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Respiratory Exam

Lung Cancer

July 1st, 2020


  • Signs of Lung Cancer

  • General Signs

  • Oxygen
  • Respiratory distress - tachypnoea, pursed lip breathing, accessory muscle use, intercostal / subcostal recession
  • Cough
  • Sputum - purulent, bloody
  • Lymphadenopathy - cervical, supraclavicular, axillary
  • Signs of Complications

  • Pleural effusion - dull percussion note, reduced breath sounds, reduced vocal resonance
  • Laryngeal nerve involvement - hoarse voice, dysphonic cough
  • SVC obstruction - facial swelling, plethora, upper limb oedema, positive Pemberton's sign
  • Pancoast tumour - Horner's syndrome (partial ptosis, miosis, anhydrosis), wasting of the small muscles of the hand
  • Hypertrophic pulmonary osteodystrophy
  • Signs of Management

  • Scars - from lobectomy or pneumonectomy
  • Radiation tattoos


  • Risk Factors for Lung Cancer

  • Genetic factors
  • Smoking (active or passive)
  • Air pollution
  • Occupational exposure - asbestosis, silicosis,
  • Chronic scarring - interstitial lung disease, tuberculosis, COPD
  • Alcohol


  • Complications of Lung Cancer

  • Pleural effusion
  • Metastases - brain, liver, adrenal, bone
  • Local compression - SVC obstruction, sympathetic chain compression (Pancoast tumour) , laryngeal nerve palsy, phrenic nerve palsy, brachial plexopathy
  • Paraneoplastic syndromes - hypercalcaemia, SIADH, Cushing's, hypertrophic pulmonary osteoarthropathy, neurologic syndromes
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