cardiovascular disorders
Cardiovascular Examination
Lung Examination
The lungs are examined for signs of Pleural Effusion and Percussionis the primary physical maneuver used to detect the presence and level of pleural effusion. Finding areas of dullness during percussion signifies underlying fluid or, less commonly, consolidation. Palpationincludes tactile fremitus (vibration of the chest wall felt while a patient is speaking); fremitus is decreased in pleural effusion and pneumothorax and increased in pulmonary consolidation (eg, lobar pneumonias). Auscultation is an important component of the examination of patients with suspected cardiac disease. The character and volume of breath sounds are useful in differentiating cardiac from pulmonary disorders. Adventitious sounds are abnormal sounds, such as crackles, rhonchi, wheezes, and stridor. Crackles (previously called rales) and wheezes are abnormal lung sounds that may occur in heart failure as well as non-cardiac diseases. are discontinuous adventitious breath sounds. Fine crackles are short high-pitched sounds; coarse crackles are longer-lasting low-pitched sounds. Crackles have been compared to the sound of crinkling plastic wrap and can be simulated by rubbing strands of hair together between 2 fingers near one’s ear. They occur most commonly with atelectasis, alveolar filling processes (eg, pulmonary edema in Heart Failure (HF) ), and are whistling, musical breath sounds that are worse during expiration than inspiration. Wheezing can be a physical finding or a symptom and is usually associated with dyspnea. Wheezes occur most commonly with asthma but can also occur in cardiac disease such as Heart Failure (HF) . 