This document provides guidance on evaluating symptoms related to respiratory system issues during a patient history. It discusses key questions to ask about common symptoms like cough, expectoration, chest pain, dyspnea, and hemoptysis. For each symptom, the document outlines factors to comment on such as timing, character, severity, exacerbating/relieving factors, and associated symptoms. Understanding these details can provide clues to determining possible respiratory conditions. A thorough respiratory exam involves analyzing each symptom and understanding how it relates to potential diagnoses.
These lecture notes were prepared by Dr. Hamdi Turkey- Pulmonologist- Department of internal medicine - Taiz university
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These lecture notes were prepared by Dr. Hamdi Turkey- Pulmonologist- Department of internal medicine - Taiz university
Do Not Forget To Visit Our Pages On Facebook on the following Links:
https://www.facebook.com/groups/569435236444761/
AND
https://www.facebook.com/groups/690331650977113/
DYSPNOEA IS DEFINED AS THE UNDUE AWARENESS OF UNPLEASANT BREATHING.WHEN THERE IS AMIS MATCH BETWEEN THE AFFERENT VENTILATORY SIGNALS AND THE EFFERENT RESPIRATORY SIGNALS IN THE BRAIN WE MAY GET AN UNIGNORABLE FEELING FOR NEED OF MORE AND MORE OXYGEN.
Interstitial lung disease is a general category that includes many different lung conditions. All interstitial lung diseases affect the interstitium, a part of the lungs' anatomic structure.
Some of the types of interstitial lung disease include:
Interstitial pneumonia: Bacteria, viruses, or fungi may infect the interstitium of the lung. A bacterium called Mycoplasma pneumonia is the most common cause.
Idiopathic pulmonary fibrosis : A chronic, progressive form of fibrosis (scarring) of the interstitium. Its cause is unknown.
Nonspecific interstitial pneumonitis: Interstitial lung disease that's often present with autoimmune conditions (such as rheumatoid arthritis or scleroderma).
DYSPNOEA IS DEFINED AS THE UNDUE AWARENESS OF UNPLEASANT BREATHING.WHEN THERE IS AMIS MATCH BETWEEN THE AFFERENT VENTILATORY SIGNALS AND THE EFFERENT RESPIRATORY SIGNALS IN THE BRAIN WE MAY GET AN UNIGNORABLE FEELING FOR NEED OF MORE AND MORE OXYGEN.
Interstitial lung disease is a general category that includes many different lung conditions. All interstitial lung diseases affect the interstitium, a part of the lungs' anatomic structure.
Some of the types of interstitial lung disease include:
Interstitial pneumonia: Bacteria, viruses, or fungi may infect the interstitium of the lung. A bacterium called Mycoplasma pneumonia is the most common cause.
Idiopathic pulmonary fibrosis : A chronic, progressive form of fibrosis (scarring) of the interstitium. Its cause is unknown.
Nonspecific interstitial pneumonitis: Interstitial lung disease that's often present with autoimmune conditions (such as rheumatoid arthritis or scleroderma).
COMPLETE EXAMINATION OF RESPIRATORY SYSTEM IN PEDIATRICS. IT HAS BEEN SUMMARIZED FROM ALL WELL KNOWN 32 BOOKS UNDER GUIDANCE OF ONE OF THE BEST PEDIATRIC DOCTORS AND PROFESSORS .
BY DR. SURAJ R. DHANKIKAR.
How to present a Thoracic Case | IACTS SCORE 2020IACTSWeb
This presentation entails around the clinical presentation and description of thoracic lesions. It includes basic clinical examination, concepts around lesion and diagnosis, perioperative care, postoperative care, sequelae/ complications and management of specific lesions such as Pneumothorax, Empyema Thoracis, Bronchiectasis, Lung Abscess, Tuberculosis, Emphysema/ Bullae.
The presentation elucidates on the current modalities and management of neoplasms of the lung and oesophagus, as well as management of chest wall lesions.
This is courtesy of Prof. Srikrishna S.V, MS, MCh, FRCS(Ed.), FIACS. He currently serves as Professor and Senior Consultant of Thoracic Surgery at Narayana Institute of Cardiac Sciences, Bommasandra, Bengaluru.
