重庆医科大学：《临床技能学》课程教学课件（PPT讲稿）呼吸系统查体 Physical Examination in Respiratory System

PhysicalExamination inRespiratorySystem

Physical Examination in Respiratory System

Anterior imaginary lines andlandmarksSuprasternalfossaSupraclavicularfossaInfraclavicularfossaSternallineParasternallineAnteriormidlineMidclavicularlineepigastricangle

Anterior imaginary lines and landmarks epigastric angle Infraclavicular fossa Anterior midline Suprasternal fossa Supraclavicular fossa Sternal line Parasternal line Midclavicular line

Lateral imaginary linesLIAALCROAALRPPosterioraxillarylineAnterioraxillarylineMidaxillaryline(ROMAL(LMAL

Lateral imaginary lines Anterior axillary line Midaxillary line Posterior axillary line

Posterior imaginary lines andlandmarksSuprascapularregionInterscapularregionInfrascapularregionScapularlinePosteriormidline

Posterior imaginary lines and landmarks Scapular line Posterior midline Infrascapular region Interscapular region Suprascapular region

Anterior view of lobes1SUbIst Ics2ndLULRULLULRUE3rdppl40thRMLRMLRLL6t

Anterior view of lobes

Posterior view of lobesLULRULRLULRLLTthLLL1RLL

Posterior view of lobes

Right lateral view of lobesRULBRULa4thRibRMLRLLRILURML6thRibC

Right lateral view of lobes

Left lateral view of lobesLULULLLLLL6th Rib

Left lateral view of lobes

Thoracic deformityKyphosis

Thoracic deformity Pectus excavatum Barrel chest Kyphosis

InspectionRespiratorymovementAbdominal breathing:male adult and childThoracic breathing:femaleadultRespiratoryrate:16-20f/minTachypnea:>24f/minBradypnea:<12f/minShallow and fastrespiratorymuscularparalysis,elevatedintraabdominal口pressure,pneumonia,pleurisyDeep andfastAgitation, intension二Deep and slowSeveremetabolicacidosis(Kussmaul'sbreathing)

Inspection 1. Respiratory movement ◼ Abdominal breathing: male adult and child ◼ Thoracic breathing: female adult 2. Respiratory rate: 16-20 f/min ◼ Tachypnea: >24 f/min ◼ Bradypnea: <12 f/min ◼ Shallow and fast  respiratory muscular paralysis, elevated intraabdominal pressure, pneumonia, pleurisy ◼ Deep and fast  Agitation, intension ◼ Deep and slow  Severe metabolic acidosis (Kussmaul’s breathing)