information , organizes the literature into topics and documents a need for a proposed study.”
Importance of literature review are-
Identification of a research problem and development or refinement of research questions.
Generation of useful research questions or projects for the discipline.
Orientation to what is known and not known about an area of enquiry to ascertain to what research can best contribute to knowledge.
Determination of any gaps or inconsistencies in a body of knowledge.
Discovery of unanswered questions about subjects , concepts or problems.
Determination of a need to replicate a prior study in different study settings or different samples or size or different study populations.
Purposes of literature review:
To explore the area of interests in view of narrowing down the topic.
The purpose of literature review is to convey to the reader previous knowledge and facts established on a topic and their strengths and weakness.
The literature review allows the reader to be updated with the state of research in a field and any contraindications that may exist with challenges findings of other research studies.
4. It also provide the knowledge about the problems faced by the previous reseachers while studying same topic.
The literature review allows the reader to be updated with the state of research in a field and any contraindications that may exist with challenges findings of other research studies.
4. It also provide the knowledge about the problems faced by the previous reseachers while studying same topic.
The literature review allows the reader to be updated with the state of research in a field and any contraindications that may exist with challenges findings of other research studies.
4. It also provide the knowledge about the problems faced by the previous reseachers while studying same topic.
Review of literature# Literature review # definition of review of literature# importance of literature review# purposes of literature review#
ROLE OF RESEARCH, LEADERSHIP AND MANAGEMENT.pptxvaibhavpaul9
Role of research, leadership and management plays a vital role in field of Nursing. So here the definition of nursing ,definition of research, meaning of research, definition of nursing research, development of nursing research from nightingale to present, importance of research in nursing, role of research in nursing ,nurses responsibility in relation to research ,level of participation in nursing research is explained through diagram and gif animations .Definition of leader, characteristics and qualities of leader is explained, Leadership theories include trait theory, contigency theory, greatman theory, situational theory, leader member exchange theory, transformational theory etc. Leadership style includes Autocratic, democratic, pace setting, coaching, laissez faire etc. Role of nursing leaders. Definition of management ,functions of management, need of management in nursing, current research in nursing is also added .
Peripheral vascular disease is the disease that involves narrowing of blood vessels including artery , vein and lymphatic vessels. Here introduction, definition and Types of peripheral vascular
disease are well classified in flowchart. Types of arterial , venous and lymphatic disease described . All the diseases are explained with their definition, risk factors, causes, sign and symptoms,diagnostic evaluation,medical management, surgical management with diagramatic presentation, nursing management is explained. Youtube link of procedures is also available in ppt. Nursing diagnosis of PVD is included .
breast cancer is a disease which is more common in females. Introduction and definition of breast cancer is explained in slides. Incidence according to american cancer society estimation in united states 2023 is explained here.Types of breast cancer elaborated through images . Stages, pathophysiology, sign and symptoms, essential diagnostic evaluation of breast cancer and TNM classification in detail
described. Medical management includes chemotherapy, neoadjuvant therapy, adjuvant therapy, endocrine therapy, various radiation therapy etc. Pharmacological management described. Surgeries of breast cancer described. Nursing management and post operative management explained .Nursing diagnosis of breast cancer is prioritized.
myasthenia gravis , a neurological disorder, causes skeletal muscle weakness. There are classification according to american clinical classification of myasthenia gravis.Risk factors and causes of myasthenia gravis with animated gif shown in ppt. Types of muscle weakness and pathophysiology of myasthenia gravis explained. Clinical manifestation explained through animated gif. Important diagnostic test explained through pictures. Medical management, surgical management, nursing management explain in detail of myasthenia gravis. Excercise goals and rehablitation management of myasthenia gravis is explained. Types of rehablitation excercise for myasthenia gravis explained. Complications of myasthenia gravis and research article of myasthenia gravis is included in ppt. Summary and conclusion is also included in ppt.
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Assessment of respiratory system ptx
1. KING GEORGE’S MEDICAL UNIVERSITY
K.G.M.U. COLLEGE OF NURSING
ASSESSMENT OF RESPIRATORY ASSESSMENT
SUBMITTED TO SUBMITTED BY
DR. RASHMI P. JOHN DIVYA PAL
PRINCIPAL M.SC. NURSING 1ST YEAR
K.G.M.U. ,COLLEGE OF NURSING K.G.M.U. COLLEGE OF NURSING
3/27/2023 1
2. OUTLINE
• Introduction
• Indications of assessment of respiratory system
• Purposes of assessment of respiratory system
• Parts of respiratory system and their function
• Preliminary measures
• Assessment of respiratory system
• Physical examination
• Diagnostic evaluation
3/27/2023 2
3. Introduction
• The Respiratory tract extends from the nose to the alveoli and includes not only
the air conducting passages also but the blood supply.
