Clubbing, also known as Hippocratic fingers, is a thickening of tissues at the base of fingernails and toenails such that the normal angle between the nail and digit is filled in. It is caused by increased levels of vascular endothelial growth factor (VEGF) which induces vascular changes and tissue proliferation in the nails. Common causes include lung diseases like bronchitis and cancer, as well as non-lung conditions such as liver cirrhosis. Clubbing can range from nail bed fluctuation to severe bony changes and is classified in grades based on physical appearance.
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).
Bronchiectasis
A condition characterized by chronic permanent dilation & destruction of bronchi due to destructive changes in the elastic and muscular layers of bronchial walls.
The common thread in the pathogenesis of bronchiectasis consists of difficulty clearing secretions & recurrent infections with a “vicious circle” of infection and inflammation resulting in airway injury and remodelling.
PLEASE REFER TO REFERENCE TEXTBOOKS FOR CLARITY.
A concise presentation on clubbing. Can be used for revising or presenting or for teaching purposes.
PS: You may use this presentation without any restriction.
Brief Presentation on clinical examination of Cardio Vascular System with Report of Normal case
references:
macleod's clinical examination 13th edition
hutchinson clinical methods
Brief Presentation on clinical examination of Respiratory System with Report of Normal case
references:
macleod's clinical examination 13th edition
hutchinson clinical methods
R Alagappan - Manual of Practical Medicine, 4th Edition
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).
Bronchiectasis
A condition characterized by chronic permanent dilation & destruction of bronchi due to destructive changes in the elastic and muscular layers of bronchial walls.
The common thread in the pathogenesis of bronchiectasis consists of difficulty clearing secretions & recurrent infections with a “vicious circle” of infection and inflammation resulting in airway injury and remodelling.
PLEASE REFER TO REFERENCE TEXTBOOKS FOR CLARITY.
A concise presentation on clubbing. Can be used for revising or presenting or for teaching purposes.
PS: You may use this presentation without any restriction.
Brief Presentation on clinical examination of Cardio Vascular System with Report of Normal case
references:
macleod's clinical examination 13th edition
hutchinson clinical methods
Brief Presentation on clinical examination of Respiratory System with Report of Normal case
references:
macleod's clinical examination 13th edition
hutchinson clinical methods
R Alagappan - Manual of Practical Medicine, 4th Edition
1. CLUBBING
First described by Hippocrates about
2500yrs ago, hence also called as
Hippocratic finger
ABHIJIT SAMAL
080201386
2. DEFINITION
• Thickening of the tissues at the base of the
finger and toe nails such that the normal angle
between the nail & the digit is filled in.
3. Pathophysiology
• VEGF is the key entity, platelet derived growth
factor stimulated by hypoxia and produced in
diverse malignancies.
• VEGF induces vascular hyperplasia, edema,
and fibroblast or osteoblast proliferation at
peripheral levels in nails
5. Criteria
• Loss of normal angle between nail and nail
bed.
• Inc. Nail bed fluctuation
• Inc. nail bed curvature in the later stages
• Inc. bulk of soft tissue over the terminal
phalanges
6.
7. Grades of clubbing
• Grade 1: Nail bed fluctuation
• Grade 2: Obliteration of Lovibond angle
• Grade 3: Parrot beaking
• Grade 4: Hypertrophic osteo-
arthropathy(HOA)
9. Hypertrophic Osteo-arthropathy
• Earlier known as hypertrophic pulmonary
osteo-arthropathy(HPOA)
• Syndrome of clubbing of the digits, periostitis
of the long bones and arthritis.
• Primary: occurs w/o any underlying cause and
is familial
• Secondary: pulmonary, cardiac, hepatic,
intestinal disease.
10. Hypertrophic Osteo-arthropathy
• Earlier known as hypertrophic pulmonary
osteo-arthropathy(HPOA)
• Syndrome of clubbing of the digits, periostitis
of the long bones and arthritis.
• Primary: occurs w/o any underlying cause and
is familial
• Secondary: pulmonary, cardiac, hepatic,
intestinal disease.