Adult bronchiolitis physical examination: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
No edit summary
 
(4 intermediate revisions by 2 users not shown)
Line 4: Line 4:


==Overview==
==Overview==
Patients with [disease name] usually appear [general appearance]. Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].
Patients with adult bronchiolitis usually appear lethargic. Physical examination of patients with adult bronchiolitis is usually remarkable for bilateral basilar lung crackles, [[tachypnea]], [[Wheeze|wheezing]] and sometimes, a low grade [[fever]].
 
OR
 
Common physical examination findings of [disease name] include [finding 1], [finding 2], and [finding 3].
 
OR
 
The presence of [finding(s)] on physical examination is diagnostic of [disease name].
 
OR
 
The presence of [finding(s)] on physical examination is highly suggestive of [disease name].


==Physical Examination==
==Physical Examination==
* Physical examination of patients with [disease name] is usually normal.
Patients with adult bronchiolitis usually appear lethargic. Physical examination of patients with adult bronchiolitis is usually remarkable for bilateral basilar lung crackles, [[tachypnea]], [[Wheeze|wheezing]] and sometimes, a low grade [[fever]].<ref name="pmid19129282">{{cite journal |vauthors=Devouassoux G, Cottin V, Lioté H, Marchand E, Frachon I, Schuller A, Béjui-Thivolet F, Cordier JF |title=Characterisation of severe obliterative bronchiolitis in rheumatoid arthritis |journal=Eur. Respir. J. |volume=33 |issue=5 |pages=1053–61 |date=May 2009 |pmid=19129282 |doi=10.1183/09031936.00091608 |url=}}</ref><ref name="pmid24806161">{{cite journal |vauthors=Barker AF, Bergeron A, Rom WN, Hertz MI |title=Obliterative bronchiolitis |journal=N. Engl. J. Med. |volume=370 |issue=19 |pages=1820–8 |date=May 2014 |pmid=24806161 |doi=10.1056/NEJMra1204664 |url=}}</ref>
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===
===Appearance of the Patient===
*Patients with [disease name] usually appear [general appearance].
*Lethargic and faitgue


===Vital Signs===
===Vital Signs===
 
*Low-grade [[fever]]
*High-grade / low-grade fever
*[[Tachypnea]]  
*[[Hypothermia]] / hyperthermia may be present
*[[Shallow breathing]]
*[[Tachycardia]] with regular pulse or (ir)regularly irregular pulse
*[[Bradycardia]] with regular pulse or (ir)regularly irregular pulse
*Tachypnea / bradypnea
*Kussmal respirations may be present in _____ (advanced disease state)
*Weak/bounding pulse / pulsus alternans / paradoxical pulse / asymmetric pulse
*High/low blood pressure with normal pulse pressure / [[wide pulse pressure]] / [[narrow pulse pressure]]


===Skin===
===Skin===
* Skin examination of patients with [disease name] is usually normal.
OR
*[[Cyanosis]]  
*[[Cyanosis]]  
*[[Jaundice]]
*Evidence of mineral dust or other material staining the skin
* [[Pallor]]
* Bruises
 
<gallery widths="150px">
 
UploadedImage-01.jpg | Description {{dermref}}
UploadedImage-02.jpg | Description {{dermref}}
 