• The primary purpose of the respiratory system is gas exchange , which involves
the transfer of oxygen and carbon dioxide between the atmosphere and the blood.
• The respiratory system is divided into two parts:-
• The upper respiratory tract and the lower respiratory tract.
3/27/2023 3
4. Indications of assessment of respiratory system
Indications of respiratory system assessment:-
• Dyspnea
• Cough (wet or dry)
• Sore throat
• Running nose
• Sneezing
3/27/2023 4
5. Purposes
• To detect the abnormality of organs.
• To find out the abnormal sounds.
• Interpretations of vital signs.
• Inspection of patient’s breathing pattern.
• Skin colour and respiratory status.
• Auscultation of lung sounds, normal and abnormal.
3/27/2023 5
6. Upper respiratory tract
The upper respiratory tract includes-
• The nose
• Pharynx
• Adenoids
• Tonsils
• Epiglottis
• Larynx
• Trachea
3/27/2023 6
8. • The right lung is divided into three lobes-
• Upper
• Middle
• Lower
• The left lung into two lobes-
• Upper and lower
• The structures of the chest wall-ribs, pleura, muscles of respiration
3/27/2023 8
9. Nose
Also called external nares.
• Divided into two halves by the nasal septum.
• Contains the paranasal sinuses where air is warmed.
• Contains cilia which is responsible,
For filtering out foreign bodies.
3/27/2023 9
10. Internal nares - opening to exterior
• External nares - opening to pharynx
• Nasal conchae - folds in the mucous membrane that increase air turbulence and
ensures that most air contacts the mucous membranes.
3/27/2023 10
11. Functions
• Provides and airway for respiration.
• Moistens and warms entering air.
• Filters and cleans inspired air.
• Resonating chamber for speech.
• Detects odors in the air stream.
3/27/2023 11
12. Pharynx
• Common space used by both the respiratory and digestive systems.
• Commonly called the throat.
• Originates posterior to the nasal and oral cavities and extends inferiorly near the
level of the bifurcation of the larynx and esophagus.
• Common pathway for both air and food.
• Walls are lined by a mucosa and contain skeletal muscles that are primarily used for
swallowing.
• Flexible lateral walls are distensible in order to force swallowed food into the
esophagus.
3/27/2023 12
14. Nasopharynx:-
• Contains the pharyngeal tonsils (adenoids) which aid in the body's immune
defense.
Oropharynx:-
• Back portion of the mouth that contains the palatine tonsils which aid in the
body's immune defense.
Laryngopharynx:-
• Bottom section of the pharynx where the respiratory tract divides into the
esophagus and the larynx. 3/27/2023 14
15. Larynx
Voice box is a short, somewhat cylindrical airway ends in the trachea, prevents
swallowed materials from entering the lower respiratory tract.
3/27/2023 15
16. • Conducts air into the lower respiratory tract.
• Produces sounds.
• Supported by a framework of nine pieces of cartilage (three individual pieces
and three cartilage pairs) that are held in place by ligaments and muscles.
3/27/2023 16
17. Bronchial tree
• A highly branched system of air-conducting passages that originate from the left and
right primary bronchi.
• Progressively branch into narrower tubes as they diverge throughout the lungs before
terminating in terminal bronchioles.
3/27/2023 17
18. • Incomplete rings of hyaline cartilage support the walls of the primary bronchi to
ensure that they remain open.
• Right primary bronchus is shorter, wider, and more vertically oriented than the
left primary bronchus.
• Foreign particles are more likely to lodge in the right primary bronchus.
3/27/2023 18
19. Lungs
• Each lung has a conical shape.
• Its wide, concave base rests upon the muscular diaphragm.
• Its superior region called the apex projects superiorly to a point that is slightly
superior and posterior to the clavicle.
• Both lungs are bordered by the thoracic wall anteriorly, laterally, and posteriorly,
and supported by the rib cage.
3/27/2023 19
20. • Toward the midline, the lungs are separated from each other by the mediastinum.
• The relatively broad, rounded surface in contact with the thoracic wall is called
the costal surface of the lung.
