Clinical Manifestations of Foreign Body Airway Obstruction

In this article, we will discuss the Clinical Manifestations of Foreign Body Airway Obstruction. So, let’s get started.

Clinical Manifestations

The clinical feature varies according to severity of obstruction.

I. In partial obstruction due to a foreign body, the patient may struggle with the obstruction and tries to ‘ cough it out ‘ or tries to swallow or ‘ wash it down with water ‘. The patient is responsive and can cough forcibly. If air entry is poor, then signs of poor air exchange will appear such as weak ineffective cough, high-pitched noise while inspiration (stridor), increased respiratory difficulty and cyanosis.

II. With complete airway obstruction, the patient may clutch the neck with the thumb and fingers (universal distress sign for choking) and following signs may appear:

  • Inability to speak, breath and cough
  • Pallor followed by cyanosis
  • Loss of consciousness and collapse

If obstruction is not relieved immediately patient may develop cardiac arrest and die.

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Definition of Pulmonary Embolism

In this article, we will discuss the Definition of Pulmonary Embolism. So, let’s get started.

Definition

It is the obstruction of pulmonary artery or one of its branches by an embolus. The embolus usually is a blood clot swept into circulation from a large peripheral vein, particularly a vein in the leg or pelvis. The effects of pulmonary embolism depend on the size of the embolus and the amount of lung tissue involved. When an embolus becomes lodged in a pulmonary blood vessel, it prevents adequate blood supply to the lung, interferes with the exchange of oxygen and carbon dioxide, and results in arterial hypoxia. Simple, uncomplicated embolism produces such cardiopulmonary symptoms as dyspnea, tachypnea, persistent cough, pleuritic pain, and hemoptysis. Apprehension is a common symptom. On rare occasions the cardiopulmonary symptoms may be acute, occuring suddenly and quickly producing cyanosis and shock.

Symptoms

  • Increased temperature, pulse, and respiratory rate
  • Changes in patient color
  • Severe chest pain/dyspnea
  • Pleurisy/blood stained sputum
  • Cough, diaphoresis, apprehension
  • Low grade fever
  • Bulging neck veins
  • Altered mental status

Definition of Atelectasis

In this article, we will discuss the Definition of Atelectasis. So, let’s get started.

Definition

It is a condition characterised by the collapse of alveoli, preventing the respiratory exchange of carbon dioxide and oxygen in the lungs. Symptoms may include diminished breath sounds or respiratory crackles, a mediastinal shift toward the side of the collapse, fever, and increased dyspnea. As the remaining portion of the lungs eventually hyperinflate, the oxygen saturation of the blood is often nearly normal. Atelectasis is a potential complication following surgery, especially in individuals who have undergone chest or abdominal operations resulting in associated abdominal or chest pain during breathing. Anyone undergoing chest or abdominal surgery using general anaesthesia is at risk of developing atelectasis, since breathing is often shallow post surgery in order to avoid pain from the surgical incision, this causes significant decrease in airflow to the alveoli, contributes to pooling of secretions, which in turn can cause infection.

Clinical Features

  • Increased temperature, pulse, and respiratory rate
  • Flushed/feverish patient
  • Tightness/discomfort of the affected side of the chest
  • Poor chest expansion
  • X-ray reveals collapse of lung (in first 48 hours post surgery)

Definition of Aspiration Pneumonia

In this article, we will discuss the Definition of Aspiration Pneumonia.So, let’s get started.

Definition

It is due to aspiration of foreign material into the lungs. Aspiration Pneumonia may occur during anaesthesia or recovery from anaesthesia. Patients receiving enteral feeding therapies may also be at risk of developing aspiration pneumonia. It occurs as a result of inhalation or aspiration of infected solid or liquid material into the lungs. Large volumes of aspirate causes asphyxia, smaller amounts cause a necrotic or gangrenous pneumonia, in anterior and ventral parts of the lung. There is profound toxemia, cough, gargling or squeaky rales, and usually pleurisy producing pleural friction rub. Signs and Symptoms include fever, hemoptysis, increased respiratory rate, foul-smelling sputum. Complications include exudative pleural effusion, empyema, and lung abscess. If continual aspiration occurs, the chronic inflammation can cause compensatory thickening of the inside of the lungs, resulting in bronchiectasis.

Physical and Systemic Signs of Cor Pulmonale

In this article we will discuss the Physical and Systemic Signs of Cor Pulmonale. So, let’s get started.

Physical Signs

  • Patient is orthopnoic, sits with elbows supported on a table and legs dangling by the side of the bed.
  • Purse-lip breathing and cyanosis (lips, tongue, and buccal cavity) will be present in patients with COPD with acute exacerbation.
  • Periorbital edema
  • Neck veins: Distended with raised JVP and ‘VY’ collapse due to tricuspid regurgitation.
  • Peripheral edema

Systemic Signs

  • Respiratory system may show signs of COPD (barrel-shaped chest, restricted chest movements and expansion, hyper-resonant note and vesicular breathing with prolonged expiration, muffled breath sounds).
  • Signs of RV hypertrophy or failure, e.g. parasternal heave, loud P2, midsystolic and early diastolic (Grahm-steel) murmur and pansystolic or holosystolic murmur of tricuspid regurgitation (Carvallo’s sign) may be present.
  • Abdominal examination: Abdomen may be distended with tender hepatomegaly. Hepatojugular reflex may be present. Ascites may also be present.