Emphysema physical examination: Difference between revisions
Created page with "{{Emphysema}} {{CMG}} ==Overview== Emphysema can result in hyperventilation and respiratory distress. A physical examination may reveal signs of "pink puffers" and distress in t..." |
No edit summary |
||
| Line 4: | Line 4: | ||
==Overview== | ==Overview== | ||
Emphysema can result in hyperventilation and respiratory distress. A physical examination may reveal signs of "pink puffers" and distress in the lungs. | Emphysema can result in hyperventilation and respiratory distress. A physical examination may reveal signs of "pink puffers" and distress in the lungs. | ||
==Physical Examination== | ==Physical Examination== | ||
| Line 19: | Line 16: | ||
Clinical signs on at the fingers include cigarette stains (although actually tar) and asterixis (metabolic flap) at the wrist if they are carbon dioxide retainers (NOTE: Finger clubbing is NOT a general feature of emphysema). | Clinical signs on at the fingers include cigarette stains (although actually tar) and asterixis (metabolic flap) at the wrist if they are carbon dioxide retainers (NOTE: Finger clubbing is NOT a general feature of emphysema). | ||
Fluid overload can be seen in advanced disease, with pitting [[peripheral edema]]. | Fluid overload can be seen in advanced disease, with pitting [[peripheral edema]]. | ||
==Signs== | |||
Emphysema patients are sometimes referred to as "pink puffers". This is because emphysema sufferers may hyperventilate to maintain adequate blood oxygen levels. Hyperventilation explains why mild emphysema patients do not appear [[Cyanosis|cyanotic]] as chronic [[bronchitis]] (another [[COPD]] disorder) sufferers often do; hence they are "pink puffers" (able to maintain almost normal blood gases through hyperventilation) and not "blue bloaters" ([[cyanosis]]; inadequate oxygen in the blood). However, any severely chronically obstructed (COPD) respiratory disease will result in hypoxia (decreased blood partial pressure of oxygen) and hypercapnia (increased blood partial pressure of Carbon Dioxide); so called Blue Bloaters. Blue Bloaters are so named as they have almost normal ventilatory drive (due to decreased sensitivity to carbon dioxide secondary to chronic hypercapnia), are plethoric (red face/cheeks due to a polycythemia secondary to chronic hypoxia) and [[cyanotic]] (due to decreased [[hemoglobin]] saturation). | |||
==References== | ==References== | ||
Revision as of 18:29, 23 September 2011
|
Emphysema Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Emphysema physical examination On the Web |
|
American Roentgen Ray Society Images of Emphysema physical examination |
|
Risk calculators and risk factors for Emphysema physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Emphysema can result in hyperventilation and respiratory distress. A physical examination may reveal signs of "pink puffers" and distress in the lungs.
Physical Examination
Ear, nose and throat
Examination of the face reveals a plethoric complexion (if there is a secondary polycythemia), pursed-lipped breathing, and central cyanosis.
Lungs
Examination of the chest reveals increased percussion notes (particularly over the liver) and a difficult to palpate apex beat (all due to hyperinflation), decreased breath sounds, audible expiratory wheeze. Classically,clinical examination of an emphysematic patient reveals no overt crackles, however, in some patients the fine opening of airway 'popping' (dissimilar to the fine crackles of pulmonary fibrosis or coarse crackles of mucinous or oedematous fluid) can be auscultated. This is known as "Barclay's sign".
Extremities
Clinical signs on at the fingers include cigarette stains (although actually tar) and asterixis (metabolic flap) at the wrist if they are carbon dioxide retainers (NOTE: Finger clubbing is NOT a general feature of emphysema). Fluid overload can be seen in advanced disease, with pitting peripheral edema.
Signs
Emphysema patients are sometimes referred to as "pink puffers". This is because emphysema sufferers may hyperventilate to maintain adequate blood oxygen levels. Hyperventilation explains why mild emphysema patients do not appear cyanotic as chronic bronchitis (another COPD disorder) sufferers often do; hence they are "pink puffers" (able to maintain almost normal blood gases through hyperventilation) and not "blue bloaters" (cyanosis; inadequate oxygen in the blood). However, any severely chronically obstructed (COPD) respiratory disease will result in hypoxia (decreased blood partial pressure of oxygen) and hypercapnia (increased blood partial pressure of Carbon Dioxide); so called Blue Bloaters. Blue Bloaters are so named as they have almost normal ventilatory drive (due to decreased sensitivity to carbon dioxide secondary to chronic hypercapnia), are plethoric (red face/cheeks due to a polycythemia secondary to chronic hypoxia) and cyanotic (due to decreased hemoglobin saturation).