Chest disease signs

Chronic chest physical examination is one of the important tests in the chest examination. There are six major types of disease signs: lobar pneumonia. 2, chronic bronchitis and chronic obstructive emphysema. 3. Bronchial asthma. 4, pleural effusion. 5, pneumothorax. 6, other signs. Through auscultation, visual inspection, percussion, palpation, etc., observe the normality of the chest to determine the symptoms. Basic Information Specialist Category: Respiratory Examination Category: Other Inspections Applicable gender: whether men and women apply fasting: not fasting Tips: Poor rest, improper diet, excessive fatigue. Normal value There is no research yet. Clinical significance Abnormal result First, lobar pneumonia Lobarpneumonia is a inflammatory lesion of the lung with a large leafy distribution. Its pathogen is mainly pneumococci. Pathological changes can be divided into three stages of hyperemia, consolidation and dissipative. (A) Symptoms: Most of the patients are young and middle-aged, suffering from cold, fatigue is the cause of it, rapid onset, chills, high fever, body temperature can reach 39 ° C ~ 40 ° C, often showing heat, shortness of breath, chest pain, cough, rust and rust. (B) signs: common acute fever, herpes and cold sores. During the hyperemia period, the local respiratory motility was weakened, the speech tremor was slightly enhanced, and the voiced voice was diagnosed. In the real-time period, the tremor of the voice is obviously enhanced, and the percussion is voiced or real, and the bronchial breath sound can be heard. During the dissipating period, the percussion gradually became unvoiced, and the auscultation of bronchial breath sounds → wet rales → breathing sounds gradually returned to normal. Second, chronic bronchitis and chronic obstructive emphysema Chronic bronchitis is a chronic inflammation of the trachea, bronchial mucosa and surrounding tissues, leading to chronic obstructive emphysema, pulmonary hypertension, and pulmonary heart disease. Mainly changed to bronchial mucosa congestion, edema, increased glandular secretion, bronchial mucosa atrophy, smooth muscle rupture, perivascular fibrous tissue hyperplasia, bronchial distal (including alveolar duct, alveolar sac and alveoli) expansion and hyperinflation. (A) Symptoms: mainly for long-term cough, cough or wheezing. It is aggravated in winter, and the morning cough is heavier with white foam. When combined with infection, the sputum is mostly purulent. When combined with chronic obstructive emphysema, often feel shortness of breath, chest tightness, increased when tired. (B) Signs: Chronic bronchitis often hear scattered dry and wet rales at the bottom of the lungs, and can be reduced or disappeared after coughing. People who are breathing can hear dry rales. With obstructive emphysema, the barrel chest can be seen, the intercostal space is widened, the respiratory motility is weakened, and the speech resonance is weakened. Percussive lungs were over-voiced, the lower lungs moved down, and the lower lungs moved less. The heart is dulled and the liver is dull. The alveolar breath sounds weakened and the expiratory phase prolonged. The heart sound is far away. Third, bronchial asthma Bronchial asthma (bronchialasthma) is an airway chronic inflammation mainly characterized by allergies. Its airway is highly reactive to irritating substances, and susceptible people can cause various degrees of extensive reversible airway obstruction. Bronchial smooth muscle spasm, mucosal congestion, edema, and increased glandular secretion during onset. (A) Symptoms: Most of the onset in childhood or adolescence, repeated attacks, often seasonal. Before the onset, there are often mucosal allergic signs such as nasopharynx itching, sneezing, salivation or dry cough, followed by chest tightness, obvious expiratory breathing difficulties, wheezing and coughing. More than a few hours or days, before the onset of the attack, often a lot of thin sputum. (B) Signs: no obvious signs during the remission period. Severe expiratory breathing difficulties occur during the attack, sitting breathing, sweating, lips cyanosis, full thoracic. The respiratory motility is reduced, the speech resonance is weakened, the two lungs are percussed, and the heart sounds are narrowed. Both lungs are full of dry rales and wheezing sounds. Anti-recurrent authors often have obstructive emphysema. Fourth, pleural effusion Under normal circumstances, the trace fluid in the pleural cavity maintains a dynamic