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| __NOTOC__ | | __NOTOC__ |
| {{Atelectasis}} | | {{Atelectasis}} |
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| | {{CMG}} {{AE}} {{Cherry}} |
| | ==Overview== |
| | Patients with atelectasis usually have non specific signs on physical examination. Physical examination of patients with atelectasis is usually remarkable for decreased [[Respiratory examination|chest expansion]], mediastinal displacement towards the affected side and elevation of the [[Thoracic diaphragm|diaphragm]]. Patients may develop dullness to percussion over the involved area, [[Wheeze|wheezing]] and diminished or absent breath sounds on [[auscultation]]. |
| | ==Physical Examination== |
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| {{CMG}} | | ===Appearance of the Patient=== |
| | | *Patients with atelectasis usually appear normal with non specific signs on physical exam.<ref name="pmid12531090">{{cite journal |vauthors=Peroni DG, Boner AL |title=Atelectasis: mechanisms, diagnosis and management |journal=Paediatr Respir Rev |volume=1 |issue=3 |pages=274–8 |year=2000 |pmid=12531090 |doi=10.1053/prrv.2000.0059 |url=}}</ref> |
| ==Physical Examination== | |
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| ===Vital Signs=== | | ===Vital Signs=== |
| * Low [[oxygen saturation]], | | * [[Hypotension]] |
| | * [[Tachycardia]] |
| * [[Fever]] | | * [[Fever]] |
| * [[Tachycardia]] or increased heart rate | | * [[Tachypnea]] |
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| ===Lung=== | | ===Lung=== |
| * [[Pleural effusion]] (transudate type) | | * Inspection: |
| | | ** Decreased [[Respiratory examination|chest expansion]] |
| ===Extremities===
| | ** Mediastinal and cardiac displacement towards the affected side |
| *[[Cyanosis]] (late sign) | | ** Elevation of the [[Thoracic diaphragm|diaphragm]] |
| | | * Palpation: |
| Physical exam
| | ** Decreased chest excursion of the involved hemithorax |
| Hypotension
| | * Percussion: |
| Tachycardia
| | ** Dullness to percussion over the involved area |
| Fever
| | * Auscultation: |
| Shock
| | ** Diminished or absent breath sounds |
| | | ** Lungs are hyporesonant |
| | | ** [[Rhonchi]] may be heard |
| The signs and symptoms of atelectasis are often non-specific:
| | ** [[Wheezing]] may be present |
| | |
| Signs of atelectasis:
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| Tachypnoea
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| | |
| reduced breath sounds
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| constant wheeze
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| reduced chest wall expansion
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| wheeze
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| cyanosis
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| asphyxia
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| mediastinal and cardiac displacement
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| elevation of the diaphragm.
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| SIGNS
| |
| Physical Examination
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| Dullness to percussion over the involved area
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| Diminished or absent breath sounds
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| Decreased chest excursion of the involved hemithorax
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| Mediastinal deviation towards the affected side
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| ==Physical Examination==
| |
| * 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 [disease name] usually appear [general appearance].
| |
| | |
| ===Vital Signs===
| |
| | |
| *High-grade / low-grade fever
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| *[[Hypothermia]] / hyperthermia may be present
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| *[[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]]
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| | |
| ===Skin===
| |
| * Skin examination of patients with [disease name] is usually normal.
| |
| OR
| |
| *[[Cyanosis]] | |
| *[[Jaundice]] | |
| * [[Pallor]] | |
| * Bruises
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| | |
| <gallery widths="150px">
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| | |
| UploadedImage-01.jpg | Description {{dermref}}
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| UploadedImage-02.jpg | Description {{dermref}}
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| | |
| </gallery>
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| | |
| ===HEENT===
| |
| * HEENT examination of patients with [disease name] is usually normal.
