Clinical Signs of Respiratory Diseases

Question 1

What is the difference between symptoms and signs?

Answer 1

Symptoms are what the patient feels

Signs are the physical variations from the norm. Slide 4

Question 2

What is stridor?

Answer 2

A harsh wheese on INSPIRATION. Slide 5

Question 3

What should you look for at the start of a general examination?

Answer 3

Respiratory distress
Nutritional state
Cyanosis
CO2 flap
Skin
Finger clubbing
Eyes in respiratory disease
The neck
JVP. Slide 5-23

Question 4

What are the 4 things you do when examining the chest?

Answer 4

Inspection
Palpation
Percussion
Auscultation. Slide 25

Question 5

What do you look for when you are inspecting the chest?

Answer 5

Chest wall deformity
Operations scars
Respiratory abdominal movement. Slide 26+27

Question 6

What are you looking for when palpating a chest?

Answer 6

Tracheal deviation e.g. towards collapse
Crepitations e.g. chest wall trauma
Chest expansion e.g. unilateral pneumothorax. Slide 31-33

Question 7

What are you looking for when performing percussion on a chest?

Answer 7

Hyper-resonance e.g. pneumothorax
Impaired resonance e.g. consolidation
Stony dull percussion e.g. pleural effusion. Slide 34

Question 8

What are you looking for when performing auscultaion on a chest?

Answer 8

Breath sounds
Added sounds
Voice sounds. Slide 37

Question 9

What are you looking for when auscultating for breath sounds?

Answer 9

Normal (vesicular) e.g. muffled transmitted bronchial sounds
Reduced e.g. effusion, collapse
Transmitted (bronchial) - Consolidation with patent bronchial system. Slide 38

Question 10

How can you test for a consolidation in the lungs when performing auscultation?

Answer 10

Whispering pectoriloquy - patients whisper words you wouldn’t hear without a consolidation e.g. Toy boat or scooby doo. Slide 39

Question 11

What are you looking for when auscultating for added sounds?

Answer 11

Wheeze e.g. musical sound
Localised e.g. large airway tumour
Generalised e.g. polyphonic
Squeaks e.g. bronchiolitis
Crackles e.g. non musical, usually on inspiration
Pleural rub e.g. leathery, creaking. Slide 40-42

Question 12

What are you looking for when auscultating for voice sounds?

Answer 12

Vocal resonance e.g. reduced with effusion, collapse. Increased with consolidation
Whispering pectoriloquy e.g. consolidation without bronchial obstruction. Slide 43