Exame físico do tórax 2 tipos de tórax

Summary

This video focuses on the methods of thoracic inspection, outlining the four primary techniques: inspection, palpation, percussion, and auscultation. The inspection is divided into static and dynamic types, with the static focusing on physical characteristics and the dynamic assessing respiratory movements. The video also covers various thoracic deformities, such as barrel chest, kyphosis, and pectus excavatum, often linked to conditions like emphysema, rickets, and scoliosis. Practical examples and detailed visual aids are provided to help students understand these clinical signs, essential for diagnosing respiratory and musculoskeletal disorders.

Takeaways

• 😀 The inspection of the thorax involves four main methods: inspection, palpation, percussion, and auscultation.
• 😀 Thorax inspection is divided into two types: static and dynamic. Static inspection requires no body movement, while dynamic inspection involves evaluating body movement.
• 😀 When performing thorax inspection, it's important to check both the anterior and posterior aspects of the chest. Ensure that both sides are fully examined.
• 😀 Key aspects of thorax inspection include evaluating skin color, hydration, presence of lesions, and checking for scars, such as surgical or trauma-related scars.
• 😀 The presence of collateral circulation should be checked, as it can indicate various pathologies.
• 😀 The shape of the thorax can vary due to conditions or syndromes. Common shapes include a normal thorax, flat thorax, and barrel-shaped thorax (often seen in emphysema patients).
• 😀 A barrel-shaped thorax, or 'tonal chest,' is common in patients with emphysema or the elderly, due to reduced pulmonary compliance.
• 😀 The inspection also covers types of thorax deformities, such as kyphosis (hunched back), pectus excavatum (funnel chest), and pectus carinatum (pigeon chest).
• 😀 Pectus excavatum, often seen in children with rickets, presents as a concave chest, whereas pectus carinatum is characterized by a protruding chest, like a bird’s breast.
• 😀 Scoliosis and kyphoscoliosis can distort the thorax, leading to asymmetry in chest shape and potentially affecting the internal organs.
• 😀 The inspection of the thorax must also include the evaluation of respiratory rhythm, effort, and movement amplitude, which are further explained in a separate video.

Q & A

What are the four main methods used in thoracic examination?

The four main methods used in thoracic examination are inspection, palpation, percussion, and auscultation.

What is the difference between static and dynamic thoracic inspection?

Static inspection evaluates visible characteristics without requiring any body movement, while dynamic inspection involves assessing the patient's body movement to observe the normal functioning of the body.

How does positioning of the patient affect thoracic inspection?

Positioning affects how the thorax is examined. The patient can either be sitting or lying down, but care must be taken to assess both the anterior and posterior thorax, especially when the patient is in a lying position.

Why is it important to inspect both the anterior and posterior thorax?

It is essential to inspect both the anterior and posterior thorax to ensure a comprehensive evaluation. Missing the posterior thorax can lead to incomplete findings, as certain abnormalities may only be visible from the back.

What are some of the characteristics assessed during static inspection of the thorax?

During static inspection, characteristics such as skin color, hydration, presence of lesions, hair distribution, and any scars (surgical or traumatic) are assessed.

What is a barrel chest, and in which patients is it commonly seen?

A barrel chest (tórax em Tonel) is characterized by an enlarged anteroposterior diameter of the chest, creating a rounded appearance. It is commonly seen in older adults or patients with chronic obstructive pulmonary disease (COPD), particularly those with emphysema.

What does a kyphotic chest indicate, and how does it affect the thoracic shape?

A kyphotic chest is associated with a curvature of the spine due to kyphosis, which causes the thoracic shape to become more rounded and often leads to difficulty in respiration.

What is a pigeon chest, and what are some common causes?

A pigeon chest (tórax cariniforme) is a condition where the sternum protrudes outward. It is commonly caused by rickets in childhood or chronic conditions like asthma.

What does a funnel chest look like, and what is its typical cause?

A funnel chest (tórax infundibuliforme) features an inward depression of the sternum, creating a concave chest shape. It is often seen in patients who had rickets or other childhood conditions affecting bone growth.

How does a scolio-kyphotic chest appear, and what are its causes?

A scolio-kyphotic chest results from a combination of scoliosis (curvature of the spine) and kyphosis (abnormal spine curvature), causing the thorax to appear twisted or deformed. This condition is typically associated with scoliosis and can also affect lung function.