3/27/2023 20
21. Inhalation
Breathing in is called inhalation (inspiration) each inhalation, the air pressure
inside the lungs is equal to the air pressure of the atmosphere, which is about 760
mmhg.
• Air to flow into the lungs, the pressure inside the alveoli
• Must become lower than the atmospheric pressure.
• This condition is achieved by increasing the size of the lungs.
3/27/2023 21
22. Exhalation
• Breathing out or exhalation starts when the inspiratory muscles relax. As
• The diaphragm relaxes, its dome moves superiorly owing to its elasticity.
• As the external intercostals relax, the ribs are depressed.
• The pressure in the lungs is greater than the pressure of the atmosphere. Normal
exhalation during quiet breathing.
3/27/2023 22
23. It is a passive process because no muscular contractions are involved. Instead,
exhalation results from elastic recoil of the chest wall and
• Lungs, both of which have a natural tendency to spring back after they
have been stretched.
• Two inwardly directed forces contribute to elastic recoil:
• A. The recoil of elastic fibers that were stretched during inhalation b. The inward
pull of surface tension due to the film of alveolar fluid.
3/27/2023 23
24. Physiology of respiration
The process of gas exchange in the body, called respiration, it has three basic steps:
1. Pulmonary ventilation or breathing: -
• It is the inhalation (inflow) and exhalation (outflow) of air and involves the
exchange of air between the atmosphere and the alveoli of the lungs.
3/27/2023 24
25. External (pulmonary) respiration:-
• It is the exchange of gases between the alveoli of the lungs and the blood in
pulmonary capillaries across the respiratory membrane.
• In this process, pulmonary capillary blood gains o, and loses co₂
3/27/2023 25
26. 3. Internal (tissue) respiration:-
• It is the exchange of gases between blood in systemic capillaries and tissue cells.
In this step the blood loses 0, and gains CO₂. Within cells, the metabolic
reactions that consume 0, and give off CO, during the production of ATP are
termed cellular respiration.
3/27/2023 26
27. Physical examination
Preparation:-
• Ask the person to sit upright and disrobe to the waist
• Provide warm room,a warm diaphragm endpiece perform inspection,palpation,
percussion and auscultation on the
• Posterior and lateral thorax
• Then repeat anterior chest
• Clean the stethoscope end piece with alcohol wipe
3/27/2023 27
28. Mouth and pharynx
• Inspects the interior of the mouth for color, lesions, masses, gum retraction,
bleeding, and poor dentation.
• Tongue is inspected for symmetry and presence of lesions inspect pharynx for
exudate, ulceration, swelling or postnasal.
• Drip tonsils are noted for colour, symmetry and any enlargement.
• Assess for gag reflex-indicates the cranial nerves IX and X are intact.
3/27/2023 28
29. Neck
Inspects for symmetry and presence of tender or swollen areas the lymph nodes are
palpated while the patient is sitting erect with the neck slightly flexed.
• Patient may have small, mobile, non-tender nodes (shotty nodes) which are not a
sign of a pathological condition.
• Tender, hard or fixed nodes indicates disease.
3/27/2023 29
30. Thorax and lungs-inspection
• Appearance-evidences of respiratory distress, tachypnea or use of accessory
muscles.
• Shape-elliptical shape with downward slopping ribs about 45 degrees relative to
the spine .
• Chest movements-equal, symmetry, ap diameter < transverse diameter by a ratio
1:2
3/27/2023 30
31. Palpation of the trachea
Palpate the trachea to assess for possible deviation. From in front of the patient
gently place the index and middle fingers on either side of the trachea in the
suprasternal notch.
• In a normal patient the trachea will be placed in the centre. If there is deviation
to one side there will be a bigger gap on one side compared to the other.
• Reduction in the normal three to four fingers' width from the suprasternal notch
to cricoid cartilage suggests over inflation of the chest.
3/27/2023 31
32. Palpation of the chest
• Palpate for any mass, tenderness, crepitus.
• Apex beat: the apex beat is often impalpable in a chest which is hyper-expanded
secondary to chronic airflow obstruction.
• Movement of the apex beat from one side to the other may be caused by several
conditions including pleural effusion, tension pneumothorax.
• Location of the apex beat.
3/27/2023 32
33. Chest expansion
By assessing chest expansion the examiner aims to assess-
• The range and symmetry of chest wall movements.
