Archive:COPD Examination - Revision history

wikademia>Wikademia: moved COPD Examination to Archive:COPD Examination

2009-06-08T17:56:19Z

moved COPD Examination to Archive:COPD Examination

← Older revision	Revision as of 17:56, 8 June 2009
(No difference)

wikademia>Wikademia at 01:20, 21 April 2009

2009-04-21T01:20:50Z

← Older revision		Revision as of 01:20, 21 April 2009
Line 5:		Line 5:
	Chronic bronchitis - airway narrowing and mucous production		Chronic bronchitis - airway narrowing and mucous production
	*chronic cough		*chronic cough
			{{ntnes}}

	And now a stepwise approach to the OSCE examination		And now a stepwise approach to the OSCE examination

wikademia>Wikademia: 12 revisions

2009-04-21T01:14:29Z

12 revisions

← Older revision	Revision as of 01:14, 21 April 2009
(No difference)

wikademia>HenkvD: Removed category "Respiratory Medicine"; Quick-adding category "Respiratory medicine" (using HotCat)

2009-03-09T20:52:04Z

Removed category "Respiratory Medicine"; Quick-adding category "Respiratory medicine" (using HotCat)

← Older revision		Revision as of 20:52, 9 March 2009
Line 97:		Line 97:
	{{OSCE2}}		{{OSCE2}}
	[[Category:OSCE]]		[[Category:OSCE]]
	~~[[Category: Respiratory Medicine]]~~
	[[Category: Clinical Skills]]		[[Category: Clinical Skills]]
			[[Category:Respiratory medicine]]

wikademia>Donek at 00:12, 25 June 2008

2008-06-25T00:12:22Z

← Older revision		Revision as of 00:12, 25 June 2008
Line 97:		Line 97:
	{{OSCE2}}		{{OSCE2}}
	[[Category:OSCE]]		[[Category:OSCE]]
	[[Category:Medicine]]		[[Category: Respiratory Medicine]]
			[[Category: Clinical Skills]]

82.39.96.218: /* Inspection */

2008-04-19T15:57:34Z

Inspection

← Older revision		Revision as of 15:57, 19 April 2008
Line 31:		Line 31:
	**Central - look at lips, oral mucosa and tongue		**Central - look at lips, oral mucosa and tongue
	**Peripheral - nails, hands and feet		**Peripheral - nails, hands and feet
	*Look at fingers for ~~nicotine~~ stains and clubbing of fingernails		*Look at fingers for cigarette tar stains and clubbing of fingernails
	*Shape of chest		*Shape of chest
	**Chest wall deformities or trauma		**Chest wall deformities or trauma

209.57.32.30: /* CXR */

2007-10-20T10:41:04Z

CXR

← Older revision		Revision as of 10:41, 20 October 2007
Line 71:		Line 71:
	*hyperinflated lungs with flattened diaphragms		*hyperinflated lungs with flattened diaphragms
	*retrosternal airspace		*retrosternal airspace
	*heart ~~sahdow~~ long and narrow or enlarged if RVF/cor pulmonale		*heart shadow long and narrow or enlarged if RVF/cor pulmonale
	*may see bullae with emphysema		*may see bullae with emphysema

wikademia>Koppertone at 23:27, 17 May 2007

2007-05-17T23:27:12Z

← Older revision		Revision as of 23:27, 17 May 2007
Line 1:		Line 1:
	Before you start some definitions		==Before you start some definitions==

	Emphysema - dilation and destruction of air spaces distal to bronchioles		Emphysema - dilation and destruction of air spaces distal to bronchioles
Line 11:		Line 11:
	1. Knock on the door, walk in and introduce yourself. Wash hands and make sure the patient is comfortable then begin the examination.		1. Knock on the door, walk in and introduce yourself. Wash hands and make sure the patient is comfortable then begin the examination.

	2. General		==General==
	*ABCs		*ABCs
	**as a general rule, if the patient can talk to you their airway and breathing are okay		**as a general rule, if the patient can talk to you their airway and breathing are okay
Line 27:		Line 27:
	**Tracheal tug		**Tracheal tug

	3. Inspection		==Inspection==
	*Look for cyanosis		*Look for cyanosis
	**Central - look at lips, oral mucosa and tongue		**Central - look at lips, oral mucosa and tongue
Line 38:		Line 38:
	*Look for intercostal, subcostal and supraclavicular indrawing		*Look for intercostal, subcostal and supraclavicular indrawing

	4. Palpation		==Palpation==
	*Feel for tracheal position and presence of a downward tug		*Feel for tracheal position and presence of a downward tug
	*Feel for range and symmetry of movement on inspiration - decreased range with hyperinflated lungs of COPD		*Feel for range and symmetry of movement on inspiration - decreased range with hyperinflated lungs of COPD
	*Feel for tactile fremitus - decreased in COPD		*Feel for tactile fremitus - decreased in COPD

