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CLINICAL APPROACH TO PATIENT WITH RESPIRATORY DISEASE

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CLINICAL APPROACH TO PATIENT WITH RESPIRATORY DISEASE Dr. Hayat Kamfar Dr. Saad Alsaedi Pediatric department Continue .symptom Hemoptysis (coughing bloody sputum ... – PowerPoint PPT presentation

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Title: CLINICAL APPROACH TO PATIENT WITH RESPIRATORY DISEASE


1
CLINICAL APPROACH TO PATIENT WITH RESPIRATORY
DISEASE
  • Dr. Hayat Kamfar
  • Dr. Saad Alsaedi
  • Pediatric department

2
  • Learning Objectives
  • Student will be able to recognize and describe
  • The common symptoms of pulmonary diseases and
    significant characteristics to identify n the
    review
  • The characteristics of the 4 types of normal
    breath sounds ( tracheal, bronchial,
    broncho-vesicular and vesicular)
  • The appropriate terms for describing normal and
    abnormal lung sounds

3
  • Continueobjective.
  • Appropriate history taking /physical examination
    of the respiratory system and interpret symptoms
    with the signs
  • Common causes for abnormalities identified during
    physical examination of patient with respiratory
    diseases
  • The value of other assessment adjuncts e.g. chest
    x-ray, PFM and ABG

4
  • Common Symptoms
  • cough
  • voluntary or involuntary, timing, chronicity and
    nature, type, characteristic
  • breathlessness( dyspnoea)
  • onset, nature, associations
  • Wheeze
  • types (monophonic, polyphonic)

5
Continue.symptom
  • Hemoptysis
  • (coughing bloody sputum)
  • Sputum production
  • Chest pain
  • Cyanosis
  • fever

6
LUNG SOUNDS??
  • Normal and abnormal

7
Normal bronchovesicular sounds
Normal tracheobronchial sounds
Normal vesicular sounds
Fine crackles
Coarse crackles
Ins.crackles,ex.wheeze
Lung consolidation
M.ex.wheeze
8
?? sleepy
Wake-upmore to come
9
HISTORY AND PHYSICAL EXAMINATION
10
The principles of interviewing pulmonary patient
include careful listening and questioning, in
association with skillful observation Initial
and subsequent interviews usually centered around
a discussion of patients chief complaints or
symptoms
11
  • Full relevant systematized and careful history
    taking that includes
  • identifying data
  • chief complaint and H/O present illness
  • systemic review
  • past history
  • family history
  • social, occupational and travel history
  • smoking history

12
All health professionals should become expert in
techniques of physical examination Phy. Ex. In
pulmonary patient entails the time-honored
combination of inspection, palpation, percussion
and auscultation of the chest
13
  • Inspection
  • observe if in pain or distressed
  • type of breathing rapid, slow, shallow or deep
    and use of accessory muscles
  • chest and spinal deformities, skin changes,
    breast and nutritional status
  • other areas such as nails, lips for cyanosis and
    clubbing and neck JVP and lymph nodes

14
  • Palpation
  • confirms skeletal abnormalities and areas of
    tenderness
  • can reveal masses, pulsations and areas of
    crepitation( subcutaneous emphysema)
  • transmitted vibration through chest wall
    (fremitus)
  • palpate neck for trachea

15
  • Percussion
  • determine the appropriate density of the
    patients lungs
  • resulting sounds classified as normal, increased
    or decreased resonance

16
  • Auscultation
  • The act of listening to sounds produced in the
    body e.g. by lung sounds
  • the art of use of stethoscope
  • application and skill development conditions
    such as quiet room, ICU, and ventilated patient
  • avoid common errors such as listening to breath
    sound through patients gown, auscultating only
    the convenient areas

17
Is clinical assessment completed??
18
  • Other assessment adjuncts
  • chest roentgenogram
  • pulmonary function test
  • arterial blood gases
  • other specific laboratory /or roentgenogram
  • surgical diagnostic procedures such as
    bronchoscopy and lung biopsy

19
  • Some pulmonary diseases or conditions
  • infections such as pneumonia and tuberculosis
  • bronchial asthma
  • chronic bronchitis
  • bronchiectasis
  • pneumothorax
  • emphysema
  • pleural effusion
  • congestive heart failure

20
(No Transcript)
21
  • Summary
  • clinical approach of patients with respiratory
    diseases requires KSA
  • K knowledge of basic information of the
    respiratory system (anatomy, physiology,
    histopathology and biochemistry)
  • S skills needed for appropriate full careful
    medical history and physical examination approach
    of patients with respiratory symptom/s
  • A attitude of learner facilitate highly in
    developing and understanding patients with
    respiratory complaint

22
THANK YOU
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