Pneumomediastinum physical examination: Difference between revisions
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==Physical Examination== | ==Physical Examination== | ||
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]], [[Cystic fibrosis physical examination|cystic fibrosis]], [[Mediastinitis physical examination|mediastinitis]], [[ | 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]], [[Cystic fibrosis physical examination|cystic fibrosis]], [[Mediastinitis physical examination|mediastinitis]], [[interstitial lung disease]], or [[Acute respiratory distress syndrome physical examination|ARDS]].<ref name="pmid11993787">{{cite journal |vauthors=Kobashi Y, Okimoto N, Matsushima T, Soejima R |title=Comparative study of mediastinal emphysema as determined by etiology |journal=Intern. Med. |volume=41 |issue=4 |pages=277–82 |date=April 2002 |pmid=11993787 |doi= |url=}}</ref> | ||
===Vital Signs=== | ===Vital Signs=== | ||
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===Appearance of the Patient=== | ===Appearance of the Patient=== | ||
*Patients with spontaneous pneumomediastinum usually appear normal | *Patients with spontaneous pneumomediastinum usually appear normal. | ||
===Skin=== | ===Skin=== | ||
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===Lungs=== | ===Lungs=== | ||
* | *Bronchial breathing sound may be heard on auscultation. | ||
*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). | *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 emphysema physical examination|Subcutaneous crepitation]]. | *[[Subcutaneous emphysema physical examination|Subcutaneous crepitation]] may be present. | ||
===Heart=== | ===Heart=== | ||
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===Neuromuscular=== | ===Neuromuscular=== | ||
* | * Neuromuscular examination of patients with pneumomediastinum is usually normal. | ||
===Extremities=== | ===Extremities=== | ||
Revision as of 16:23, 17 December 2018
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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, cystic fibrosis, mediastinitis, interstitial lung disease, or ARDS.[1]
Vital Signs
- Tachypnea
- Tachycardia with regular pulse
- Low SpO2
Appearance of the Patient
- Patients with spontaneous pneumomediastinum usually appear normal.
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 may be heard on auscultation.
- 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 may be present.
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
- Neuromuscular examination of patients with pneumomediastinum is usually normal.
Extremities
- Extremities examination of patients with pneumomediastinum is usually normal