This presentation is part of a video that belongs to the lecture series of IACTS SCORE 2020 held at the SSSIHMS Whitefield, Bengaluru between 7th and 8th March, 2020.
social cognition domains and impairment.pptxDoha Rasheedy
Social cognition refers to a set of neurocognitive processes underlying the individuals’ ability to “make sense of others’ behavior” as a “crucial prerequisite of social interaction” The different psychological processes by which we perceive, interpret, and process social information about ourselves and others. These processes allow people to understand social behavior and respond in ways that are appropriate and beneficial Social cognitive impairments are a prominent concern, or even a core facet, of several neurodegenerative (e.g., behavioral variant of frontotemporal dementia), neuropsychiatric (e.g., schizophrenia, major depressive disorder, and bipolar disorder), and neurodevelopmental (e.g., autism spectrum disorder and attention deficit hyperactivity disorder) conditions, and often occur after acute brain damage (e.g., traumatic brain injury and stroke). Moreover, such deficits are critical predictors of functional outcomes because they affect the ability to create and maintain interpersonal relationships, thereby removing their benefits in everyday life Social cognitive disturbances might be relatively subtle and harder to detect informally. Structured social cognitive assessment is, therefore , mandated.
Basic of geriatrics and internal medicine for physiotherapistDoha Rasheedy
collection of lectures for physiotherapy undergraduate students including notes of common health issues (frailty, sarcopenia, osteoporosis, neuropsychiatric issues, constipation, metabolic syndrome and its components, orthostatic hypotension, CLD, CKD, anemia, immobilization, dizziness, falls, fatigue) and how to handle in practice.
summary of age related changes and geriatric pharmacology, safe analgesic prescription in elderly
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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Clinical assessment 3
1. 3- Respiratory system
History taking
Dr Doha Rasheedy
Lecturer of Geriatric Medicine
Department of Geriatric and Gerontology
Ain Shams University
2. Symptoms of chest case
1- Cough.
2- Expectoration.
3- Chest pain.
4- Haemoptysis.
5- Dyspnea.
6- Toxic symptoms.
7- wheeze.
8- Oedema of lower limb.
9- Mediastinal compression.
10- Cyanosis.
11- Pain in the right hypochondrium.
12- Any other positive symptoms of other systems.
4. Analysis of cough
• Timing
• duration
• Posture
• Character
• Severity
• Expectoration or dry
• Associated symptoms
5. a- Time of cough:
• Early morning, e.g.: In chronic bronchitis
• Night, e.g.: in P.N.D (P.V.C)
• All over the day, e.g.: in chest infection
6. Duration of cough
• acute, defined as lasting less than three
weeks
• subacute, lasting three to eight weeks
• chronic, lasting more than eight weeks
9. Cough of suppurative lung diseases or cavitary
syndrome:
– Cough with huge amount of yellow-greenish
fetid sputum.
– Cough and expectoration are related to
posture.
Cavitary or Suppurative Lung Disease
Includes:
1- Bronchiectasis.
2- Lung abscess.
3- Empyema with broncho - pleural fistula.
10. Some characteristic coughs
– Laryngitis: Cough with a hoarse voice.
– Tracheitis: Dry and very painful.
– Pleurisy: Sharp pain (chest wall)
– Post-nasal drip: Tickly
– Asthma: Chronic, paroxysmal, worse after exercise and at night
– Oesophageal reflux Dry and nauseating. Often first thing in the
morning.
– Tracheo-oesophageal fistula (rare) Nauseating and worse after eating
– Epiglottitis: Barking
– Laryngeal nerve palsy: hollow, brassy
– Left heart failure:Productive and worse on lying flat
13. Expectoration
• Comment on :
– Amount
– Colour
– Odour
– Consistency
– Relation to time
– What ↑, ↓
– Relation to posture
– hemoptysis
14. Amount
• Regular coughing up of large volumes of purulent
sputum influenced by posture is characteristic of
bronchiectasis.
• The sudden production of large amounts of purulent
sputum on a single occasion suggests the rupture of a
lung abscess or empyema into the bronchial tree.
• Large volumes of watery sputum with a pink tinge in an
acutely breathless patient suggests pulmonary oedema,
• whereas large volumes of watery sputum for weeks
(bronchorrhoea) is a symptom of alveolar cell cancer.
