Symptoms and Signs in RESP Flashcards
What are some common respiratory symptoms?
- Cough
- Dyspnoea
- Dysphonia (hoarseness)
- Wheeze
- Stridor
- Stertor
- Sputum
- Haemoptysis
- Chest pain
- Respiratory pattern
- Weight loss
- Rigor/Chills
- Night sweats
What are the characteristics of cough?
- Acute: < 3 weeks
- Subacute: 3-8 weeks
- Chronic cough: > 8 weeks
What could a chronic dry cough mean?
Interstitial lung disease - fibrosis
What could a moist cough mean?
- bronchiectasis
- lower respiratory tract infections
What could bovine cough with hoarsness mean?
bovine = feeble non-explosive
- lung cancer
What could a barking cough mean?
- Croup (laryngotracheobronchitis)
What are red flad symptoms associated with cough?
- Haemoptysis
- SOB
- Fever
- Chest pain
- Weight loss
What is dysphonia?
- hoarseness
- laryngitis
- damage to left recurrent laryngeal nerve
What is a wheeze?
- high-pitched whistling sound
- monophonic: lung mass
- polyphonic: COPD/asthma
caused by narrowing airways
What is stridor?
- High pitched harsh inspiratory sound
- caused by airway obstruction
- epiglottis, malacia
What is stertor?
- Muffled “hot potato” speech
- Naso-oropharyngeal blockage
- tonsil abscess
low pitched
What does purulent (thick yellow) sputum indicate?
- Infections; pneumonia, abscess
What does serous (frothy) sputum indicate?
Acute pulmonary oedema
What does mucoid sputum indicate?
clear, white
COPD/asthma
What does bloody sputum indicate?
- Lung cancer
- rusty red pneumococcal infection
What are the three ypes of chest pain associated with respiratory diseases?
- Pleural pain: sharp, stabbing - pulmonary embolism
- Chest wall pain: sudden after vigorous coughing, painful on palpation - MSK injury
- Mediastinal pain: central, retrosternal - dusts, invasive mediastinal lymph nodes
What are B symptoms?
- Weight loss
- Night sweats
- Fever + rigors
usually happen together and are in more severe disease
What are common respiratory signs on general inspection?
- Accessory muscle use
- Cachexia
- Cyanosis
- Altered mental status
- Thoracotomy scar
What respiratory signs are seen in hands?
- Clubbing
- Discolouration of nails and fingers
- CO2 retention; asterixis, bounding pulse
What respiratory sings are seen on closer inspection and palpation?
- Displaced or central trachea
- Chest shape
- Chest expansion
- Tactile fremitus
What respiratory signs are seen on percussion?
- Resonant/Hyper resonant
- Dull/Stony dull
What resp. signs are seen on auscultation?
- Vesicular vs Bronchial breathing
- Crackles
- Wheeze
- Pleural rub
What does it mean when the trachea is pulled to the abnormal side?
- Atelectasis, pneumothorax, unilaterel fibrosis, pneumonectomy
What does it mean when the trachea is pushed away from abnormal side?
- Large pleural effusion, Tension pneumothorax
What are the three chest shapes seen in resp. disease?
- Barrel chest
- Pectus Carinatum (outward)
- Pectus Excavatum (inward)
What are the two types of chest expansion when its reduced?
- Symmetrically reduced; obstructive, restrictive
- Unilaterally reduced; pneumothorax, pleural effusion
unilateral will ony affect one side of chest
What is tactile fremitus?
- transmission of sound waves from trachea to chest wall
- Increased: Consolidation
- Decreased: Atelectasis
increased with more dense LUNG
What is difference between consolidation and atelectasis?
Consolidation: some air in lungs replaced with fluid + ↑ lung size
Atelectasis: air in lungs removed + ↓ lung size, collapsed lung
What is assessed on percussion?
resp. diseases
- Resonant: normal
- Hyper resonant: pneumothorax, COPD
- Dull: pneumonia, atelectasis
- Stony Dull: pleural effusion, lung cancer
increases with density
What are vesicular breath sounds?
- Soft, low-pitched
- normal breath sounds
- inspiratory 2x expiratory time
What are bronchial breath sounds?
- loud, harsh, clear
- due to consolidation
- inspiratory = expiratory time
What is a wheeze?
- Expiratory sound
- COPD, asthma
What are creps?
- Inspiratory sound
- fluid in alveoli
pneumonia, pulmonary oedema, fibrosis
What is a Rub?
- Rare
- both inspiratory and expiratory
- inflammation of pleura
pulmonary infarct, pneumonia, chest drain
What are common symptoms and signs of pneumonia?
-
Purulent sputum
Signs - reduced chest expansion
- tactile fremitus increased
- dull percussion
- Auscultation: decreased vesicular breathing, COARSE CREPS
What are common symptoms and signs of lung cancer?
Symptoms:
- Haemoptysis
- Hoarsness
- night sweats, weight loss
- bone pain, headache, jaundice
Signs:
- Horner’s syndrome
- reduced chest expansion
- stony dull percussion
- Pembertons sign: red face when hands are raised
What are commone symptoms and signs of idiopathic pulmonary fibrosis?
Symptoms:
- progressive SOB
Signs:
- tachypnoea
- decreased chest expansion
- clubbing
- Fine inspiratory creps bilaterally
What are common symptoms and signs of PE?
Symptoms:
- pleuritic chest pain
Signs
- tachypnoea, tachycardia
pleural rub and right HF rare
What are common signs of pleural effusion?
- trachea pushed opposite side
- stony dull percussion
- decreased tactile fremitus
What are common symptoms and sings of pneumothorax?
Symptoms:
- Acute unilateral pleuritic chest pain
Signs:
- trachea pulled towards, but in tension pneumothorax pulled OPPOSITE
- Hyper resonant percussion
- decreased tactile fremitus
