هاي اهم الملاحظات مال محطة الريسبا

حطيتلكم الصوت المُشابه وكل صوت وياه كليشته وأسبابه تكدرون تعتمدون عليهن ⬇️⬇️⬇️⬇️

💥Auscultation:
Normal sound in lung Vesicular

Added sounds: wheezes-Crackles-stridor ---

Wheezing :

Normal air intensity all over the lung
vesicular breathing all over the lung with prolongation of expiratory phase

Regarding added sounds there is expiratory ( localized , generalized wheezing )
in ( mention the area )
الدكتور كال عادة نحطه (diffuse ( generalized

DDx if wheeze all over the lung

( diffuse or generalized wheezing ) :
Diffuse
Asthma
Cardiac asthma
Acute bronchitis
Chronic bronchitis
Bronchiolitis

Localized
Foreign body
Tumour
Mucus inspiration
Compression from outside
Bronchiectasis

Fine Crackles :

Normal air intensity all over the lung
Normal vesicular breathing all over the lung without prolongation of expiratory phase

Regarding added sounds there is inspiration fine crackles in ( mention the area )

DDx :
1- Idiopathic Pulmonary Fibrosis
2- Pulmonary Odema
3- ILD
4- Early Phase Of Pneumonia
5- Atypical Pneumonia

Coarse Crackles :

Normal air intensity all over the lung
Normal vesicular breathing all over the lung without prolongation of expiratory phase

Regarding added sounds there is biphasic coarse crackles in ( mention the area )

DDx :
1- Advance Pulmonary Odema
2- Pneumonia
3- Acute Bronchitis
4- Bronchiectasis
5- Lung Abscess

- Crackles it a deep breathing to represent the sudden opening of small airways

💥Vocal resonance

Causes of increased vocal resonance: consolidation and collapse

Causes of decreased vocal resonance: pleural effusion, pneumothorax, collapse with obstructed bronchus.

للي عدهم consolidation نسويلهم شي اسمه Whispering pectoriloquy نكله اهمس بصوت ناصي ونسمع بالسماعة فحنلكه الصوت عالي عبالك ديحجي بصوت عالي

وهمات نسوي شي اسمه Aegophony وهذه هنا نكوله كول eeeeee حنسمعها aaaaa

Good air intensity

Abnormal vesicular breathing replaced by bronchial breathing in abnormal locations all over the lung with prolonged of expiratory phase

There is a gap between expiration and inspiration

DDX if it is localized
lung consolidation ( most common cause )
Lung collapse
Lung tumour
Lung Abcess

DDX if it is generalized
Pulmonary fibrosis
Pulmonary Odema
Pleural effusion
Sever pneumonia

بالنسبه لل wheezing الدكتور كال لازم نحدد هذا local or diffuse وكال بال لعابه راح نحطه diffuse

ال bronchial breath sound هماتين بال لعابه راح نحطه diffuse

اما ال fine crackles كال غالبا تسمعوا بال base of lung لكن ممكن نحطه diffuse

What you say in ( mention the area ) :

1- left upper zone
2- right upper zone
3- left middle zone
4- right upper zone
5- left lower zone
6- right lower zone

اذا سمعتوا بكل الاماكن تكدرون تعبرون علي بالطريقة الي تعجبكم لكن اسهلها هي :
All over the back

شنو ممكن تنسأل بمحطة الـ Respiratory؟ 🤔🫁

DDx مبدئياً
للصوت الي سمعتوه
سواء كان generalize or localized

1-DDx of fine crackle
2- Deferent between Pulmonary odema & Pulmonary fibrosis by auscultation?
3- How to differentiate between ddx by auscultation
4- How to differentiate between fine & course crackles by auscultation?
5- DDx of course crackles ?
6- bronchial breathing sound causes of generalized/ localized?
7- DDx of diffuse wheeze
8- localized wheeze ddx
9- What’s the general look for asthmatic pt / What u gonna find in neck?
10- What’s the general look for COPD patient
11- bronchiectasis hands شنشوف?
12- TB can cause clubbing in hands?
13- Tracheal deviation

الاجوبه
🎀 Deferent between Pulmonary odema & Pulmonary fibrosis by auscultation?

•Pulmonary Edema: early fine crackles
•Pulmonary Fibrosis: late fine crackles


🎀 How to differentiate between fine & course crackles by auscultation?

If you ask the patient to cough, the crepitation would
disappear.

🎀 What’s the general look for asthmatic pt / What u gonna find in neck?

General Appearance of an Asthmatic Patient:
1. Breathing pattern: Rapid, shallow breathing and use of accessory muscles:(sternocleidomastoid, intercostals, and abdominal muscles)
2. Cyanosis (blue color) around lips and extremities
3. Chest shape: barrel chest due to hyperinflation of the lungs.
4. Posture: tripod position ( leaning forward with hands on knees to improve airflow and use their diaphragm more effectively )
5. Wheezing
6. Coughing: A frequent cough especially at night

🎀 General Appearance of an COPD Patient

• Chronic dyspnea
• Use of accessory muscles for breathing.
• Barrel chest and tracheal tug
• Cyanosis especially in lips and finger
• Chronic cough and excessive sputum production.
• Fatigue and anxiety due to breathing difficulty
• In severe cases, signs of cor pulomnale including edema, JVD and hepatomegaly.

🎀 bronchiectasis hands شنشوف?
clubbing, cyanosis, peripheral edema, and delayed capillary refill

🎀 TB can cause clubbing in hands?
no
الا اذا جان chronic TB ومديتعالج

🎀 Tracheal deviation causes
بالمصدر