Inspeção do Tórax | Exame Físico do Aparelho Respiratório 1/6

Summary

This video serves as an introduction to performing a physical examination of the respiratory system in adults. It covers key techniques such as inspection, palpation, percussion, and auscultation. The focus is on static and dynamic thoracic inspection, recognizing various thoracic shapes and skin alterations that may indicate underlying conditions, such as barrel chest or gynecomastia. The video also explains how to assess breathing patterns, symmetry, respiratory rate, and rhythm, with a particular focus on recognizing signs of respiratory distress, like abnormal patterns or retraction. It’s a valuable resource for learning the basics of respiratory physical examination.

Takeaways

• 😀 Inspection is the first step in a physical examination, and it can be divided into static and dynamic categories.
• 😀 Static inspection involves observing the shape of the chest, which can indicate certain conditions like emphysema or scoliosis.
• 😀 Dynamic inspection evaluates the patient's breathing pattern, checking for abnormalities such as asymmetry in thoracic expansion.
• 😀 Abnormal chest shapes like a barrel chest or flat chest can be indicative of specific respiratory issues, such as emphysema or restrictive diseases.
• 😀 The presence of skin alterations such as scars, cyanosis, or skin eruptions can be linked to respiratory conditions or tumors.
• 😀 Gynaecomastia, often associated with liver cirrhosis or steroid use, can sometimes point to underlying lung cancer.
• 😀 Respiratory patterns differ by sex, with females typically exhibiting a thoracic pattern and males and children demonstrating abdominal (diaphragmatic) breathing.
• 😀 Asymmetry in the chest expansion may suggest underlying pathologies like pleural effusion or lung cancer.
• 😀 Respiratory rate is an important metric; a normal rate for adults is 12-20 breaths per minute, with deviations indicating bradypnea (below 12) or tachypnea (above 20).
• 😀 Abnormal respiratory rhythms, such as Cheyne-Stokes or Kussmaul's, can signal serious conditions like brain tumors or diabetic acidosis.
• 😀 Observing for signs of 'retraction' during breathing can help identify obstructions in the airways or atelectasis.

Q & A

What is the first step in performing a respiratory system examination on an adult?

The first step is inspection, which can be divided into static and dynamic inspection.

What does static inspection of the thorax involve?

Static inspection involves examining the shape of the thorax for abnormalities like barrel chest, funnel chest, scoliotic chest, or others, as these can indicate underlying conditions such as emphysema or pleural effusion.

What are some common thoracic shapes and their associated conditions?

A barrel chest can indicate emphysema, while a flat thorax can be associated with restrictive diseases. A scoliotic chest can suggest scoliosis, and a sunken chest might indicate conditions like pectus excavatum.

What are the key things to observe in the dynamic inspection of the thorax?

In dynamic inspection, you should observe the patient’s respiratory movements, symmetry in the expansion of the thorax, and check for patterns such as abdominal or thoracic breathing.

How can you differentiate between normal and abnormal respiratory patterns?

Normal breathing patterns include abdominal breathing in men and children, and thoracic breathing in women. Any asymmetry or abnormal patterns, such as abdominal breathing in women, can indicate issues like pleuritis.

What should you look for when assessing the frequency of respirations?

You should count the number of respiratory cycles per minute. Normal respiration is 12-20 breaths per minute. Rates above or below this range can indicate tachypnea or bradypnea, respectively.

What is the significance of examining the rhythm of respiration?

The rhythm of respiration should be regular and comfortable. Irregularities or abnormal patterns, like Cheyne-Stokes or Kussmaul’s breathing, can indicate serious medical conditions, such as neurological issues or diabetic ketoacidosis.

What is ‘ginecomastia’ and how is it related to respiratory health?

Ginecomastia refers to the enlargement of breast tissue in men, which can be associated with conditions like cirrhosis, anabolic steroid use, or even lung cancer.

What is ‘tirage’ and what does it indicate?

Tirage is the retraction of intercostal spaces during breathing. It can indicate airway obstruction, atelectasis, or other conditions such as foreign body aspiration.

How can you assess the symmetry of respiratory movements in a patient?

Symmetry can be assessed by observing the expansion of the thorax during breathing. Both sides should expand equally; asymmetry can suggest conditions like pleural effusion, lung tumors, or pneumonectomy.