	5. Percussion		==Percussion==
	*Percuss anterior and posterior, comparing left to right - hyperresonance with COPD		*Percuss anterior and posterior, comparing left to right - hyperresonance with COPD
	*Estimate diaphragmatic excursion by noting the difference in the level of dullness on percussion with inspiration and expiration - normal is 5-6cm, but is decreased with hyperinflated lungs of COPD		*Estimate diaphragmatic excursion by noting the difference in the level of dullness on percussion with inspiration and expiration - normal is 5-6cm, but is decreased with hyperinflated lungs of COPD

	6. Auscultation		==Auscultation==
	*listen to each of the five lung lobes and compare findings between sides		*listen to each of the five lung lobes and compare findings between sides
	**Air entry - decreased in COPD		**Air entry - decreased in COPD
Line 55:		Line 55:
	***loud vs soft		***loud vs soft

	7. Make diagnoses		==Make diagnoses==

	Differences between emphysema and chronic bronchitis on exam:		==Differences between emphysema and chronic bronchitis on exam==
	*Inspection		===Inspection===
	**emphysema: pink puffer (SOB and tachypnea), hyperinflation, SOBOE, respiratory distress		*emphysema: pink puffer (SOB and tachypnea), hyperinflation, SOBOE, respiratory distress
	**chronic bronchitis: blue bloater, cyanotic, peripheral edema (RVF), mild SOB post cough		*chronic bronchitis: blue bloater, cyanotic, peripheral edema (RVF), mild SOB post cough
	*Percussion		===Percussion===
	**emphysema: hyperresonant, decreased diaphragmatic excursion		*emphysema: hyperresonant, decreased diaphragmatic excursion
	**chronic bronchitis: normal		*chronic bronchitis: normal
	*Auscultation		===Auscultation===
	**emphysema: decreased breath sounds, no egophony		*emphysema: decreased breath sounds, no egophony
	**chronic bronchitis: crackles and wheezes		*chronic bronchitis: crackles and wheezes

	*CXR:		==CXR==
	**hyperinflated lungs with flattened diaphragms		*hyperinflated lungs with flattened diaphragms
	**retrosternal airspace		*retrosternal airspace
	**heart sahdow long and narrow or enlarged if RVF/cor pulmonale		*heart sahdow long and narrow or enlarged if RVF/cor pulmonale
	**may see bullae with emphysema		*may see bullae with emphysema

	*ABGs		==ABGs==
	**both have decreased PaO2 and increased PaCO2 (retainers) (low pH) but chronic bronchitis is worse than emphysema.		*both have decreased PaO2 and increased PaCO2 (retainers) (low pH) but chronic bronchitis is worse than emphysema.

	*CBC		==CBC==
	**Hct normal in emphysema, increased in CB		*Hct normal in emphysema, increased in CB

	*PFTs		==PFTs==
	**Emphysema		*Emphysema
	***TLC increased (barrel chest)		**TLC increased (barrel chest)
	***RV increased		**RV increased
	***VC decreased		**VC decreased
	***FEV1 < 50%		**FEV1 < 50%
	***DLCO decreased (because alveoli destroyed)		**DLCO decreased (because alveoli destroyed)
	**Chronic bronchitis		*Chronic bronchitis
	***TLC normal		**TLC normal
	***RV slightly increased		**RV slightly increased
	***VC slightly decreased		**VC slightly decreased
	***FEV1 < 50%		**FEV1 < 50%
	***DLCO slightly decreased or normal		**DLCO slightly decreased or normal
	**cor pulmonale if FEV1 < 25%		*cor pulmonale if FEV1 < 25%
	==Other OSCE modules==		==Other OSCE modules==
	{{OSCE2}}		{{OSCE2}}
	[[Category:OSCE]]		[[Category:OSCE]]
	[[Category:Medicine]]		[[Category:Medicine]]

wikademia>JWSchmidt: {{OSCE2}}

2007-05-12T19:06:17Z

← Older revision		Revision as of 19:06, 12 May 2007
Line 94:		Line 94:
	***DLCO slightly decreased or normal		***DLCO slightly decreased or normal
	**cor pulmonale if FEV1 < 25%		**cor pulmonale if FEV1 < 25%
			==Other OSCE modules==
			{{OSCE2}}
	[[Category:OSCE]]		[[Category:OSCE]]
	[[Category:Medicine]]		[[Category:Medicine]]

wikademia>Palmd001 at 03:11, 11 May 2007

2007-05-11T03:11:46Z

← Older revision		Revision as of 03:11, 11 May 2007
Line 95:		Line 95:
	**cor pulmonale if FEV1 < 25%		**cor pulmonale if FEV1 < 25%
	[[Category:OSCE]]		[[Category:OSCE]]
			[[Category:Medicine]]