Symptoms and Physical findings of Pneumonia

In this article, we will discuss about various Symptoms and Physical findings of Pneumonia. So, let’s get started.

Symptoms and Physical findings

Fever

Sweats

Chills

Productive cough (with mucoid or purulent sputum), non-productive cough or dry cough

Hemoptysis

Rarely, pleuritic chest pain

Severely ill patients may show signs of septic shock and evidence of organ failure

Other symptoms include

Headache

Myalgia

Nausea

Vomiting

Fatigue

Sore throat

Diarrhea

Physical findings include tachycardia, arterial gas desaturation, tachypnea, use of accessory muscle during respiration, increased or decreased vocal fremitus on palpation, percussion reveals dull note on the involved area, and auscultation reveals crackles, bronchial breath sound and pleural rub over the area involved.

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Causative pathogens responsible for community-acquired pneumonia

In this article, we will discuss about the various Causative pathogens responsible for community-acquired pneumonia. So, let’s get started.

Causative pathogens

Streptococcus pneumoniae

Mycoplasma pneumoniae

Hemophilus influenzae

Influenzae, parainfluenzae viruses

Legionella species of bacteria

Staphylococcus aureus

Coxiella burnetti

Chlamydia pneumoniae

Oral anaerobes and fungal

Streptococcus pneumoniae, Staphylococcus aureus, Legionella spp, Gram negative baccilli, and Hemophilus influenzae are responsible for hospital-acquired pneumonia (ICU).

Streptococcus pneumoniae, Mycoplasma pneumoniae, Chlamydia, Hemophilus influenzae, Logionella spp, and respiratory viruses such as influenzae, parainfluenzae virus etc are responsible for hospital-acquired pneumonia (Non-ICU).

Streptococcus pneumoniae, Mycoplasma pneumoniae, Chlamydia pneumoniae, Hemophilus influenzae, Respiratory viruses are responsible for OPD cases.

Diagnosis of Severe or Massive Hemoptysis

In this article, we will discuss about the Diagnosis of Severe or Massive Hemoptysis. So, let’s get started.

Diagnosis

1. Blood work such as TLC (total leukocyte count), DLC (differential leukocyte count), Hb estimation, and platelet count can be done in order to rule out the diagnosis of any possible infection or bleeding disorder.

2. Chest x-ray provides valuable information for pulmonary congestion, pneumonia, tuberculosis, lung abscess, lung cancer, pulmonary infarcts, etc. CT scan is used to investigate peripheral lesions which are seen in the x-ray and are inaccessible to bronchoscopy and it also facilitates percutaneous needle biopsy, if indicated.

3. Sputum culture is done in order to rule out possible infection and it can also be examined for malignant cells.

4. Fibreoptic bronchoscopy is useful in localizing the site of bleeding and for visualization of endobronchial lesions. In the case of massive hemoptysis rigid bronchoscopy is more preferable than fibreoptic bronchoscopy for better airway control and efficient suction capabilities.

5. CT pulmonary angiography is indicated in patients with suspected pulmonary embolism.

6. Ventricular Perfusion (V/Q) lung scan is useful in confirming the diagnosis of suspected thromboembolic disease.

Below is the flow chart which demonstrates the Management of Massive Haemoptysis

Anatomy of Shoulder Joint

In this article, we will discuss about the Anatomy of the Shoulder Joint. So, let’s gets started.

Anatomy

Joint type– Synovial Ball and Socket Joint, Diarthrosis, and multiaxial joint

Degree of freedom– 3

Bones involved– Glenoid cavity of Scapula and Head of Humerus

Joint Spaces– Glenohumeral space (4-5 mm), Subacromial space (9-10 mm), and Axillary space.

Muscles surrounding the joint– Biceps brachii, and rotator cuff musculature (which involves subscapularis, supraspinatus, infraspinatus, and teres minor)

Joint capsule– Articular capsule of the humerus

Bursa– Subacromial-subdeltoid bursa present between the joint capsule and deltoid muscle. subacromial bursa present between the joint capsule and the acromion process, subcoracoid bursa present between the joint capsule and coracoid process, coracobrachial bursa present between the coracobrachialis muscle and the subscapularis muscle, subscapular bursa present between the joint capsule and subscapularis muscle, and supra-acromial bursa.

Ligaments– Capsular ligament, superior, middle, and inferior glenohumeral ligament, coracohumeral ligament, coraco-acromial ligament, and transverse humeral ligament.

Nerve supply– Subscapular, left pectoral, and axillary nerve.

Artery supply– Anterior and posterior circumflex humeral arteries. suprascapular artery, and scapular circumflex artery.

Shoulder joint movements (muscles involved along with axis and planes)

1. Movement- Flexion

Muscles involved- Pectoralis major, anterior fibres of the deltoid, supraspinatus, and coracobrachialis.

Axis and Plane- Frontal axis and Sagittal plane

2. Movement- Extension

Muscles involved- Lattisimus dorsi, posterior fibres of the deltoid, and triceps brachii

Axis and Plane- Frontal axis and Sagittal plane

3. Movement- Abduction

Muscles involved- Deltoid, supraspinatus, trapezius, and serratus anterior

Axis and Plane- Sagittal axis and Frontal plane

4. Movement- Adduction

Muscles involved- Pectoralis major, lattisimus dorsi, teres major, and subscapularis

Axis and Plane- Frontal plane and Sagittal axis

5. Movement- Internal rotation

Muscles involved- Deltoid (anterior fibres), teres major, pectoralis major, lattisimus dorsi, and subscapularis

Axis and Plane- Vertical axis and transverse plane

6. Movement- Lateral rotation

Muscles involved- Deltoid (posterior fibres), infraspinatus, and teres minor

Axis and Plane- Vertical axis and transverse plane

7. Movement- Horizontal abduction

Muscles involved- Subscapularis, supraspinatus, and deltoid (posterior fibres)

Axis and Plane- Vertical axis and transverse plane

8. Movement- Horizontal adduction

Muscles involved- Pectoralis major, biceps brachii, and deltoid (anterior fibres)

Axis and Plane- Vertical axis and transverse plane

9. Movement- Diagonal adduction

Muscles involved- Pectoralis major, deltoid (anterior fibres), and biceps brachii

Axis and Plane- Diagonal axis and diagonal plane

10. Movement- Diagonal abduction

Muscles involved- Subscapularis, deltoid, and supraspinatus

Axis and Plane- Diagonal axis and diagonal plane

11. Circumduction- Combination of flexion, extension, adduction, and abduction.