Respiratory system abnormalities are a significant concern in healthcare due to their potential to indicate underlying severe conditions like Chronic Obstructive Pulmonary Disease (COPD), asthma, and pneumonia. These abnormalities can often be detected through physical examination methods like inspection and percussion.
Inspection Findings
During an inspection, several findings may suggest the presence of respiratory distress or disease. Pursed-lip breathing, where exhalation is slowed by pressing the lips together, is often observed in patients with COPD or asthma. It denotes increased breathlessness and is a strategy taught to slow expiration and reduce dyspnea.
Another abnormal finding is the inability to lie flat or adopt the 'tripod position' — leaning forward with arms and elbows supported on an overbed table. This indicates moderate to severe respiratory distress and is associated with conditions like COPD, asthma exacerbation, and pulmonary edema.
Accessory muscle use, where neck and shoulder muscles assist breathing and muscles between ribs pull in during inspiration, signals severe respiratory distress and hypoxemia. This is typically seen in those with COPD, asthma in exacerbation, or secretion retention.
Other abnormal findings include splinting, increased anteroposterior (AP) diameter, tachypnea, Kussmaul respirations, cyanosis, finger clubbing, and abdominal paradox. Each of these findings carries its potential etiology and significance, ranging from thoracic incision, chronic hypoxemia, and metabolic acidosis to anxiety and fever.
Percussion Findings
Percussion, another physical examination method, can also reveal respiratory abnormalities. Hyperresonance, characterized by a loud, lower-pitched sound over areas that generally produce a resonant sound, could suggest lung hyperinflation (as seen in COPD), lung collapse (pneumothorax), or air trapping (asthma).
On the other hand, dullness, a medium-pitched sound over areas that generally produce a resonant sound, implies increased density or fluid in the pleural space. This could indicate conditions like pneumonia, large atelectasis, or pleural effusion.
Conclusion
Inspection and percussion are crucial tools in the detection of respiratory system abnormalities. These non-invasive physical examination methods can provide valuable information about a patient's respiratory health and guide further diagnostic procedures and treatment plans. Healthcare professionals must correctly understand and interpret these findings to ensure timely and effective care.
