Pleural Effusions

For the purpose of physical examination, the chest is divided into different areas in order to allow for anatomical localization lezije.Prednji part is divided into supraclavicular, infraclavicular, dairy and inframammary regijama.Bočni aspect is divided into the axillary and infra-axillary region and the back is divided into suprascapular, interscapular, and infrascapular regions. Physical examination is conducted in a series of inspections on palpation, percussion and auscultation. Measurement of the breast to spread a simple and reliable way to assess clinical ventilatory capacity, the normal expansion in adults ranges from 6-8cm.

Drums:

Note raised percussion and vibration felt pleximeter finger gives valuable clues to the state of the underlying lung and pleura. By percussion is possible to estimate the relative proportion of air, solid tissues or fluids beneath the surface.

The clinical significance of changes in the percussion note

Normal lung - Resonant normal
Hollow Viscus, penumothorax - Tympanitic
Moderate pneumothorax, emphysema, bullae - Hyper-resonant
Consolidation, collapse, fibro-thorax - Impaired resonance to moderate numbness
Pleural effusion, emphysema, obese fibrothorax - stony dullness.

Special forms of percussion including "tidal percussion" and "removal of shifting dullness." The former is employed to distinguish between numbness caused by the upper limit of the liver caused by pleural fluid or consolidation of the lower lung. Changing the numbness occurs when the fluid is free to move with the changing position of the patient. This happens in hydropneumothorax or large cavity containing fluid and air.

Auscultatory finding:

Breath sounds, vocal resonance and whispering pectoriloquy are replaced by auscultation. Breath sounds are produced oscillations set in the larger airways (trachea and bronchi greater) by turbulent airflow. Throughout most of the airways is the character of breath sounds bronchus. In the lower regions of the lung parenchyma acts as a lowpass filter that filters the higher frequency components (200 Hz and above) and to alter the character of breath sounds vesicular. When the filtering effect is lost, the sound is transferred directly to the chest and breath sounds become bronchi. This happens in the consolidation of the lungs. This is the acoustic basis bronchophony pectoriloquy and whispering as well. Adventitious sounds heard during auscultation can be "wheezes" (formerly called "rhonchi") and "crackles" (used to be known as "crepitations ").

breath sounds:

adventitious sounds continuously or interrupted. "Continuous adventitious sounds" include:

• stridor occurs in the larynx and bronchial obstruction and
• "wheezes" resulting from narrowed airways interrupted adventitious sounds are crackles (which can be fine, medium or coarse), and pleural rubs. Crackles (crepitations) are products of explosive gas pressure equilibration between the boluses of air into the airflow and sequestial open the airway during the respiratory cycle. Coarse crepitations May be due to the presence of exudates in the larger airways, and these disappear with cough and sputum production.

Physical examination of pulmonary clinical cases is very interesting, though, is not as easy as it sounds May. They require the technicalities.

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