• Place your hands firmly on the chest wall, with your thumbs slightly lifted off
the chest so that they are free to move with respiration (placing your thumbs up
provides the examiner with a visible marker to assess the range and symmetry of
chest wall movements).
3/27/2023 33
34. • Ask the patient to take a deep breath in and observe the range and symmetry of
movement.
• Reduced expansion on one side indicates a lesion on that side. This should be
performed on the front and the back of the patient's chest.
3/27/2023 34
35. Palpation –anterior chest
• Palpate symmetric chest expansion.
• Place hand on the anterior lateral wall with thumbs along the costal margin and
pointing towards xiphoid process .
• Ask the person to take a deep breath.
• Watch the thumb move apart symmetrically
• Assess tactile fremitus .
• Palpate anterior chest wall for tenderness,lumps, masses.
• Grating sensation indicates pleural friction fremitus. 3/27/2023 35
36. • Abnormal costal wide angle occurs in emphysema.
• Lag in expansion occurs in atelectasis, pneumonia, postoperative guarding.
• Granting sensation indicates pleural friction fremitus.
3/27/2023 36
37. Palpation-posterior chest
• Confirm symmetry chest expansion by placing warmed hands sideways on the
posterolateral chest wall with thumbs pointing together at the level of T9 or T10
and pinch a fold of skin.
• Ask to inhale deeply thumbs should move apart symmetrically.
• Unequal expansion seen in atelectasis, lobar pneumonia, pleural effusion,
thoracic trauma, ribs, pacumothorax pain in deep breathing seen when the pleura
are inflamed.
3/27/2023 37
38. Percussion anterior wall
As needed, percuss the anterior and lateral chest, again comparing both sides.
• The heart normally produces an area of dullness to the left of the sternum from
the 3rd to the 5th interspaces.
• Dullness represents airway obstruction from inflammation or secretions.
3/27/2023 38
39. • Because pleural fluid usually sinks to the lowest part of the pleural space
(posteriorly in a supine patient), only a very large effusion can be detected
anteriorly.
• The hyperresonance of copd may obscure dullness over the heart.
• The dullness of right middle lobe pneumonia typically occurs behind the right
breast.
• Unless you displace the breast, you may miss the abnormal percussion note.
3/27/2023 39
40. Percussion-posterior chest
Sequence for percussion-
• Start at the apices and percuss the band of normally resonant tissue across the
tops of both shoulders.
• Percuss the interspaces, mark a side to side comparison all the way down the
lung region, Percuss at 5cm intervals.
• Avoid the damping effect of scapula and ribs.
3/27/2023 40
42. Tactile fremitus
• Palpable vibrations transmitted through the broncho- pulmonary tree to the chest
wall when the patient.
• Ask the patient to repeat '99" or "1,1,1" while placing the ball of your hand or the
ulnar surface of your hand on symmetrical parts of the chest increased in
consolidation .
• Decreased in pneumothorax, pleural effusion, pleural thickening, emphysema
3/27/2023 42
43. • Variation in percussion note "Resonant"
• When percussing a normal chest the noise generated should be resonant "Dull"
• When percussing over a solid structure (such as the liver or a consolidated lung)
produces a dull note, "Stony dull”.
3/27/2023 43
44. • Percussion over a fluid filled area such as a pleural effusion produces a Stony
dull note.
• "Hyper-resonant" -percussion over hollow structures (e.G. Pneumothorax) may
produce a hyper-resonant note- such as a pneumothorax ‘Tympanatic’.
• High pitched sound while percussing gastric air bubble.
3/27/2023 44
45. Diaphragmatic excursion
Reason for assessing diaphragmatic excursion-to determine the movement of
diaphragm that occurs during inspiration. Possible reasons for decreased descent
include: atelectasis of lower lobes, emphysema, pleural effusion, pain, abdominal
changes such as tumors and extreme ascites.
• Normal range of diaphragm movement: 3-5cm but may be up to 7-8cm in well
conditioned people.
3/27/2023 45
46. Procedure
1. First, ask the person to take "exhale and hold it" while you percuss down the left
scapular line until the sound changes from resonant to dull. Mark the area. This
estimates the level of the diaphragm separating the lungs from the abdominal
viscera.
3/27/2023 46
47. 2. Allow the patient to take a few normal breaths. Then, ask the person to "take a
deep breath and hold it." Continue percussing down from the first mark to the level
where the sound changes to dull. Mark the area.
