Respiratory failure physical examination: Difference between revisions
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==Physical Examination== | ==Physical Examination== | ||
Physical examination of patients with respiratory failure is as follows:<ref name="pmid10559098">{{cite journal |vauthors=Rubenfeld GD, Caldwell E, Granton J, Hudson LD, Matthay MA |title=Interobserver variability in applying a radiographic definition for ARDS |journal=Chest |volume=116 |issue=5 |pages=1347–53 |date=November 1999 |pmid=10559098 |doi= |url=}}</ref><ref name="pmid3298678">{{cite journal |vauthors=Gattinoni L, Presenti A, Torresin A, Baglioni S, Rivolta M, Rossi F, Scarani F, Marcolin R, Cappelletti G |title=Adult respiratory distress syndrome profiles by computed tomography |journal=J Thorac Imaging |volume=1 |issue=3 |pages=25–30 |date=July 1986 |pmid=3298678 |doi= |url=}}</ref><ref name="pmid10559098">{{cite journal |vauthors=Rubenfeld GD, Caldwell E, Granton J, Hudson LD, Matthay MA |title=Interobserver variability in applying a radiographic definition for ARDS |journal=Chest |volume=116 |issue=5 |pages=1347–53 |date=November 1999 |pmid=10559098 |doi= |url=}}</ref> | |||
===Appearance of the Patient=== | ===Appearance of the Patient=== | ||
Patients with respiratory failure usually appear distressed with altered mental status | Patients with respiratory failure usually appear distressed with altered mental status | ||
===Vital Signs=== | ===Vital Signs=== | ||
| Line 20: | Line 22: | ||
*Bruises | *Bruises | ||
**May be due to insult to the neck or thorax | **May be due to insult to the neck or thorax | ||
*Clubbing | |||
*Rashes | |||
===HEENT=== | ===HEENT=== | ||
| Line 25: | Line 29: | ||
*Ophthalmoscopic exam may be abnormal with findings of papilledema | *Ophthalmoscopic exam may be abnormal with findings of papilledema | ||
*Flared nares | *Flared nares | ||
*Nasal polyps | |||
===Neck=== | ===Neck=== | ||
Bruises may be noted | *Bruises may be noted | ||
*Elevated jugular venous pulse | |||
===Lungs=== | ===Lungs=== | ||
Fine [[crackles]] upon auscultation of the lung | *Fine [[crackles]] upon auscultation of the lung bases bilaterally | ||
*Evidence of preexisting lung disease may also be present such as: | |||
**Paradoxical thoraco-abdominal breathing | |||
**Wheeze and breath sounds are typically absent secondary to severe airway obstruction, representing a silent chest which is an ominous sign. | |||
**Persistent scattered rhonchi | |||
**Prolonged expiration and wheezing | |||
**Diffusely decreased breath sound | |||
**Coarse crackles with inspiration | |||
===Neuromuscular=== | ===Neuromuscular=== | ||
| Line 37: | Line 50: | ||
===Extremities=== | ===Extremities=== | ||
[[Cyanosis]] | *[[Cyanosis]] | ||
*Peripheral edema | |||
==References== | ==References== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]
Overview
Patients with respiratory failure usually appear distressed with altered mental status. Physical examination of patients with respiratory failure is usually remarkable for dyspnea, stridor, and tachypnea.
Physical Examination
Physical examination of patients with respiratory failure is as follows:[1][2][1]
Appearance of the Patient
Patients with respiratory failure usually appear distressed with altered mental status
Vital Signs
- Tachycardia
- Arrhythmia
- Tachypnea
Skin
- Cyanosis
- Bruises
- May be due to insult to the neck or thorax
- Clubbing
- Rashes
HEENT
- Evidence of trauma
- Ophthalmoscopic exam may be abnormal with findings of papilledema
- Flared nares
- Nasal polyps
Neck
- Bruises may be noted
- Elevated jugular venous pulse
Lungs
- Fine crackles upon auscultation of the lung bases bilaterally
- Evidence of preexisting lung disease may also be present such as:
- Paradoxical thoraco-abdominal breathing
- Wheeze and breath sounds are typically absent secondary to severe airway obstruction, representing a silent chest which is an ominous sign.
- Persistent scattered rhonchi
- Prolonged expiration and wheezing
- Diffusely decreased breath sound
- Coarse crackles with inspiration
Neuromuscular
- Altered mental status
- Clonus may be present
Extremities
- Cyanosis
- Peripheral edema
References
- ↑ 1.0 1.1 Rubenfeld GD, Caldwell E, Granton J, Hudson LD, Matthay MA (November 1999). "Interobserver variability in applying a radiographic definition for ARDS". Chest. 116 (5): 1347–53. PMID 10559098.
- ↑ Gattinoni L, Presenti A, Torresin A, Baglioni S, Rivolta M, Rossi F, Scarani F, Marcolin R, Cappelletti G (July 1986). "Adult respiratory distress syndrome profiles by computed tomography". J Thorac Imaging. 1 (3): 25–30. PMID 3298678.