Pleural effusion physical examination: Difference between revisions
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When only 250 to 300ml of pleural fluid is present, physical examination may be unremarkable. | |||
At a pleural fluid volume of approximately 500 ml, the typical physical findings are:<ref name="isbn0-7817-6957-4">{{cite book | author = Light, Richard J. | authorlink = | editor = | others = | title = Pleural diseases | edition = | language = | publisher = Lippincott Williams & Wilkins | location = Hagerstwon, MD | year = 2007 | origyear = | pages = | quote = | isbn = 0-7817-6957-4 | oclc = | doi = |url = | accessdate = }}</ref> | |||
* Dullness to [[percussion]] | |||
* Decreased [[fremitus]] | |||
* Normal vesicular [[breath sounds]] of decreased intensity compared with the contralateral side | |||
At a pleural fluid volume exceeding 1000ml, there usually is:<ref name="isbn0-7817-6957-4">{{cite book | author = Light, Richard J. |authorlink = | editor = | others = | title = Pleural diseases | edition = | language = | publisher = Lippincott Williams & Wilkins |location = Hagerstwon, MD | year = 2007 | origyear = | pages = | quote = | isbn = 0-7817-6957-4 | oclc = | doi = | url = | accessdate =}}</ref> | |||
* Absence of inspiratory retraction and mild bulging of the intercostal spaces | |||
* Decreased expansion of the ipsilateral chest wall | |||
* Dullness to [[percussion]] up to the level of the scapula and axilla | |||
* Decreased or absent [[fremitus]] posteriorly and laterally | |||
* Bronchovesicular [[breath sounds]], which may be of decreased intensity at the upper level of the effusion | |||
* [[Egophony]] at the upper level of the effusion | |||
When the effusion fills the entire hemithorax, physical examination will show:<ref name="isbn0-7817-6957-4">{{cite book | author = Light, Richard J. | authorlink = | editor = | others = | title = Pleural diseases | edition = | language = | publisher = Lippincott Williams & Wilkins | location = Hagerstwon, MD | year = 2007 | origyear = | pages = | quote = | isbn = 0-7817-6957-4 | oclc = | doi = | url = |accessdate = }}</ref> | |||
* Bulging of the intracostal spaces | |||
* Minimal to no expansion of the ipsilateral chest wall | |||
* A dull or flat [[percussion]] noted over the entire hemithorax | |||
* Absent [[breath sounds]] over the majority of the chest with possible bronchovesicular bronchial [[breath sounds]] at the apex | |||
* [[Egophony]] at the upper level of the pleural effusion | |||
* Apalpable liver or spleen due to significant diaphragmatic depression | |||
==References== | ==References== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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When only 250 to 300ml of pleural fluid is present, physical examination may be unremarkable.
At a pleural fluid volume of approximately 500 ml, the typical physical findings are:[1]
- Dullness to percussion
- Decreased fremitus
- Normal vesicular breath sounds of decreased intensity compared with the contralateral side
At a pleural fluid volume exceeding 1000ml, there usually is:[1]
- Absence of inspiratory retraction and mild bulging of the intercostal spaces
- Decreased expansion of the ipsilateral chest wall
- Dullness to percussion up to the level of the scapula and axilla
- Decreased or absent fremitus posteriorly and laterally
- Bronchovesicular breath sounds, which may be of decreased intensity at the upper level of the effusion
- Egophony at the upper level of the effusion
When the effusion fills the entire hemithorax, physical examination will show:[1]
- Bulging of the intracostal spaces
- Minimal to no expansion of the ipsilateral chest wall
- A dull or flat percussion noted over the entire hemithorax
- Absent breath sounds over the majority of the chest with possible bronchovesicular bronchial breath sounds at the apex
- Egophony at the upper level of the pleural effusion
- Apalpable liver or spleen due to significant diaphragmatic depression
References
- ↑ 1.0 1.1 1.2 Light, Richard J. (2007). Pleural diseases. Hagerstwon, MD: Lippincott Williams & Wilkins. ISBN 0-7817-6957-4.