3. Measure the two marks. Repeat the same procedure on the right side. It should
be equal bilaterally and measure about 3-5 cm. In adults. It may be up to 7-8 cm. In
well-conditioned people.
4. Level of the diaphragm may be higher on the right side because of the liver.
3/27/2023 47
48. Auscultation
• When listening to the patients chest the diaphragm component of the stethoscope
is usually used to instruct the patient to breath in and out with an open mouth
every time you move the stethoscope.
• Listen both to the supraclavicular areas, anterior, axillary and posterior aspects of
the chest.
3/27/2023 48
49. • Remember to compare left with right at each level.
• Auscultation of the lungs allows an appreciation of the intensity and quality of
breath sounds and the presence of additional sounds best described as crackles,
wheezes, and rubs.
3/27/2023 49
50. Ascultation-anterior chest
Listen to the chest anteriorly and laterally as the patient breathes with mouth open,
and somewhat more deeply than normal.
• Compare symmetric areas of the lungs, using the pattern suggested for
percussion and extending it to adjacent areas, if indicated.
3/27/2023 50
51. • Listen to the breath sounds, noting their intensity and identifying any variations
from normal vesicular breathing.
• Breath sounds are usually louder in the upper anterior lung fields.
Bronchovesicular breath sounds may be heard over the large airways, especially
on the right.
3/27/2023 51
52. Breath sounds
Breath sounds are produced by vibrations due to turbulent airflow through out the
airways. These sounds are transmitted through the smaller airways and lungs to the
chest wall.
1. Vesicular breath sounds:
• The intensity of the sounds increase during inspiration and then fade away during
the first third of expiration.
• Low pitched.
3/27/2023 52
53. 2. Bronchial breath sounds:-
• Expiration is longer than inspiration. They result from enhanced transmission of
higher frequency sounds through solid lung tissue as in consolidation, pulmonary
edema.
3. Bronchovesicular sound:-
• Inspiration and expiration are equal. Typically heard in the 1’’ and the
2’’interspaces and between the scapulae.
3/27/2023 53
54. 4. Bronchial (tracheal) sounds:-
• High pitched loud .
• Hearded over trachea and larynx.
3/27/2023 54
55. Adventitious sounds
Crackles (rales):-
• Non continuous explosive popping sounds heared more often on inspiration can
also present on expiration it may be fine and coarse.
• Coarse crackles are associated with larger airways and fine crackles are
associated with smaller branches.
• Seen in asthma, copd, bronchiectasis, pulmonary edema, pneumonia, lung
cancer, pulmonary fibrosis.
3/27/2023 55
56. • Wheezes
• Continual, high pitched musical sounds heard at the end of inspiration or at the
start of expiration.
• Seen in asthma, copd, respiratory tract infection airway narrowing allows airflow
induced oscillation of airway walls producing acoustic waves.
• Monophonic wheeze- single notes.
• Polyphonic wheeze-different tones.
3/27/2023 56
57. Pleural rub
A pleural rub is a discontinuous, low-frequency, grating sound that arises from
inflammation and roughening of the visceral pleura as it slides against the parietal
pleura. This nonmusical sound is biphasic, heard during inspiration and expiration,
and often best heard in the axilla and base of the lungs.
3/27/2023 57
58. Mediastinal crunch
• A mediastinal crunch is a series of precordial crackles synchronous with the
heartbeat, not with respiration.
• Best heard in the left lateral position, it arises from air entry into the mediastinum
causing mediastinal emphysema (pneumomediastinum).
• It usually produces severe central chest pain and may be spontaneous.
• It has been reported in cases of tracheobronchial injury, blunt trauma,
• Pulmonary disease, use of recreational drugs, childbirth, and rapid ascent from
scuba diving.
3/27/2023 58
59. Bronchophony
• Ask the patient to say "ninety-nine."
• Normally the sounds transmitted through the chest wall are muffled and
indistinct.
• Louder voice sounds are called bronchophony localized bronchophony and
egophony are seen in lobar consolidation from pneumonia.
• In patients with fever and cough, the presence of bronchial breath sounds and
egophony more than triples the likelihood of pneumonia.
3/27/2023 59
61. Egophony
You will normally hear a muffled long ee sound.
• If "ee" sounds like "A" and has a nasal bleating quality, an e-to-a Change, or
egophony, is present.
• Seen in over consolidation or compression.
3/27/2023 61
62. Whispered pectoriloquy
• Ask the patient to whisper "ninety-nine" or "one-two-three."