| |
| OR
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| * 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
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| * Tenderness upon palpation of the ear pinnae/tragus (anterior to ear canal)
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| *Inflamed nares / congested nares
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| * [[Purulent]] exudate from the nares
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| * Facial tenderness
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| * Erythematous throat with/without tonsillar swelling, exudates, and/or petechiae
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| ===Neck=== | | ===Neck=== |
| * Neck examination of patients with [disease name] is usually normal. | | * Neck examination of patients with atelectasis is usually normal. |
| OR
| |
| *[[Jugular venous distension]]
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| *[[Carotid bruits]] may be auscultated unilaterally/bilaterally using the bell/diaphragm of the otoscope
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| *[[Lymphadenopathy]] (describe location, size, tenderness, mobility, and symmetry)
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| *[[Thyromegaly]] / thyroid nodules
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| *[[Hepatojugular reflux]]
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| ===Lungs===
| | *[[Tracheal deviation]] towards the affected side may be visible. |
| * Pulmonary examination of patients with [disease name] is usually normal. | |
| OR
| |
| * Asymmetric chest expansion / Decreased chest expansion
| |
| *Lungs are hypo/hyperresonant
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| *Fine/coarse [[crackles]] upon auscultation of the lung bases/apices unilaterally/bilaterally
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| *Rhonchi
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| *Vesicular breath sounds / Distant breath sounds
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| *Expiratory/inspiratory wheezing with normal / delayed expiratory phase
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| *[[Wheezing]] may be present
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| *[[Egophony]] present/absent
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| *[[Bronchophony]] present/absent
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| *Normal/reduced [[tactile fremitus]]
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| ===Heart=== | | ===Heart=== |
| * Cardiovascular examination of patients with [disease name] is usually normal.
| | * [[Cardiovascular|Cardiovascular examination]] of patients with atelectasis is usually normal. |
| OR
| |
| *Chest tenderness upon palpation
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| *PMI within 2 cm of the sternum (PMI) / Displaced point of maximal impulse (PMI) suggestive of ____
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| *[[Heave]] / [[thrill]] | |
| *[[Friction rub]]
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| *[[Heart sounds#First heart tone S1, the "lub"(components M1 and T1)|S1]]
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| *[[Heart sounds#Second heart tone S2 the "dub"(components A2 and P2)|S2]]
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| *[[Heart sounds#Third heart sound S3|S3]]
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| *[[Heart sounds#Fourth heart sound S4|S4]]
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| *[[Heart sounds#Summation Gallop|Gallops]]
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| *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
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| | |
| ===Abdomen===
| |
| Abdominal examination of patients with [disease name] is usually normal.
| |
| | |
| OR
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| *[[Abdominal distention]]
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| *[[Abdominal tenderness]] in the right/left upper/lower abdominal quadrant
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| *[[Rebound tenderness]] (positive Blumberg sign)
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| *A palpable abdominal mass in the right/left upper/lower abdominal quadrant
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| *Guarding may be present
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| *[[Hepatomegaly]] / [[splenomegaly]] / [[hepatosplenomegaly]]
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| *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)
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| *Sacral edema
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| *Costovertebral angle tenderness bilaterally/unilaterally
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| *Buffalo hump
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| | |
| ===Genitourinary===
| |
| * Genitourinary examination of patients with [disease name] is usually normal.
| |
| OR
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| *A pelvic/adnexal mass may be palpated
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| *Inflamed mucosa
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| *Clear/(color), foul-smelling/odorless penile/vaginal discharge
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| | |
| ===Neuromuscular===
| |
| * Neuromuscular examination of patients with [disease name] is usually normal.
| |
| OR
| |
| *Patient is usually oriented to persons, place, and time
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| * Altered mental status
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| * Glasgow coma scale is ___ / 15
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| * Clonus may be present
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| * Hyperreflexia / hyporeflexia / areflexia
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| * Positive (abnormal) Babinski / plantar reflex unilaterally/bilaterally
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| * Muscle rigidity
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| * Proximal/distal muscle weakness unilaterally/bilaterally
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| * ____ (finding) suggestive of cranial nerve ___ (roman numerical) deficit (e.g. Dilated pupils suggestive of CN III deficit)
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| *Unilateral/bilateral upper/lower extremity weakness
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| *Unilateral/bilateral sensory loss in the upper/lower extremity
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| *Positive straight leg raise test
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| *Abnormal gait (describe gait: e.g. ataxic (cerebellar) gait / steppage gait / waddling gait / choeiform gait / Parkinsonian gait / sensory gait)
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| *Positive/negative Trendelenburg sign
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| *Unilateral/bilateral tremor (describe tremor, e.g. at rest, pill-rolling)
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| *Normal finger-to-nose test / Dysmetria
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| *Absent/present dysdiadochokinesia (palm tapping test)
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| | |
| ===Extremities=== | | ===Extremities=== |
| * Extremities examination of patients with [disease name] is usually normal.
| | * [[Cyanosis]] (late sign) |
| OR
| |
| *[[Clubbing]]
| |
| *[[Cyanosis]] | |
| *Pitting/non-pitting [[edema]] of the upper/lower extremities
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| *Muscle atrophy
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| *Fasciculations in the upper/lower extremity
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| | |
| ==References== | | ==References== |
| {{Reflist|2}} | | {{Reflist|2}} |