Chronic bronchitis physical examination
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Chronic bronchitis can be diagnostically evaluated by physical examination through auscultation. Physical examination is quite specific and sensitive for severe disease. The signs are usually difficult to detect in cases of mild to moderate diseases. Findings on general physical examination can be cyanosis, tachypnea, use of accessory respiratory muscles, paradoxical indrawing of lower intercostal spaces is evident (known as the Hoover's sign), elevated jugular venous pulse, and peripheral edema. Pulmonary examination findings include: barrel chest (emphysema), wheezing, hyperresonance, crackles and rhonchi.
Appearance of the Patient
- Typically overweight
- Cyanosis, typically in lips and fingers
- Elevated jugular venous pulse (JVP)
- Respiratory distress indicated by use of accessory respiratory muscles
- Hoover's sign, presenting as paradoxical indrawing of lower intercostal spaces, is evident
- Prolonged expiration; wheezing
- Diffusely decreased breath sound
- Coarse crackles with inspiration
- Coarse rhonchi
- Mehta GR, Mohammed R, Sarfraz S, Khan T, Ahmed K, Villareal M, Martinez D, Iskander J, Mohammed R (2016). "Chronic obstructive pulmonary disease: A guide for the primary care physician". Dis Mon. 62 (6): 164–87. doi:10.1016/j.disamonth.2016.03.002. PMID 27087562.
- Badgett RG, Tanaka DJ, Hunt DK, Jelley MJ, Feinberg LE, Steiner JF, Petty TL (1993). "Can moderate chronic obstructive pulmonary disease be diagnosed by historical and physical findings alone?". Am. J. Med. 94 (2): 188–96. PMID 8430714.