Chronic bronchitis physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]

Overview

Chronic bronchitis can be diagnostically evaluated by physical examination through auscultation. Physical examination is quite specific and sensitive for severe disease. The signs are usually difficult to detect in cases of mild to moderate diseases. Findings on general physical examination can be cyanosis, tachypnea, use of accessory respiratory muscles, paradoxical indrawing of lower intercostal spaces is evident (known as the Hoover’s sign), elevated jugular venous pulse, and peripheral edema. Pulmonary examination findings include: barrel chest (emphysema), wheezing, hyperresonance, crackles and rhonchi.^[1]

Physical Examination

Physical examination is quite specific and sensitive for severe disease. The signs are usually difficult to detect in cases of mild to moderate diseases.^[1]^[2]

Appearance of the Patient

Typically overweight
Cyanosis, typically in lips and fingers

Vital Signs

Respiratory Rate

Tachypnea

Head

Elevated jugular venous pulse (JVP)

Lungs

Inspection

Respiratory distress indicated by use of accessory respiratory muscles
Hoover’s sign, presenting as paradoxical indrawing of lower intercostal spaces, is evident

Auscultation

Prolonged expiration; wheezing
Diffusely decreased breath sound
Coarse crackles with inspiration
Coarse rhonchi

Extremities

Peripheral edema

References

↑ ^1.0 ^1.1 Mehta GR, Mohammed R, Sarfraz S, Khan T, Ahmed K, Villareal M, Martinez D, Iskander J, Mohammed R (2016). “Chronic obstructive pulmonary disease: A guide for the primary care physician”. Dis Mon. 62 (6): 164–87. doi:10.1016/j.disamonth.2016.03.002. PMID 27087562.
↑ Badgett RG, Tanaka DJ, Hunt DK, Jelley MJ, Feinberg LE, Steiner JF, Petty TL (1993). “Can moderate chronic obstructive pulmonary disease be diagnosed by historical and physical findings alone?”. Am. J. Med. 94 (2): 188–96. PMID 8430714.

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[pmid27087562-1] 1.0 ^1.1 Mehta GR, Mohammed R, Sarfraz S, Khan T, Ahmed K, Villareal M, Martinez D, Iskander J, Mohammed R (2016). “Chronic obstructive pulmonary disease: A guide for the primary care physician”. Dis Mon. 62 (6): 164–87. doi:10.1016/j.disamonth.2016.03.002. PMID 27087562.

[pmid8430714-2] Badgett RG, Tanaka DJ, Hunt DK, Jelley MJ, Feinberg LE, Steiner JF, Petty TL (1993). “Can moderate chronic obstructive pulmonary disease be diagnosed by historical and physical findings alone?”. Am. J. Med. 94 (2): 188–96. PMID 8430714.

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