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Paed Resp exam

What are important observations in the respiratory exam? dyspnoea, use of accessory muscles (sternomastoids), nostril flaring, recession (increased negative pressure), wasted/obese/barrel chested, cyanosis, clubbing.
What should you aim to do at the observation stage? Take respiratory rate. Bronchiolitis, asthma and pneumonia have distinctive movements. In pneumonia it is reduced on affected side with rapid, shallow movements. In bronchiolitis-hyperinflation, recession, muscle use, asthma-reduced movement.
What is bronchial breathing? Harsh, with no interruption between first and second breath sound. Movement in large brochi with no influence from intervening lung. Heard above consolidation, above pleural effusion. May appear in recovering pneumonia once airways become patent.
What is it useful to palpate for? AP:ML diameter ratio - more rounded is a sign of hyperinflation. At the end feel for liver - right sided heart failure can cause large liver and hyperinflation a displaced liver. From age of 7, expansion.
Created by: rr5247