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Respiratory examination
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Components 1- General Ex 2- Inspection: from front and back 3-Palpation 4-Percussion 5-Auscultation
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General respiratory Ex We will cover these points : 1- general look 2- vital signs 3- both hands 4- eyes 5- nose 6- mouth 7- sinuses 8- neck 9- Lower limb edema
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General look Consciousness Oriented Distressed Lying flat Audible wheezing or stridor Connected to IV line or O2 mask Lip pursing Acting nasal alae Using accessory muscle A : apperance B : body built C : color D : distressed E : environment
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Hands 1- Nail Clubbing, cyanosis, nicotine staining 2-palm Warm, pallor 3-Dorsum Muscle wasting 4-Tremor Fine, flapping
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5- Eyes Pallor, jaundice, sign of Horner syndrome 6- Nose Acting nasal alae 7- Mouth Central cyanosis in the tip of the tongue Peripheral cyanosis in lip or fingers Lip pursing
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8- Sinuses 9- Neck JVP Using accessory muscle LN
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Chest By inspection Type of breathing, symmetry, scar, deformity like. Pectus excavatum, pectus carinatum, barrel chest, Harrison sulcus Prominent veins, intercostals retraction back, kyphosclosis
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Pectus excavatum
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pectus carinatum
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By palpation Tactile vocal fremitus Chest expansion Tracheal tug Tracheal deviation Apex beat
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By percussion ( Resonant – Dull -Hyperresonant) ? Symmetrical?
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By auscultation 1- Air entry ( Breathing sounds) 2- Type of breathing 3- Added sounds like wheezing and fine or coarse crepitations or pleural friction rub 4- Vocal resonance
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Thank you
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