Atelectasis physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sudarshana Datta, MD [2]

Overview

Patients with atelectasis usually have non specific signs on physical examination. Physical examination of patients with atelectasis is usually remarkable for decreased chest expansion, mediastinal displacement towards the affected side and elevation of the diaphragm. Patients may develop dullness to percussion over the involved area, wheezing and diminished or absent breath sounds on auscultation.

Physical Examination

Appearance of the Patient

• Patients with atelectasis usually appear normal with non specific signs on physical exam.

Vital Signs

• Hypotension
• Tachycardia
• Fever
• Tachypnea

Lung

• Inspection:
  • Decreased chest expansion
  • Mediastinal and cardiac displacement towards the affected side
  • Elevation of the diaphragm
• Palpation:
  • Decreased chest excursion of the involved hemithorax
• Percussion:
  • Dullness to percussion over the involved area
• Auscultation:
  • Diminished or absent breath sounds
  • Lungs are hyporesonant
  • Rhonchi may be heard
  • Wheezing may be present

Neck

• Neck examination of patients with atelectasis is usually normal.

• Tracheal deviation towards the affected side may be visible.

Heart

• Cardiovascular examination of patients with atelectasis is usually normal.

Extremities

• Cyanosis (late sign)