15. colour
• Clear or 'mucoid' sputum is produced by patients with COPD without
active infection.
• Yellowish sputum is found in acute lower respiratory tract infection
(live neutrophils) and also in asthma (eosinophils).
• Green sputum (dead neutrophils) indicates chronic infection as in
exacerbations of COPD, bronchiectasis, etc. Purulent sputum is
usually green because of the presence of lysed neutrophils and their
breakdown products, specifically the green-pigmented enzyme
verdoperoxidase. The first sputum produced in the morning by a
patient with COPD may be green because of nocturnal stagnation of
neutrophils.
• In the early stages of pneumococcal pneumonia sputum may be a
characteristic rusty red colour as pneumonic inflammation passes
through the red hepatization phase.
• In coal miners with pneumoconiosis the rupture of necrotic areas of
pulmonary fibrosis can result in the expectoration of black sputum
(melanoptysis).
18. Taste or smell
• 'Foul' or 'vile' tasting or smelling sputum
suggests anaerobic bacterial infection and
can occur in bronchiectasis, lung abscess
and empyema.
• In some patients with bronchiectasis a
change of sputum taste indicates an
infective exacerbation
20. Haemoptysis
• It is important to determine whether the blood has been
coughed up from the respiratory tract, been vomited from
the upper gastrointestinal tract or has suddenly
appeared in the mouth without coughing, suggesting a
nasopharyngeal origin.
23. • Ccc: a small or large amount of pure blood. Streaking of clear sputum
with blood or the presence of blood clots in the sputum.
• Haemoptysis with purulent sputum suggests an infective cause such
as bronchiectasis.
• Diffuse staining of sputum with blood (pink froth) can occur in acute
pulmonary oedema.
• Coughing up large amounts of pure blood is fortunately rare but
potentially life-threatening; the most frequent causes are
bronchiectasis, tuberculosis, and lung cancer.
• Haemoptysis occurring intermittently for a few years, usually in
association with a respiratory tract infection occurs in bronchiectasis.
• Daily haemoptysis for a week or more is a common symptom of lung
cancer, other causes include tuberculosis and lung abscess.
• Single episodes of haemoptysis may need immediate investigation if
they are very large or associated with symptoms, e.g. pleuritic chest
pain and breathlessness suggesting pulmonary thromboembolism
and infarction.
26. Chest pain
• Chest pain related to pulmonary disease
usually results from involvement of the
chest wall , mediastinal structures or
parietal pleura.
• Comment on:
– Site, radiation
– Character
– What ↑,↓
– Duration
– Associated symptoms
27. • Pleuritic pain is typically sharp, stabbing and always intensified by inspiration or
coughing.
– parietal pleura of the upper six ribs is perceived as a localized pain
– irritation of the parietal pleura overlying the central diaphragm is referred to the neck or shoulder tip.
– The lower six intercostal nerves innervate the parietal pleura of the lower ribs and the outer diaphragm,
pain referred to the upper abdomen.
• Mediastinal pain Mediastinal pain is typically central, retrosternal and unrelated to
respiration or cough.
– pain originating from the tracheobronchial tree due to infection or inhalation of irritant dusts is typically
retrosternal, with a raw burning character, and is greatly worsened by cough
– . A dull aching retrosternal pain that progresses to disturb sleep can be a feature of malignancy
invading mediastinal lymph nodes or enlarging thymoma.
– Massive pulmonary thromboembolism sufficient to induce an acute increase in right ventricular
pressure may produce central chest pain identical to myocardial ischaemia.
• Chest wall pain: may indicate respiratory or musculoskeletal disease. patients with
chronic cough or breathlessness develop a generalized feeling of chest tightness or
diffuse pain.
31. Dyspnea
• Dyspnea occurs whenever the work of
breathing is increased
• Dyspnea may be due to diseases of
bronchi, lungs, pleura or thoracic cage,
cardiac failure, increased demand for
oxygen, neurological diseases and
psychogenic causes.
32. Comment on
• Onset
• Progression
• Frequency (Pulmonary embolism, asthma)
• Severity
• Exertional, positional
• Associated symptoms
33.
