Chronic Obstructive Pulmonary Disease | Respiratory Exam - MedSchool
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Respiratory Exam
 
 
Respiratory Exam
Several clinical signs allow for the clinical suspicion of chronic obstructive pulmonary disease, which can then be confirmed with pulmonary function testing.
The Patient
Hands
Arms
Face
Neck
Chest Inspection
Chest Palpation
Chest Percussion
Chest Auscultation
 

Chronic Obstructive Pulmonary Disease

 
 
On this page:PathogenesisComplications

Overview

  • 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

Pathogenesis

    • Risk Factors for COPD

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

Complications

    • 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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