Download MBBS (Bachelor of Medicine and Bachelor of Surgery) Clinical Signs in Pulmonary Fibrosis PowerPoint PPT presentation
Pulmonary fibrosis
Abnormal formation of fibre like scar tissue in the lung
May take 3 forms
REPLACEMENT FIBROSIS
FOCAL FIBROSIS
INTERSTITIAL FIBROSIS
Replacement fibrosis
Fibrous tissue is laid down in the areas of lung destruction
Clinical signs
Chest is asymmetrical with flattening of the affected side
Drooping of shoulder
Decreased movement
Trachea and the mediastinal structures are pul ed
towards the same side
Percussion note is diminished
Vocal fremitus and vocal resonance depend on the severity of
fibrosis . In severe fibrosis they are decreased
In extensive fibrosis the breath sounds are considerably diminished
Adventitious sounds may be heard
Interstitial fibrosis
Interstitial lung disease may result from connective
tissue disorders like progressive systemic sclerosis,
collagen vascular disease, sarcoidosis,
chronic pulmonary edema etc
50% occur without any identifiable cause and are known as
idiopathic pulmonary fibrosis
In all these cases there is increased deposition of fibrous tissue in the
interstitium which affect the diffusion of oxygen across alveolar
membrane
Clinical signs
Gross clubbing
Tachypnoea
Cyanosis
Decreased respiratory movements
Since these changes affect both lungs there is NO marked shift of
midline structures
Breath sounds are decreased
Diffuse rales which persist after coughing are characteristic
The characteristic end inspiratory Velcro crackles are present in IPF
Chest x ray shows generalised loss
PFT shows restrictive pattern usually
of translucency and increased
decreased vital capacity
reticulations
In advanced cases of ILD traction
Cardiac findings include
bronchiectasis and subpleural
honeycombing may be seen
right ventricular hypertrophy
Loud pulmonic second sound
Pulmonary
collapse
When a portion of the lung becomes airless,it is termed as
pulmonary collapse or atelectasis
Causes include foreign body, tumors of bronchus, copius
secretions,p neumothorax and pleural effusion
Clinical findings
Symptoms depend on the extent of the collapse and its onset
Acute lesions are more symptomatic
Massive collapse lead to dyspnoea with or without cyanosis
Movement of the affected side is reduced and the chest is flattened
Trachea and cardiac apex is shifted to the same side
Percussion note over the affected side is reduced
Breath sounds are diminished or absent
Adventitious sounds are absent
Chest Xray
Direct signs
Indirect signs
q Displacement of the interlobar
q Elevation of hemidiaphragm
fissure
q mediastinal displacement
q Loss of aeration
q Hilar displacement
q Vascular and bronchial signs
q Compensatory hyperinflation
Patterns
Complete lung collapse
Partial lung collapse
Golden's S sign
Juxtaphrenic peak sign
This post was last modified on 12 August 2021