Restrictive clinical presentation

Question 1

Interstitial pulmonary fibrosis clinical presentation?

Answer 1

1. Inspection = increased RR + shallow breathing, clubbing, cyanosis, dry unproductive cough, decreased chest expansion
2. Palpation = increased tactile fremitus (because wall is thicker)
3. Percussion = dull
4. Auscultation = late fine insp crackles
5. ABGs = decrease O2, decrease CO2
6. Chest XR = small contracted lungs, raised diaphragm, bilateral lung disease

Question 2

Atelectasis clinical presentation?

Answer 2

1. Inspection = IPSILATERAL TRACHEA DEVIATION, increased RR, shallow breathing, cyanosis, dyspnea
2. Palpation = decreased tactile fremitus, decreased chest wall expansion on side of atelectasis
3. Percussion = dull directly over compressed tissue
4. Auscultation = decreased BS or absent, fine inspiratry crackles
5. Chest XR = ipsilateral deviation of mediastinum

Question 3

ARDs clinical presentation?

Answer 3

1. Inspection = severe dyspnea (often requires mechanical ventilation at high PEEP), cyanosis, increased RR
2. Palpation = increased tactile fremitus
3. Percusion = dull
4. Auscultation = insp crackles, wheezing
5. ABGs = severe low O2, decrease CO2

Question 4

Pneumothorax clinical presentation?

Answer 4

1. Inspection = chest pain, signs of resp distress (especially in tension), dyspnea, increased RR, dry cough
2. Palpation = decreased tactile fremitus
3. Percussion = hyper-resonant
4. Auscultation = decreased or absent breath sounds
5. ABGs = decreased O2

Question 5

Pleural effusion clinical presentation?

Answer 5

1. Inspection = increased RR, dry cough, may have chest pain
2. Palpation = decreased tactile fremitus, chest wall excursion decreased on side of effusion
3. Percussion = dull
4. Auscultation = pleural friction rub, decreased or absent sounds directly over effusion
5. ABGs = decreased O2, decreased CO2

Question 6

Chest wall deformity clinical presentation?

Answer 6

1. Inspection = dyspnea, SOBOE, abnormal thorax shape
2. Palpation = depends
3. Percussion = depends
4. Auscultation = depends
5. ABGs = decreased O2