CERTAIN OBSERVATION IN THEIR SIGNIFICANCE IN RESPIRATORY SYSTEM EXAMINATION

CERTAIN OBSERVATION IN THEIR SIGNIFICANCE IN RESPIRATORY SYSTEM EXAMINATION

Observation                                                                                          Significance

Respiratory rate > 60 / minute(new born)                                             Tachypnea

Working of accessory muscles like ala nasi                                          Respiratory distress

Stridor obstruction                                                                                 Upper airway (supratracheal) inspiratory

Grunting                                                                                                 Lung parenchyma  disease(pneumonia), HMD

Wheezing                                                                                               Expiratory obstruction (asthma)

Moderate tachypnea with chest retraction                                             Parenchyma disease (pneumonia), HMD

Marked tachypnea without chest retraction aspiration in the                Bronchial disease(asthma), meconium newborn

Silent dyspnea, in ability to phonate, paradoxical /seasaw                    Respiratory muscle paralysis (GBS, acute respiratory failure)

Breathing

Severe tachypnea but no manifestations of respiratory disorder           Metabolic acidosis

Peripheral cyanosis                                                                                Moderate oxygen desaturation

Central cyanosis                                                                                     Extreme oxygen desaturation

Clubbing                                                                                                Chronic hypoxia

Increased tactile vocal fremitus(TVF)                                                   Pneumonia, pure pleural effusion

Decreased TVF                                                                                      Pneumothorax, pleural effusion with underlying collapse

Harrison sulcus                                                                                      Chronic airway obstruction

Chest tenderness                                                                                    Empyema

Hyperresonant note                                                                                Emphysema, Pneumothorax

Hyporesonant note                                                                                 Collapse / Consolidation

Stony dull note                                                                                       Pleural effusion

High-pitched bronchial breathing                                                          Consolidation

Low-pitched bronchial breathing                                                          Cavity

Post-tussive suction                                                                               Cavity

Succession splash                                                                                  Hydropneumothorax

Pleural rub                                                                                             Pleuritis

Fine crepitations (crackles)                                                                   Alveolar lesion

Coarse crepitations(crackles)                                                                Bronchial lesion

Rhonchi(Wheeze)                                                                                 Bronchospasm, bronchial obstruction

Conducted sounds                                                                                 URI, laryngomalacia

Signs of pneumonia anteriorly and in upper half                                 Upper lobe pneumonia

Signs of pneumonia anteriorly and in middle half                                Middle lobe  pneumonia

Signs of pneumonia posteriorly                                                            Lower lobe pneumonia

Clinical signs defying and pattern                                                        Mediastinal tumor