Bronchitis physical examination: Difference between revisions

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A [[physical examination]] will often reveal decreased intensity of breath sounds, wheeze (rhonchi) and prolonged [[Exhalation|expiration]].  Most doctors rely on the presence of a persistent dry or wet cough as evidence of bronchitis.
A [[physical examination]] will often reveal decreased intensity of breath sounds, wheeze (rhonchi) and prolonged [[Exhalation|expiration]].  Most doctors rely on the presence of a persistent dry or wet cough as evidence of bronchitis.
==Physical Examination==
==Physical Examination==
The physical examination findings in acute bronchitis can be:
*Common physical examination findings of [[acute bronchitis]] are non specific and includes<ref name="pmid21121518">{{cite journal |vauthors=Albert RH |title=Diagnosis and treatment of acute bronchitis |journal=Am Fam Physician |volume=82 |issue=11 |pages=1345–50 |year=2010 |pmid=21121518 |doi= |url=}}</ref><ref name="pmid17108344">{{cite journal |vauthors=Wenzel RP, Fowler AA |title=Clinical practice. Acute bronchitis |journal=N. Engl. J. Med. |volume=355 |issue=20 |pages=2125–30 |year=2006 |pmid=17108344 |doi=10.1056/NEJMcp061493 |url=}}</ref>:
===Eyes===
:1. Fever 2. Prolonged expiration 3. Wheezing due to bronchospasm and reduced FEV1 has been shown in up to %40 of patients 4. Rhonchi 5. Rales
* [[Conjunctivitis]]
*Common physical examination findings of [[chronic bronchitis]] can be cyanosis, tachypnea, use of accessory respiratory muscles, paradoxical indrawing of lower intercostal spaces is evident (known as the ''Hoover sign''), elevated jugular venous pulse and peripheral edema. In pulmonary examination barrel chest(emphysema), wheezing, hyperresonance, crackles and rhonchi may be found. '''Blue bloaters''', are plethoric(red face/cheeks due to a polycythemia secondary to chronic hypoxia) and cyanotic(due to decreased hemoglobin saturation) seen in advanced stages of disease<ref name="pmid8430714">{{cite journal |vauthors=Badgett RG, Tanaka DJ, Hunt DK, Jelley MJ, Feinberg LE, Steiner JF, Petty TL |title=Can moderate chronic obstructive pulmonary disease be diagnosed by historical and physical findings alone? |journal=Am. J. Med. |volume=94 |issue=2 |pages=188–96 |year=1993 |pmid=8430714 |doi= |url=}}</ref>.
===Ear===
* Bullous myringitis
 
===Nose===
 
* [[Rhinorrhea]]
===Throat===
* Pharyngeal erythema
===Lungs===
 
* Use of accessory muscles suggesting labored breathing.
 
* [[Rhonchi]], and [[wheeze]]s that change in location and intensity after a deep and productive cough.
 
* Presence of inspiratory [[stridor]] indicate obstruction of a major bronchi or the trachea.
 
===Heart===
 
* Sustained [[heave]] felt along the left sternal border, suggests [[right ventricular hypertrophy]] secondary to [[chronic bronchitis]].
 
===Extremities===
 
* [[Lymphadenopathy]]
 
* [[Clubbing]] on the digits
 
* Peripheral [[cyanosis]]


==References==
==References==

Revision as of 14:10, 15 September 2016

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]

Bronchitis Main page

Patient Information

Overview

Causes

Classification

Acute bronchitis
Chronic bronchitis

Differential Diagnosis

Overview

A physical examination will often reveal decreased intensity of breath sounds, wheeze (rhonchi) and prolonged expiration. Most doctors rely on the presence of a persistent dry or wet cough as evidence of bronchitis.

Physical Examination

1. Fever 2. Prolonged expiration 3. Wheezing due to bronchospasm and reduced FEV1 has been shown in up to %40 of patients 4. Rhonchi 5. Rales
  • Common physical examination findings of chronic bronchitis can be cyanosis, tachypnea, use of accessory respiratory muscles, paradoxical indrawing of lower intercostal spaces is evident (known as the Hoover sign), elevated jugular venous pulse and peripheral edema. In pulmonary examination barrel chest(emphysema), wheezing, hyperresonance, crackles and rhonchi may be found. Blue bloaters, are plethoric(red face/cheeks due to a polycythemia secondary to chronic hypoxia) and cyanotic(due to decreased hemoglobin saturation) seen in advanced stages of disease[3].

References

  1. Albert RH (2010). "Diagnosis and treatment of acute bronchitis". Am Fam Physician. 82 (11): 1345–50. PMID 21121518.
  2. Wenzel RP, Fowler AA (2006). "Clinical practice. Acute bronchitis". N. Engl. J. Med. 355 (20): 2125–30. doi:10.1056/NEJMcp061493. PMID 17108344.
  3. Badgett RG, Tanaka DJ, Hunt DK, Jelley MJ, Feinberg LE, Steiner JF, Petty TL (1993). "Can moderate chronic obstructive pulmonary disease be diagnosed by historical and physical findings alone?". Am. J. Med. 94 (2): 188–96. PMID 8430714.


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