• The whispered voice is normally heard faintly and indistinctly, if at all.
• Louder, clearer whispered sounds are called whispered pectoriloquy seen in mild
consolidation.
3/27/2023 62
63. Pursed lip breathing
A breathing practice often taught which includes a long slow expiration against
pursed lips.
• Seen in COPD
• Inflammation of the airways leads to destruction of lung parenchyma results in
reduction in elastic recoil fibrosis, and muscle hypertrophy causes increased
airways resistance and premature airway closing on expiration or expiratory
airflow limitation this results in air trapping at end expiration and with time
hyperinflation.
3/27/2023 63
64. Tracheal tug
Downward displacement of thyroid cartilage during inspiration most common-
respiratory distress/COPD campbell's sign.
• Less common-arch of aorta aneurysm (oliver’s sign).
3/27/2023 64
65. Barrel chest
• Anterioposterior diameter tranverse diameter with ratio of 1:1
• Ribs are horizontal indicated normal.
• Downward slope soon in normal aging and hyperinflated lungs such as COPD.
• Due to overactivity of scalene and sternocleidomastoid muscle which lifts the
upper ribs and sternum and this overase causes remodelling of the chest.
3/27/2023 65
67. Pectus excavatum-funnel breast
A markedly sunken or concave appearance of sternum and adjacent cartilages
depression begins with 2nd intercoastal becoming depressed most at junction of
xyphoid process congenital disorder.
3/27/2023 67
68. Pectus carinatum -pigeon chest
A forward protrusion of the sternum with ribs sloping back at either side and
vertical depression along costochondral junctions congenital disorder.
3/27/2023 68
69. Scoliosis
A lateral s-shaped curvature of the thoracic and lumbar spine with involved
vertebrae rotation.
3/27/2023 69
71. Harrison's sulcus (harrison's groove)
Visible depression of the lower ribs above the costal margin, at the area of
attachment of the diaphragm.
• Seen in rickets, severe asthma in childhood, cystic fibrosis, pulmonary fibrosis.
• Before the bone mineralize and harden the downward tension from the
diaphragm and other accessory muscles used during increased respiratory effort
can bend the ribs inwards over time.
3/27/2023 71
73. Hoover's sign
• Paradoxical inward movement of the lower costal margins on inspiration .
• Seen in emphysema, chest hyperinflation- C.O.P.D.
• When the chest becomes hyperinflated, the diaphragm often becomes stretched,
which causes contraction of diaphragm at inspiration results in an inward
movement, bringing the costal margins with it, as opposed to normal downward
movement.
3/27/2023 73
75. Diagnostic evaluation
Oximetry:- Arterial 02 saturation can be monitored noninvasively and continuously
using a pulse oximetry probe on the finger, toe, ear, forehead, or bridge of the nose.
• The abbreviation spo2is used to indicate the o2 saturation of hemoglobin as measured
by pulse oximetry. Spo2 and heart rate are displayed on the monitor as digital
readings.
• Normal spo2 values are 94% to 99%
3/27/2023 75
76. BLOOD STUDIES
Hemoglobin:-
• Test reflects the amount of hemoglobin available for combination with oxygen.
• Normal-13.5 to18mg/dl (men) , 12 to 16 mg/dl (women)
Hematocrit:-
• Test reflects ratio of red cells to plasma.
• Increased hematocrit found in hypoxemia.
• Normal-40 to 54% (men) ,38 to 47 (women)
3/27/2023 76
77. Arterial blood gases
ABGs are obtained to determine oxygenation status and acid-base balance.
• ABG analysis includes measurement of the pao2, paco2 (the partial pressure of CO2 in
arterial blood), acidity (ph), bicarbonate (HCO3 ), and sa02.
• Blood for ABG analysis can be obtained by arterial puncture or from an arterial catheter,
which is usually inserted into the radial or femoral artery.
• Both techniques allow only intermittent analysis, but an arterial catheter permits abg
sampling without repeated arterial punctures.
• The normal pao2 decreases with advancing age.
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78. SPUTUM STUDIES
Culture and sensitivity:-
• Single sputum specimen is collected in a sterile container.
• Purpose is to diagnose bacterial infection, select antibiotics and evaluate
treatment.
• Takes 48-72 hours for results.
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79. Gram stain:-
• Staining of sputum permits classification of bacteria into gram negative positive
types.
• Results guides therapy until culture and sensitivity results are obtained.
