Pneumonia physical examination: Difference between revisions
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{{CMG}}; {{AE}} [[Priyamvada Singh|Priyamvada Singh, M.D.]] [mailto:psingh13579@gmail.com] | |||
==Overview== | ==Overview== | ||
[[Physical examination]]may reveal [[fever]] or sometimes [[hypothermia|low body temperature]], an [[tachypnea|increased respiratory rate]], [[hypotension|low blood pressure]], a [[tachycardia|fast heart rate]], or a low [[oxygen saturation]], which is the amount of oxygen in the blood as indicated by either [[pulse oximetry]] or [[arterial blood gas|blood gas analysis]]. People who are struggling to breathe, who are confused, or who have [[cyanosis]] (blue-tinged skin) require immediate attention. [[Auscultation]] findings include lack of normal breath sounds, the presence of crackling sounds ([[rales]]), or increased loudness of whispered speech (whispered pectoriloquy) with areas of the lung that are stiff and full of fluid, called consolidation. The physical examination, though not very sensitive and specific in diagnosis of community acquired pneumonia, helps in determining the severity of illness and ruling out other differentials. Vital signs are useful in determining the severity of illness and have predictive values. However, a high degree of suspicion should be kept in elderly as the presentation could be subtle in them. | |||
The physical examination, though not very sensitive and specific in diagnosis of community acquired pneumonia, helps in determining the severity of illness and ruling out other differentials. Vital signs are useful in determining the severity of illness and have predictive values. However, a high degree of suspicion should be kept in elderly as the presentation could be subtle in them. | |||
==Physical Examination== | ==Physical Examination== | ||
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* Crackles, [[Rales]] | * Crackles, [[Rales]] | ||
* Increased volume of whispered (vocal fremitus).{{ref|Metlay}} | * Increased volume of whispered (vocal fremitus).{{ref|Metlay}} | ||
==References== | ==References== | ||
Revision as of 15:25, 4 November 2014
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Priyamvada Singh, M.D. [2]
Overview
Physical examinationmay reveal fever or sometimes low body temperature, an increased respiratory rate, low blood pressure, a fast heart rate, or a low oxygen saturation, which is the amount of oxygen in the blood as indicated by either pulse oximetry or blood gas analysis. People who are struggling to breathe, who are confused, or who have cyanosis (blue-tinged skin) require immediate attention. Auscultation findings include lack of normal breath sounds, the presence of crackling sounds (rales), or increased loudness of whispered speech (whispered pectoriloquy) with areas of the lung that are stiff and full of fluid, called consolidation. The physical examination, though not very sensitive and specific in diagnosis of community acquired pneumonia, helps in determining the severity of illness and ruling out other differentials. Vital signs are useful in determining the severity of illness and have predictive values. However, a high degree of suspicion should be kept in elderly as the presentation could be subtle in them.
Physical Examination
Vital Signs
- Decreased oxygen saturation
- Fever
- Hypotension < 90 mm Hg
- Tachycardia > 125 beats/min
- Tachypnea
Lungs
Palpation
- Increased tactile fremitus
Percussion
- Dullness on percussion
Auscultation
- Decreased breath sounds
- Bronchial breath sounds
- Rhonchi
- Crackles, Rales
- Increased volume of whispered (vocal fremitus).[3]