《呼吸系统课件：呼吸常见病-大叶性肺炎.ppt》由会员分享，可在线阅读，更多相关《呼吸系统课件：呼吸常见病-大叶性肺炎.ppt（40页珍藏版）》请在三一办公上搜索。
1、Major symptoms and signs of respiratory diseases,大叶性肺炎Lobar pneumonia,大叶性肺炎,Symptom,Triggers:“cold”,fatigue,alcoholismOnset:acuteCinical features:Generalized:chills and fever(3940oC,enecia),headach,myalgia,Pulmonary:chest pain,tachypnea,cough and sputum(rusty),Sign and physical examination,Inspectio
2、n视诊Face flushing,nares flaring,dyspnea,cyanosis,chest expansion reduced on the affected side Palpation触诊the vocal fremitusPleural friction fremitus,Percussion叩诊the percussion note is dull or flat over the affected area.Auscultation听诊breath sounds is increasedbronchial breath sounds moist rales vocal
3、 resonance increasedpleural friction rub if an acute pleuritis exists,Signs of lobar pneumonia,Pulmonary emphysema,Emphysema is a long-term,progressive disease of the lungs that primarily causes shortness of breath.In people with emphysema,the tissues necessary to support the physical shape and func
4、tion of the lungs are destroyed.It is included in a group of diseases called chronic obstructive pulmonary disease or COPD.,Emphysema is called an obstructive lung disease because the destruction of lung tissue around smaller sacs,called alveoli,makes these air sacs unable to hold their functional s
5、hape upon exhalation.,Etiology,SmokingIndoor and Outdoor Air PollutionInfectionOccupational Dusts and ChemicalsSocioeconomic Status,Pathology,Symptoms,Chronic cough Sputum production Exertional dyspnea,Signs,InspectionA“barrel chest deformity”The chest is on an inspiratory position,with the ribs hor
6、izontal.The apex beat心尖搏动 of the heart is not visible.,Palpation：The tactile fremitus is diminished over both side of the chest,Percussion：hyperresonance 过清音the area of cardiac dullness is diminishedThe upper limit of liver dullness is lowered,Auscultation：the breath sounds diminished in intensity o
7、r almost inaudibleExpiration is commonly prolongedRhonchi/wheezes or moist crackles may be heared,Bronchial asthma,Symptoms,Onset:childhood/adolencenceFeatures:recurrent attack,seasonal symptomsTriggers:allergen exposure with allergic rhinitisDyspnea with wheezing,Cough with/without sputumResolution
8、 with/without medications,Signs,Rapid shallow breathingProlonged expirationOrthopneaSweating Cyanosis respiratory mevement vocal fremitusHyperresonanceDiffused wheezing,expiratory,PLEURAL EFFUSION,Pleural effusion is excess fluid that accumulates in the pleura,the fluid-filled space that surrounds t
9、he lungs.Excessive amounts of such fluid can impair breathing by limiting the expansion of the lungs during respiration.,Symptoms,Pleuritic chest pain,relieved on lyingDry coughDyspnea,if the fluid500mlCyanosis,hypotensionFever,heart failure,edema,Inspection：decreased movement of the chest on the af
10、fected sidethe intercostal spaces may actually bulgePalpation：The vocal fremitus is absent or markedly diminishedpleural friction rub,Signs,Percussion：stony dullness to percussion over the fluidThe cardiac border may be changed,Auscultation：The vocal resonance is diminished or absentThe breath sound
11、s are diminished or absent over the area of the effusion Bronchovesicular breath sounds are often heard at the upper limit of the fluidA pleural friction rub may be heard,Pneumothorax,Pneumothorax,Pneumothorax is a collection of air or gas in the pleural cavity of the chest between the lung and the
12、chest wall.,Causes,Diseases of the airways:COPD(especially when emphysema and lung bullae are present),acute severe asthma,cystic fibrosisLung infectionsInterstitial lung diseasesCancerendometriosis in the chesttraumatic,Symptoms,Trigger:hold breath,heavy taker,exercise,coughChest pain and dyspneaTh
13、e symptoms of a pneumothorax are determined by the size of the air leak and the speed by which it occurschest pain in most cases:sudden onset of unilateral chest pain Sudden shortness of breath in manydry cough,Inspection：The affected side of the chest may be hyperexpanded and show decreased movemen
14、t,with increased movement on the other side cyanosisPalpation：The vocal resonance and tactile fremitus is diminished or abolished over the affected side.Subcutaneous emphysema,Signs,Percussion：hyperresonant or tympanicAuscultation：The breath sounds are markedly diminished on the affected sideThe vocal resonance is usually diminished,Thank you!,