balance. When certain pathological factors exist, such as increased hydrostatic pressure in the pleural capillaries (heart failure, etc.), decreased colloid osmotic pressure (such as hypoproteinemia due to cirrhosis, nephrotic syndrome, etc.) or pleural capillary wall Increased permeability (such as tuberculosis, pneumonia, tumors, etc.). Causes increased fluid production or decreased absorption in the pleural cavity, resulting in pleural effusion (pleuraleffusion). According to the nature or cause of pleural effusion, it can be divided into exudate and leakage. (1) Symptoms: The symptoms are different due to the etiology of pleural effusion, the nature of the fluid, the rate of fluid formation, and the amount of fluid. When the pleural effusion is less than 300ml, the symptoms are not obvious. Some patients often have dry cough and ipsilateral chest pain in the early stage. When the effusion increases, the pleural visceral layer is separated from the wall layer, and the chest pain is relieved or disappeared. Patients with moderate or higher pleural effusion often complain of shortness of breath and chest tightness. If the effusion is slow, the symptoms are mild. If the effusion is formed quickly, palpitations, difficulty breathing, and even sitting breathing, purpura, etc. may occur. In addition, there may be some manifestations of underlying diseases such as fever and edema. (B) physical signs: a small amount of effusion, often no obvious signs, or only see the affected side of the chest respiratory motility weakened. When the fluid is above the medium amount, the patient often has shortness of breath, the respiratory movement of the affected side is limited, the intercostal space is full, the apex beats and the trachea moves to the healthy side. Speech tremor and speech resonance weaken or disappear. The effusion area is dull. Patients with moderate effusion without pleural thickening can obtain the Damoiseau line at the upper boundary of the effusion zone, the Garland triangle at the upper rear of the effusion zone, the Scoda turbid drum area in front of the effusion zone, and the healthy side. Signs such as the Grocco triangle next to the lower spine. A large number of patients with pleural effusion or with pleural thickening adhesions are referred to as real sounds. The breath sounds in the effusion zone weaken or disappear. Bronchial breath sounds are sometimes heard above the effusion zone. Pleural fibrillation can be heard in fibrinous pleurisy. Five, pneumothorax Gas is accumulated in the pleural cavity and is called pneumothorax. Often due to chronic respiratory diseases, the pleural effusion of the pleural effusion caused by the subpleural pulmonary bleb on the lung surface causes the gas in the lungs and bronchi to enter the pleural cavity, and may also be caused by chest trauma, pleural puncture or acupuncture treatment. (A) Symptoms: The severity of symptoms is related to the cause, the urgency of the disease, and the amount of gas. Less gas accumulation or slow onset, mild symptoms; acute onset, increased gas accumulation, severe symptoms, such as sudden chest pain, progressive dyspnea, irritability, sweating, or even shock. (B) signs: a small amount of pleural effusion, often no obvious signs. When the amount of gas is large, the affected side is full, the intercostal space is widened, the respiratory motility is weakened, and the speech tremor and speech resonance are weakened or disappeared. The trachea and heart move to the healthy side, and when the left pneumothorax, the apex beats. Percussion on the affected side is drum sound, when the left pneumothorax, the left heart can not be seen, the right pneumothorax when the liver dull tone down. Auscultation side breathing sounds weakened or disappeared, and the left heart pneumothorax was far away. People who need to be examined for abnormalities in the chest. Precautions Taboo before the examination: poor rest, improper diet, excessive fatigue. Requirements for inspection: Actively cooperate with the doctor's work. 1. Warm and quiet environment; 2, good exposure; 3, stethoscope and hand warm; 4, breathing should be deep during auscultation; 5, before, side, then back; 6, left and right contrast, up and down contrast; 7, according to the touch. Inspection process Through auscultation, visual inspection, percussion, palpation, etc., observe the normality of the chest to determine the symptoms. Not suitable for the crowd Inappropriate crowd: None.

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