Diaphragmatic paralysis physical examination: Difference between revisions
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==Overview== | ==Overview== | ||
Patients with unilateral diphragmatic paralysis usually appear normal. Patients with bilateral diaphragmatic paralysis usually are in respiratory distress. The severe forms of bilateral diaphragmatic paralysis would lead to pulmonary hypertension. | Patients with unilateral diphragmatic paralysis usually appear normal. Patients with bilateral diaphragmatic paralysis usually are in [[respiratory distress]]. The severe forms of bilateral diaphragmatic paralysis would lead to [[pulmonary hypertension]]. | ||
==Physical Examination== | ==Physical Examination== | ||
* Physical examination of patients with unilateral diphragmatic paralysis is usually normal.Patients with bilateral diaphragmatic paralysis usually are in respiratory distress. The severe forms of bilateral diaphragmatic paralysis would lead to pulmonary hypertension. | * Physical examination of patients with unilateral diphragmatic paralysis is usually normal.Patients with bilateral diaphragmatic paralysis usually are in [[respiratory distress]]. The severe forms of bilateral diaphragmatic paralysis would lead to [[pulmonary hypertension]]. | ||
*The severe forms of bilateral diaphragmatic paralysis would lead to pulmonary hypertension. For more information about physical examination in pulmonary hypertension '''[[Pulmonary hypertension physical examination|click here]]'''. | *The severe forms of bilateral diaphragmatic paralysis would lead to [[pulmonary hypertension]]. For more information about physical examination in pulmonary hypertension '''[[Pulmonary hypertension physical examination|click here]]'''. | ||
===Appearance of the Patient=== | ===Appearance of the Patient=== | ||
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*[[Tachypnea]] with exercise may be seen in unilateral diaphragmatic paralysis. <ref name="pmid6292583" /> | *[[Tachypnea]] with exercise may be seen in unilateral diaphragmatic paralysis. <ref name="pmid6292583" /> | ||
*[[Tachypnea]] at rest may be seen in unilateral diaphragmatic paralysis with underlying lung disease. <ref name="pmid15595343">{{cite journal |vauthors=Kumar N, Folger WN, Bolton CF |title=Dyspnea as the predominant manifestation of bilateral phrenic neuropathy |journal=Mayo Clin. Proc. |volume=79 |issue=12 |pages=1563–5 |year=2004 |pmid=15595343 |doi=10.4065/79.12.1563 |url=}}</ref> | *[[Tachypnea]] at rest may be seen in unilateral diaphragmatic paralysis with underlying lung disease. <ref name="pmid15595343">{{cite journal |vauthors=Kumar N, Folger WN, Bolton CF |title=Dyspnea as the predominant manifestation of bilateral phrenic neuropathy |journal=Mayo Clin. Proc. |volume=79 |issue=12 |pages=1563–5 |year=2004 |pmid=15595343 |doi=10.4065/79.12.1563 |url=}}</ref> | ||
*Patients with bilateral diphragmatic paralysis have tachypnea that worsens in [[supine position]]. | *Patients with bilateral diphragmatic paralysis have [[tachypnea]] that worsens in [[supine position]]. | ||
===Skin=== | ===Skin=== | ||
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* Cardiovascular examination of patients with diaphragmatic paralysis is usually normal. | * Cardiovascular examination of patients with diaphragmatic paralysis is usually normal. | ||
===Abdomen=== | ===Abdomen=== | ||
Abdominal examination of patients with diaphragmatic paralysis is usually normal. | * Abdominal examination of patients with diaphragmatic paralysis is usually normal. | ||
===Back=== | ===Back=== | ||
Revision as of 13:43, 20 February 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahda Alihashemi M.D. [2]
Overview
Patients with unilateral diphragmatic paralysis usually appear normal. Patients with bilateral diaphragmatic paralysis usually are in respiratory distress. The severe forms of bilateral diaphragmatic paralysis would lead to pulmonary hypertension.
Physical Examination
- Physical examination of patients with unilateral diphragmatic paralysis is usually normal.Patients with bilateral diaphragmatic paralysis usually are in respiratory distress. The severe forms of bilateral diaphragmatic paralysis would lead to pulmonary hypertension.
- The severe forms of bilateral diaphragmatic paralysis would lead to pulmonary hypertension. For more information about physical examination in pulmonary hypertension click here.
Appearance of the Patient
- Patients with unilateral diaphragmatic paralysis usually appear normal.[1]
- Patients with bilateral diaphragmatic paralysis usually are in respiratory distress.[2]
Vital Signs
- Tachypnea with exercise may be seen in unilateral diaphragmatic paralysis. [1]
- Tachypnea at rest may be seen in unilateral diaphragmatic paralysis with underlying lung disease. [3]
- Patients with bilateral diphragmatic paralysis have tachypnea that worsens in supine position.
Skin
- Skin examination of patients with diaphragmatic paralysis is usually normal.
HEENT
- HEENT examination of patients with diphragmatic paralysis is usually normal.
Neck
- Neck examination of patients with diaphragmatic paralysis is usually normal.
- Jugular venous distension in severe bilateral diphragmatic paralysis.[4]
Lungs
- Pulmonary examination of patients with unilateral diphragmatic paralysis is usually normal.
- Bilateral diaphragmatic paralysis can lead to pulmonary hypertension
Heart
- Cardiovascular examination of patients with diaphragmatic paralysis is usually normal.
Abdomen
- Abdominal examination of patients with diaphragmatic paralysis is usually normal.
Back
- Back examination of patients with diaphragmatic paralysis is usually normal.
Genitourinary
- Genitourinary examination of patients with diaphragmatic paralysis is usually normal.
Neuromuscular
- Neuromuscular examination of patients with diphragmatic paralysis is usually normal.
Extremities
- Extremities examination of patients with diaphragmatic paralysis is usually normal.
References
- ↑ 1.0 1.1 Piehler JM, Pairolero PC, Gracey DR, Bernatz PE (1982). "Unexplained diaphragmatic paralysis: a harbinger of malignant disease?". J. Thorac. Cardiovasc. Surg. 84 (6): 861–4. PMID 6292583.
- ↑ Kumar N, Folger WN, Bolton CF (2004). "Dyspnea as the predominant manifestation of bilateral phrenic neuropathy". Mayo Clin. Proc. 79 (12): 1563–5. doi:10.4065/79.12.1563. PMID 15595343.
- ↑ Kumar N, Folger WN, Bolton CF (2004). "Dyspnea as the predominant manifestation of bilateral phrenic neuropathy". Mayo Clin. Proc. 79 (12): 1563–5. doi:10.4065/79.12.1563. PMID 15595343.
- ↑ Kumar N, Folger WN, Bolton CF (2004). "Dyspnea as the predominant manifestation of bilateral phrenic neuropathy". Mayo Clin. Proc. 79 (12): 1563–5. doi:10.4065/79.12.1563. PMID 15595343.