</gallery>


===HEENT===
===HEENT===
* HEENT examination of patients with [disease name] is usually normal.
*Usually normal HEENT examination
OR
*Facial tenderness if experiencing [[Rhinosinusitis|sinusitis]]
* Abnormalities of the head/hair may include ___
* Evidence of trauma
* Icteric sclera
* [[Nystagmus]]
* Extra-ocular movements may be abnormal
*Pupils non-reactive to light / non-reactive to accommodation / non-reactive to neither light nor accommodation
*Ophthalmoscopic exam may be abnormal with findings of ___
* Hearing acuity may be reduced
*[[Weber test]] may be abnormal (Note: A positive Weber test is considered a normal finding / A negative Weber test is considered an abnormal finding. To avoid confusion, you may write "abnormal Weber test".)
*[[Rinne test]] may be positive (Note: A positive Rinne test is considered a normal finding / A negative Rinne test is considered an abnormal finding. To avoid confusion, you may write "abnormal Rinne test".)
* [[Exudate]] from the ear canal
* Tenderness upon palpation of the ear pinnae/tragus (anterior to ear canal)
*Inflamed nares / congested nares
* [[Purulent]] exudate from the nares
* Facial tenderness
* Erythematous throat with/without tonsillar swelling, exudates, and/or petechiae
 
===Neck===
* Neck examination of patients with [disease name] is usually normal.
OR
*[[Jugular venous distension]]
*[[Carotid bruits]] may be auscultated unilaterally/bilaterally using the bell/diaphragm of the otoscope
*[[Lymphadenopathy]] (describe location, size, tenderness, mobility, and symmetry)
*[[Thyromegaly]] / thyroid nodules
*[[Hepatojugular reflux]]


===Lungs===
===Lungs===
* Pulmonary examination of patients with [disease name] is usually normal.
*Fine [[crackles]] upon auscultation of the lung bases unilaterally or bilaterally
OR
*[[Rhonchi]]
* Asymmetric chest expansion / Decreased chest expansion
*Bronchial breathing
*Lungs are hypo/hyperresonant
*Expiratory wheezing with delayed expiratory phase
*Fine/coarse [[crackles]] upon auscultation of the lung bases/apices unilaterally/bilaterally
*Rhonchi
*Vesicular breath sounds / Distant breath sounds
*Expiratory/inspiratory wheezing with normal / delayed expiratory phase
*[[Wheezing]] may be present
*[[Wheezing]] may be present
*[[Egophony]] present/absent
*Fine [[rales]]
*[[Bronchophony]] present/absent
*May use [[Accessory muscles of respiration|accessory muscles]] to breathe
*Normal/reduced [[tactile fremitus]]
 
===Heart===
* Cardiovascular examination of patients with [disease name] is usually normal.
OR
*Chest tenderness upon palpation
*PMI within 2 cm of the sternum  (PMI) / Displaced point of maximal impulse (PMI) suggestive of ____
*[[Heave]] / [[thrill]]
*[[Friction rub]]
*[[Heart sounds#First heart tone S1, the "lub"(components M1 and T1)|S1]]
*[[Heart sounds#Second heart tone S2 the "dub"(components A2 and P2)|S2]]
*[[Heart sounds#Third heart sound S3|S3]]
*[[Heart sounds#Fourth heart sound S4|S4]]
*[[Heart sounds#Summation Gallop|Gallops]]
*A high/low grade early/late [[systolic murmur]] / [[diastolic murmur]] best heard at the base/apex/(specific valve region) may be heard using the bell/diaphgram of the otoscope
 
===Abdomen===
Abdominal examination of patients with [disease name] is usually normal.
 
OR
*[[Abdominal distention]]
*[[Abdominal tenderness]] in the right/left upper/lower abdominal quadrant
*[[Rebound tenderness]] (positive Blumberg sign)
*A palpable abdominal mass in the right/left upper/lower abdominal quadrant
*Guarding may be present
*[[Hepatomegaly]] / [[splenomegaly]] / [[hepatosplenomegaly]]
*Additional findings, such as obturator test, psoas test, McBurney point test, Murphy test
 
===Back===
* Back examination of patients with [disease name] is usually normal.
OR
*Point tenderness over __ vertebrae (e.g. L3-L4)
*Sacral edema
*Costovertebral angle tenderness bilaterally/unilaterally
*Buffalo hump
 
===Genitourinary===
* Genitourinary examination of patients with [disease name] is usually normal.
OR
*A pelvic/adnexal mass may be palpated
*Inflamed mucosa
*Clear/(color), foul-smelling/odorless penile/vaginal discharge
 
