Pneumomediastinum physical examination: Difference between revisions
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==Overview== | ==Overview== | ||
In spontaneous pneumomediastinum, the patient appears normal. Patient with pneumomediastinum secondary to an exacerbation of asthma may appear distressed. On physical examination, the most pathognomic sign of pneumomediastinum is Hamman's sign, which is mediastinal crunch or click present on auscultation over the cardiac apex and the left sternal border synchronous with the heartbeat. Subcutaneous emphysema can also be detected in a patient with pneumomediastinum. | In spontaneous pneumomediastinum, the patient appears normal. Patient with pneumomediastinum secondary to an [[Asthma exacerbation resident survival guide|exacerbation of asthma]] may appear distressed. On physical examination, the most pathognomic sign of pneumomediastinum is [[Hamman's sign]], which is mediastinal crunch or click present on [[auscultation]] over the [[Apex of the heart|cardiac apex]] and the [[left sternal border]] synchronous with the heartbeat. [[Subcutaneous emphysema]] can also be detected in a patient with pneumomediastinum. | ||
==Physical Examination== | ==Physical Examination== | ||
The patient may present with the physical finding of the primary condition causing pneumomediastinum or precipitating factors including, asthma, | The patient may present with the physical finding of the primary condition causing pneumomediastinum or precipitating factors including, [[Asthma physical examination|asthma]], [[Chronic obstructive pulmonary disease physical examination|COPD]], [[Pneumonia/Physical examination|pneumonia]], [[Pneumothorax physical examination|pneumothorax]], [[Boerhaave syndrome physical examination|Boerhaave syndrome]] or [[Acute respiratory distress syndrome physical examination|ARDS]]. | ||
===Vital Signs=== | ===Vital Signs=== | ||
*Tachypnea | *[[Tachypnea]] | ||
*[[Tachycardia]] with regular pulse | *[[Tachycardia]] with regular pulse | ||
*Low SpO2 | *Low [[Oxygen saturation|SpO2]] | ||
===Appearance of the Patient=== | ===Appearance of the Patient=== | ||
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===HEENT=== | ===HEENT=== | ||
* HEENT examination of patients with primary spontaneous pneumomediastinum is usually normal. | * HEENT examination of patients with primary spontaneous pneumomediastinum is usually normal. | ||
*Subcutaneous crepitation may be present on the face. | *[[Subcutaneous emphysema physical examination|Subcutaneous crepitation]] may be present on the face. | ||
===Neck=== | ===Neck=== | ||
*Subcutaneous crepitation may be present. | *[[Subcutaneous emphysema physical examination|Subcutaneous crepitation]] may be present. | ||
===Lungs=== | ===Lungs=== | ||
*Bronchial breathing sound | *[[Bronchial breathing sound]]. | ||
*Mediastinal crunch or click present on auscultation over the cardiac apex and the left sternal border synchronous with the heart sound(Hamman's sign). | *Mediastinal crunch or click present on [[auscultation]] over the [[Apex of the heart|cardiac apex]] and the [[left sternal border]] synchronous with the heart sound(Hamman's sign). | ||
*Subcutaneous crepitation. | *[[Subcutaneous emphysema physical examination|Subcutaneous crepitation]]. | ||
===Heart=== | ===Heart=== | ||
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===Abdomen=== | ===Abdomen=== | ||
* [[Abdomen|Abdominal]] examination of patients with pneumomediastinum is usually normal. | * [[Abdomen|Abdominal]] examination of patients with pneumomediastinum is usually normal. | ||
*Subcutaneous crepitation may be present. | *[[Subcutaneous emphysema physical examination|Subcutaneous crepitation]] may be present. | ||
===Back=== | ===Back=== | ||
Revision as of 18:07, 14 December 2018
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Pneumomediastinum physical examination On the Web |
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Risk calculators and risk factors for Pneumomediastinum physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Trusha Tank, M.D.[2]
Overview
In spontaneous pneumomediastinum, the patient appears normal. Patient with pneumomediastinum secondary to an exacerbation of asthma may appear distressed. On physical examination, the most pathognomic sign of pneumomediastinum is Hamman's sign, which is mediastinal crunch or click present on auscultation over the cardiac apex and the left sternal border synchronous with the heartbeat. Subcutaneous emphysema can also be detected in a patient with pneumomediastinum.
Physical Examination
The patient may present with the physical finding of the primary condition causing pneumomediastinum or precipitating factors including, asthma, COPD, pneumonia, pneumothorax, Boerhaave syndrome or ARDS.
Vital Signs
- Tachypnea
- Tachycardia with regular pulse
- Low SpO2
Appearance of the Patient
- Patients with spontaneous pneumomediastinum usually appear normal[1].
Skin
- Skin examination of patients with primary spontaneous pneumomediastinum is usually normal.
HEENT
- HEENT examination of patients with primary spontaneous pneumomediastinum is usually normal.
- Subcutaneous crepitation may be present on the face.
Neck
- Subcutaneous crepitation may be present.
Lungs
- Bronchial breathing sound.
- Mediastinal crunch or click present on auscultation over the cardiac apex and the left sternal border synchronous with the heart sound(Hamman's sign).
- Subcutaneous crepitation.
Heart
- Cardiovascular examination of patients with pneumomediastinum is usually normal.
Abdomen
- Abdominal examination of patients with pneumomediastinum is usually normal.
- Subcutaneous crepitation may be present.
Back
- Back examination of patients with pneumomediastinum is usually normal.
Genitourinary
- Genitourinary examination of patients with pneumomediastinum is usually normal.
Neuromuscular
- Nuromascular examination of patients with pneumomediastinum is usually normal.
Extremities
- Extremities examination of patients with pneumomediastinum is usually normal