Respiratory acidosis physical examination

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

Overview

The medical manifestations of respiratory acidosis are regularly the ones of the underlying disorder. Physical examination may vary, relying on the severity of the disorder and on the rate of development of hypercapnia. mild to moderate hypercapnia that develops slowly generally has minimum symptoms.

Physcial Examination

  • Physical examination of patients with respiratory acidosis is usually non specific.[1][2][3][4][5]

Lungs

  • In COPD patients physcial exmanination of chest shows
    • Diffuse wheezing
    • Barrel chest
    • Decreased breath sounds
    • Hyperresonanc
    • Prolonged expiration
    • Rhonchi

Appearance of the Patient

  • Patients with respiratory acidosis usually appear Anxious

Skin

  • Cyanosis
  • Digital clubbing 

Neuromuscular

  • Seizures.
  • Asterixis.
  • Myoclonus.

HEENT

  • Papilledema.
  • Conjunctival and superficial facial dilation of blood vessels.
  • Nasal flaring is a sign of respiratory acidosis.[6][7]

References

  1. Zorrilla-Riveiro JG, Arnau-Bartés A, Rafat-Sellarés R, García-Pérez D, Mas-Serra A, Fernández-Fernández R (April 2017). "Nasal flaring as a clinical sign of respiratory acidosis in patients with dyspnea". Am J Emerg Med. 35 (4): 548–553. doi:10.1016/j.ajem.2016.12.008. PMID 28007319.
  2. Mas A, Zorrilla JG, García D, Rafat R, Escribano J, Saura P (April 2010). "[Utility of the detection of nasal flaring in the assessment of severity of dyspnea]". Med Intensiva (in Spanish; Castilian). 34 (3): 182–7. doi:10.1016/j.medin.2009.09.008. PMID 19954861.
  3. Soo Hoo GW, Santiago S, Williams AJ (August 1994). "Nasal mechanical ventilation for hypercapnic respiratory failure in chronic obstructive pulmonary disease: determinants of success and failure". Crit. Care Med. 22 (8): 1253–61. PMID 8045145.
  4. Epstein SK, Singh N (April 2001). "Respiratory acidosis". Respir Care. 46 (4): 366–83. PMID 11262556.
  5. Bruno CM, Valenti M (2012). "Acid-base disorders in patients with chronic obstructive pulmonary disease: a pathophysiological review". J. Biomed. Biotechnol. 2012: 915150. doi:10.1155/2012/915150. PMC 3303884. PMID 22500110.
  6. Zorrilla Riveiro JG, Arnau Bartés A, García Pérez D, Rafat Sellarés R, Mas Serra A, Fernández Fernández R (0 2015). "[Nasal flaring as a predictor of mortality in patients with severe dyspnea]". Emergencias (in Spanish; Castilian). 27 (1): 27–33. PMID 29077330. Check date values in: |date= (help)
  7. Mas A, Zorrilla JG, García D, Rafat R, Escribano J, Saura P (April 2010). "[Utility of the detection of nasal flaring in the assessment of severity of dyspnea]". Med Intensiva (in Spanish; Castilian). 34 (3): 182–7. doi:10.1016/j.medin.2009.09.008. PMID 19954861.

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