===Neuromuscular===
* Neuromuscular examination of patients with [disease name] is usually normal.
OR
*Patient is usually oriented to persons, place, and time
* Altered mental status
* Glasgow coma scale is ___ / 15
* Clonus may be present
* Hyperreflexia / hyporeflexia / areflexia
* Positive (abnormal) Babinski / plantar reflex unilaterally/bilaterally
* Muscle rigidity
* Proximal/distal muscle weakness unilaterally/bilaterally
* ____ (finding) suggestive of cranial nerve ___ (roman numerical) deficit (e.g. Dilated pupils suggestive of CN III deficit)
*Unilateral/bilateral upper/lower extremity weakness
*Unilateral/bilateral sensory loss in the upper/lower extremity
*Positive straight leg raise test
*Abnormal gait (describe gait: e.g. ataxic (cerebellar) gait / steppage gait / waddling gait / choeiform gait / Parkinsonian gait / sensory gait)
*Positive/negative Trendelenburg sign
*Unilateral/bilateral tremor (describe tremor, e.g. at rest, pill-rolling)
*Normal finger-to-nose test / Dysmetria
*Absent/present dysdiadochokinesia (palm tapping test)


===Extremities===
===Extremities===
* Extremities examination of patients with [disease name] is usually normal.
OR
*[[Clubbing]]  
*[[Clubbing]]  
*[[Cyanosis]]  
*[[Cyanosis]]
*Pitting/non-pitting [[edema]] of the upper/lower extremities
*Muscle atrophy
*Fasciculations in the upper/lower extremity
 
 


==References==
==References==

Latest revision as of 13:30, 5 April 2018

Adult bronchiolitis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Occupational lung disease from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Adult bronchiolitis physical examination On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Adult bronchiolitis 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 Adult bronchiolitis physical examination

CDC on Adult bronchiolitis physical examination

Adult bronchiolitis physical examination in the news

Blogs on Adult bronchiolitis physical examination


Risk calculators and risk factors for Adult bronchiolitis physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]

Overview

Patients with adult bronchiolitis usually appear lethargic. Physical examination of patients with adult bronchiolitis is usually remarkable for bilateral basilar lung crackles, tachypnea, wheezing and sometimes, a low grade fever.

Physical Examination

Patients with adult bronchiolitis usually appear lethargic. Physical examination of patients with adult bronchiolitis is usually remarkable for bilateral basilar lung crackles, tachypnea, wheezing and sometimes, a low grade fever.[1][2]

Appearance of the Patient

  • Lethargic and faitgue

Vital Signs

Skin

  • Cyanosis
  • Evidence of mineral dust or other material staining the skin

HEENT

  • Usually normal HEENT examination
  • Facial tenderness if experiencing sinusitis

Lungs

  • Fine crackles upon auscultation of the lung bases unilaterally or bilaterally
  • Rhonchi
  • Bronchial breathing
  • Expiratory wheezing with delayed expiratory phase
  • Wheezing may be present
  • Fine rales
  • May use accessory muscles to breathe

Extremities

References

  1. ↑ Devouassoux G, Cottin V, Lioté H, Marchand E, Frachon I, Schuller A, Béjui-Thivolet F, Cordier JF (May 2009). "Characterisation of severe obliterative bronchiolitis in rheumatoid arthritis". Eur. Respir. J. 33 (5): 1053–61. doi:10.1183/09031936.00091608. PMID 19129282.
  2. ↑ Barker AF, Bergeron A, Rom WN, Hertz MI (May 2014). "Obliterative bronchiolitis". N. Engl. J. Med. 370 (19): 1820–8. doi:10.1056/NEJMra1204664. PMID 24806161.
Retrieved from "https://www.wikidoc.org/index.php?title=Adult_bronchiolitis_physical_examination&oldid=1459322"