pulmonary Flashcards
kyphoscloliosis
can lead to cor pulmonale and portal HTN
horizontal sloped ribs in…
obstructive lung diseases (emphysema, COPD, chronic bronchitis, status asthmaticus)
beading of costochondral joints in…
rickets! (rachitic rosary)
Hoover’s sign
COPD, flattened diaphragm on inspiration, more acute subcostal angle
pectus excavatum
sunken, funnel chest
due to Marfan’s, Rickets, Noonans
accessory muscles of breathing
inspiration: SCM, scalenes
expiration: abdominal muscles
- if clavicle moves up >5mm=severe obstructive lung disease
- inspiratory retraction of suprasternal and supraclavicular fossa
Cheyne-stokes breathing
- progressively deeper and faster breathing until temporary stop (apnea)
- due to damage to respiratory centers in brain or heart failure, high altitude
- poor prognosis
- swings in cerebral blood flow (swing between alert/agitated and sleepy/slow)
Biot’s breathing
groups of quick shallow inspiration followed by period of apnea
- brainstem damage
- opiod use
kussmaul breathing
deep labored breathing assoc. w/ severe metabolic acidosis (eg. DKA)
DDX: MAKEUPL (Methanol, Aspirin, Ketones, Ethylene glycol, Uremia, Paraldehyde, Lactic Acidosis)
paradoxical respiration
- all or part of lung is deflated during inhalation and inflated during exhalation
- due to flail chest (rib fractures)
- diaphragm paralysis
expiratory bulging of intercostal spaces
if focal–>pneumothorax
if diffuse–>obstructive disease
tirage breathing
inspiratory retraction of intercostal spaces seen w/ focal obstruction
cyanosis
ineffective ventilation
pallor, diaphoresis, agitation
ineffective oxygenation
symptoms of SVC syndrome
shortness of breath, arm or face swelling
Dahl’s sign
COPD patients lean forward and rest on knees to breath, calluses above knees
ipsilateral deviation of trachea
atelectasis
contralateral deviation of trachea
pneumothorax, large pleural effusion
axial fixation of trachea
tumor or mediastinal fibrosis
oliver’s sign
systolic “tug” seen w/ aortic aneurysm, synchronous with each heart beat
campbell’s sign
tracheal descent with inspiration, due to chronic airflow obstruction, seen w. COPD
costochondritis
tietze’s syndrome
inflammation of costal cartilage