Acid fast smear and culture:-
• Test is to performed to collect sputum for acid fast bacilli.
• A series of three early morning specimen is used .
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80. Cytology
Single sputum specimen is collected in special container with fixative solution.
• Purpose is to determine presence of abnormal cells that may indicate
Malignant condition.
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81. Chest x-ray
It is most commonly used test for assessment that exposes a patients respiratory
system used to assess progressive of disease and response to treatment.
• The most common views used are the posterior-anterior view and lateral.
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82. Computed tomography
A computed tomography, which exposes a patients to radiation may be used to
examine cross section of the entire body.
• Used to evaluates areas that are difficulty to assess by conventional x rays.
• Common types of CT scan are helical or spiral CT in which contrast dye is
usually used in high resolution CT contrast dye is not used.
• Spiral CT is most common non invasive imaging procedure used to diagnose
pulmonary embolism.
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84. Magnetic resonance imaging
In a strong magnetic field the alignment of spinning nuclei can be changed with a
super imposed radio frequency and the rate at which they return to alignment with
the field can be measured the patient is not exposed to radiation.
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85. Ventilation-perfusion scan
A ventilation perfusion scan is used primarily to check the presence of pulmonary
Embolism, but it cannot determine with 100% certainty of the presence of PE.
• An iv isotope is given and the pulmonary vasculature is outlined and photographed the
patient inhales a radioactive gas (xenon, krypton) which outlines the alveoli and
another photograph is taken.
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86. Pulmonary angiography
Pulmonary angiography is the most specific examination used to confirm the
diagnosis of pulmonary edema.
• A series of x-ray is taken after radio opaque dye is injected into the pulmonary
artery. This test also detect congenital and acquired lesions of the pulmonary
vessels.
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87. Positron emission tomography
Positron emission tomography scans the use of radio nuclides with short half lives
used to distinguish benign and malignant solitary pulmonary nodules, because
malignant lung cells have an increased uptake of glucose.
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88. Bronchoscopy
Bronchoscopy is a procedure in which the bronchi are visualised through a
fiberoptic tube.
• Used to obtain biopsy specimen and assess changes resulting from treatment
small amount (30ml) of sterile saline may be injected through the scope and
withdrawn and examined for cells ,a technique termed as bronchoalveolar lavage
used to diagnose pneumonia, mucus plug, foreign bodies.
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90. Mediastinoscopy
A scopy is inserted through a small incision in the supra sternal notch and
advanced through mediastinum to inspect and biopsy lymph nodes.
• The test is used to diagnose carcinoma, non-hodgkins lymphoma, granulomatous
infections, and sarcoidosis.
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91. Lung biopsy
Lung biopsy may be done -
1. Transbronchially
2. Percutaneously or via transthoracic needle aspiration
3. Video assisted thoracic surgery
4. As an open lung biopsy
Purpose is to obtain tissue cells or secretion for evaluation.
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92. Thoracentesis
It is the insertion of a large bore needle through the chest wall into pleural space to
obtain specimen for diagnosis, evaluation, remove pleural fluids, or instil
medications into the pleural space.
• The patient is positioned upright with elbows in an overbed table and feet
supported.
• The skin is cleansed and a local anesthetic is instilled subcutaneously.
• A test tube may be inserted to permit further drainage of fluids
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94. Pulmonary function test
• Pulmonary function test measures lung volumes and airflow the results of PFT
are used to diagnose pulmonary disease, monitor disease progression evaluate
disability and evaluate response to bronchodilators airflow is measured by a
spirometer and administered by trained personal.
• The patients inserts a mouth piece, takes as deep breath as possible and exhales
as hard fast and long as possible.
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96. Spirometry
• Spirometry may be ordered before and after the administration of bronchodilator
to determine the degree of response.
• Home spirometry may be used to monitor lung function in person with asthma or
cystic fibriods.
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97. Exercise testing
Exercise testing is used to diagnose in determining exercise capacity and for
disability evaluation A complete exercise test involves walking on a threadmill
while expired.
• Oxygen and carbon dioxide, respiratory rate, heart rate, and heart rhythm are
monitored a modified test (desaturation test) may be used to monitor spo2.
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99. Skin test
Skin test may be performed to test for allergic reactions or exposure to tuberculosis bacilli or
fungai.
• It involves the intradermal injection of an antigen.
• A positive result on a TB skin test indicate the TB
is currently active.
• A negative results indicates patients has exposed to TB.
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