Respiratory Exam
Respiratory Exam

Chronic Obstructive Pulmonary Disease



  • Several clinical signs allow for the clinical suspicion of chronic obstructive pulmonary disease, which can then be confirmed with pulmonary function testing.
    • Signs of Chronic Obstruction Pulmonary Disease

    • General Signs

    • Respiratory distress - tachypnoea, pursed lip breathing, accessory muscle use, intercostal / subcostal recession
    • Barrel chest (emphysema)
    • Tar-stained fingers (smoking)
    • Asterixis (CO2 retention)
    • Reduced chest expansion
    • Reduced breath sounds
    • Wheeze
    • Signs of Complications

    • Infective exacerbation - fevers, green sputum
    • Cor pulmonale - raised JVP, ascites, pleural effusions, peripheral oedema
    • Pulmonary hypertension - prominent a wave, parasternal heave, loud / palpable P2
    • Polycythaemia - polycythaemic facies
    • Steroid complications - Cushing’s syndrome, oral candidiasis
    • Signs of Management

    • Oxygen
    • Inhalers
    • Lung transplant scar


    • Risk Factors for COPD

    • Smoking
    • Occupational exposure - coal, toluene (plastics)
    • Environmental air pollution
    • Alpha-1 antitrypsin deficiency


    • Complications of COPD

    • Disease-Related

    • Pneumonia
    • Cor pulmonale
    • Pulmonary hypertension
    • Pneumothorax
    • Respiratory failure
    • Polycythaemia
    • Treatment-Related

    • Cushing’s syndrome (steroids)
    • Oral candidiasis (steroids)
    • Tremor (beta agonists)
Last updated on November 25th, 2019
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