34. Variability, aggravating/relieving factors
• Left ventricular failure and respiratory muscle weakness commonly present
with breathlessness when lying flat (orthopnoea). This is due to inability of
the left ventricle to compensate for the normal increased venous return to
the heart on lying down or to embarrassment of the diaphragm in respiratory
muscle weakness. However, orthopnoea can be a feature of any severe
lung disease.
• Breathlessness that wakes the patient from sleep is typical of asthma and
left ventricular failure (paroxysmal nocturnal dyspnoea). Patients with
asthma are typically awoken between 3 and 5 a.m. and have associated
wheezing.
• Breathlessness that is worst first thing on waking in the morning is more
typical of COPD and may settle after coughing up sputum.
• Patients with exercise-induced asthma may notice that their breathlessness
continues to worsen for 5-10 minutes after stopping activity.
• If asthma is suspected ask directly whether exposure to allergens (e.g.
animals, shaking bedding, mowing the lawn), irritants with smoke,
perfumes, fumes, cold air or drugs (e.g. aspirin) or non-steroidal anti-
inflammatory drugs is associated with breathlessness.
• Breathlessness that improves at the weekend or on holiday is suggestive of
occupational asthma or extrinsic allergic alveolitis.
35. Types of Dyspnea in Various Respiratory Diseases
1. upper respiratory obstruction: dyspnea associted with the presence
of stridor and inspiratory retraction of supraclavicular fossae.
2. Pulmonary parenchymal diseases: (Pneumonia, extensive
tuberculosis, bronchogenic carcinoma and interstitial lung diseases
such as sarcoidosis and pneumoconiosis): There is tachypnea. The
respiratory movements may be shallow. Respiratory failure may
develop and this manifests as central cyanosis, mental confusion
and flapping tremors.
3. Bronchial asthma: Acute intermittent obstruction with expiratory
wheezing is typical of bronchial asthma. The attacks occur suddenly
in paroxysms, especially worsened in the early hours of the
morning. Several allergens like pollen or dust, environmental
factors, respiratory infection and anxiety precipitate the attacks.
Often the duration of dyspnea extends over several years. Family
history of asthma and other atopic disorders may be present in
many cases. Other allergic manifestations may coexist with asthma
36.
37. 7. Diaphragmatic paralysis: Bilateral diaphragmatic paralysis
leads to dyspnea. Transverse myelitis and demyelinating diseases
such as Guillain-Barre syndrome may lead to diaphragmatic
paralysis. Pressure on the phrenic nerves by tumors gives rise to
uni-or bilateral paralysis. The patient is tachypneic. The abdominal
wall is sucked in during inspiration and this is termed paradoxical
respiration.
8. Diseases of the chest wall: Gross kyphoscoliosis and pectus
excavatum which reduce the intrathoracic volume and distort
intrathoracic structures give rise to dyspnea. The patient is
tachypneic. Expansion of the chest is asymmetrical and non-
uniform. Repeated respiratory infections and progressive changes
in the lungs lead to the development of cor-pulmonale and
respiratory failure.
41. Toxic symptoms
• Night fever
• Night sweating
• Loss of appetite
• Loss of weight
Occur with chronic inflammatory, infectious
conditions (TB, Bronchiectasis, Chronic
lung abscess).
44. Comment on
• At what age did the wheezing begin
• At rest / exercise
• Expiratory/ inspiratory
• Frequency
• Timing in the day season
• In between attacks free or not
• Allergen Are there any precipitating factors, such as
foods, odors, emotions, animals, etc.?"
• What usually stops the attack
• Family history of atopy
• Drugs: BB, NSAIDs
45. • Typically wheeze is limited to, and louder during,
expiration.
• A common mistake is failure to distinguish wheeze from
inspiratory stridor caused by the partial occlusion of a
large airway by tumour or foreign body
• It is most commonly seen in bronchial asthma and other
conditions where there is bronchial narrowing. In asthma
this symptom occurs paroxysmally. When the bronchial
obstruction is due to structural lesions, wheezing may be
constant.
52. Sleep Apnea
• disruptive snoring, episodes of upper airway
obstruction during sleep.(obstructive)
• Breathing pauses during sleep
• excessive daytime fatigue or sleepiness.
• chronic fatigue, morning headaches
• Unexplained Cor pulmonale
• These patients are often obese and
hypertensive
• History of neurological disorder(central)