Wednesday, July 30, 2008

Respiratory System

Radiographs

COPD
Asthma
Emphysema
Cor Pulmonale
Lung Cancer
Punemonia
Diffuse Infiltrate
ARDS
Pleural effusion
Atelectasis

Pleural effusion

Pulmonary Function Test



Pulmonary Nodule
Solitary Nodule
<35>
while in canada in first yr it is 3-6 month in first yr and every 6 month n 2nd year.
>50yrs, smoker is high risk for carcinoma.
Open Lung biopsy is best choice for diagnosis in USA as bronchoscopy wud not yield anything other than inflammatory cells in peripheral lesions.
While in canada CT , transthoracic aspiration cyto /Bronchoscopy precedes open lung biposy as per protocol.
Difference between Benign and Malignant Nodule Check kaplans for that.

Atelectasis

Acute atelectasis


most common reason
Post-op 1st day owing to poor inspiration and inadequate coughing
Other causes:
Tumour
Mucus plug
Foreign body

Signs and Symptoms:-

Acute atelectasis:-
Tacypnea, mild fever , cough , dypspnea ,hypoxemia.

Chronic :asymptomatic clinically , seen on x ray only.

X RAYS:

Upper lobe atelectasis:
Trachea deviation on same side

Lower Lobe atelectasis:
Elevation of diaphragm on same side.

Massive atelectasis:
Mediastinal shift

Treatment

Post op:
induce deep breathing
stimulate coughing
Incebtive spirmetery and pulmonary toilet are effective.

Treatment of choice in spontaneous atelectasis
Bronchospy with removal of mucus plug



Canada Examination portion:-

Chest wall abnormalities

Anterior chest wall

pectus carinatum , excavatun , sternal fissures

surgery for

Cosmetic purposes

resp./ cardiovascular insufficiency

Psychosocial factors

Thoracic outlet synd.

impingement of subclvian vessels and brachial plexus

etio: Congenital rib, Trauma, degenrative( osteoporosis , arthritis)

Sx/syx:

Neurogenic: distribution areas of ulnar and motor+sensory fn of median nerve

Arterial: Cold, fatigue,weakness, ischemic pain, paresthesia.

Venous:edema , collateral formation, cyanosis , venous distension

Treatment:

Conservative50-90%

Physiotherapy

Surgery if conservative fails , removal of cervical or first rib indicated.

No comments: