Pneumonia physical examination

Pneumonia Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Pneumonia from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Criteria
Diagnostic Algorithm
History and Symptoms
Physical Examination
Laboratory Findings
Chest X Ray
CT
Other Imaging Findings
Treatment
Medical Therapy
Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Pneumonia physical examination On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Pneumonia physical examination All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Pneumonia physical examination
CDC onPneumonia physical examination
Pneumonia physical examination in the news
Blogs on Pneumonia physical examination
Directions to Hospitals Treating Pneumonia
Risk calculators and risk factors for Pneumonia physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hamid Qazi, MD, BSc [2], Priyamvada Singh, M.D. [3]

Overview

Physical examination may 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. Patients who have difficulty breathing, 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. 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

The physical exam findings for pneumonia are as follows:

• Physical examination of patients with [disease name] is usually normal.

OR

• Physical examination of patients with [disease name] is usually remarkable for:[finding 1], [finding 2], and [finding 3].
• The presence of [finding(s)] on physical examination is diagnostic of [disease name].
• The presence of [finding(s)] on physical examination is highly suggestive of [disease name].

Appearance of the Patient

• Patients with pneumonia usually appear normal or in distress.

Vital Signs

Criteria for Tachypnea Age Breaths/min < 2 months > 60 2-12 months > 50 1- 5 years > 40 > 5 years > 20

• Decreased oxygen saturation
• Fever
• Hypotension < 90 mm Hg
• Tachycardia > 125 beats/min
• Tachypnea

Skin

• Skin examination of patients with pneumonia is usually normal.

HEENT

• HEENT examination of patients with pneumonia is usually normal.

Neck

• Neck examination of patients with pneumonia is usually normal.

Lungs

Palpation

• Increased tactile fremitus

Percussion

• Dullness on percussion

Auscultation

• Decreased breath sounds
• Bronchial breath sounds
• Rhonchi
• Crackles, Rales
• Increased vocal fremitus

Heart

• Cardiovascular examination of patients with pneumonia is usually normal.

Abdomen

Abdominal examination of patients with pneumonia is usually normal.

Back

• Back examination of patients with pneumonia is usually normal.

Genitourinary

• Genitourinary examination of patients with pneumonia is usually normal.

Neuromuscular

• Neuromuscular examination of patients with pneumonia is usually normal.

Extremities

• Extremities examination of patients with pneumonia is usually normal.