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Download MBBS Important Topics Respiratory System

Download MBBS (Bachelor of Medicine, Bachelor of Surgery) Important Topics Respiratory System for MBBS 1st Year Important Topics, MBBS 2nd Year Important Topics, MBBS 3rd Year Important Topics & MBBS Final Year Important Topics.

This post was last modified on 24 July 2021

MBBS 2021 Important Topics and Materials for 1st Year, 2nd Year, 3rd Year and Final Year


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RESPIRATORY SYSTEM

  1. Introduction
    Name: Age: Sex: Handedness: Resident of:

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    Education: Occupation: Religion: Informant: Reliability:
  2. Chief Complaints (in chronological order)
  3. HOPI
    1. Cough Onset, Dry/Wet, Day/Night/ Postural/seasonal variation, associated with, aggravated by / relieved by, present status
    2. Expectoration Color, Consistency, Quantity, Smell, Diurnal/ Postural variation, More in the early morning, Aggravated by / Relieved by, Present status
    3. Hemoptysis Color, Quantity, Frequency, Postural variation, Associated with, Last episode, Postural symptoms, Aggravated by / Relieved by, Present status
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    5. Dyspnoea Onset, Progression (describe wrt activities), Associated with, Aggravated by / Relieved by, Present status, MMRC grading (0-4), PND, Orthopnoea
    6. Wheeze Duration, Periodicity, Seasonal/Diurnal variation, Associated allergic features like allergic rhinitis, urticaria, recurrent sneezing, Aggravated by / Relieved by, Present status
    7. Chest pain-(OLD CAARTS) Onset, Location, Duration, Character, Associated features, Aggravating and Relieving factors, Radiation, Time, Severity
    8. Fever Grade, Max Temp, Type, Associated with chills& rigors, Diurnal variation, Evening rise of temp., night sweats, relieved by, present status
    9. Anorexia
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    11. Weight loss Quantified/Unquantified, Intentional /Unintentional, Significant/insignificant
    12. Hoarseness of voice
    13. Ptosis
    14. Recurrent respiratory infection
    15. History suggestive of Collagen Vascular Disease-Joint pain/rash/oral ulcers/seizures/excessive hairfall
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    17. Palpitation /Easy fatiguability
    18. Bladder / Bowel symptoms
    19. Swelling of face/ edema
    20. CNS symptoms-LOC/Head ache/weakness/vomiting
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  5. Past History
    DM/HTN/TB/Bronchial asthma/IHD
    Childhood infection
    Jaundice/Blood Txn
    Allergies/FB inhalation

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    Trauma/Surgeries/ similar illness in the past
  6. Personal History
    Smoking - pack years/smoking index/ Chula smoking
    Alcohol/Tobacco
    Veg/Non veg

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    Marital status/Children/Menstrual history in detail
    High risk behavior/Bladder/Bowel/Sleep
    Immunization history
    Socio-economic status/ over crowding
  7. Family history

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    TB/Similar illness in the family
  8. Treatment history
  9. Summary at the end of the history
  10. Impression/DD
    General physical examination
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  • Conscious/oriented/comfortable
  • Ht- Weight- BMI- Temp-
  • Pulse- (Rate, Rhythm, Volume, Character, Peripheral pulses. R-R/ R-F delay, Pulse deficit, Vessel wall, Carotid bruit)
  • BP- mmHg, Respiration - Rate, Rhythm, Type (Abdomino-Thoracic / Thoraco-Abdominal)
  • SpO2- BCG scar
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  • P/J/CY/CI/LNE/PE/JVP/rash/facial plethora/neck veins/puffiness of face/Pemberten sign/Lt supra clavicular LN /Voice/asterixis
  • Signs of Malnutrition- Temporal / Buccal fat wasting, Hollowness of supraclavicular - infraclavicular fossae, Emaciated look
  • Nicotine stain- lips, Nail, teeth, gums, Vitamin deficiencies
  • Spine - Kyphosis / Scoliosis/Gibbus, Skull
  • Peripheral signs of TB / Sarcoid / HIV
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  • Marfanoid features, Thyroid, Testes, Low hair line, Horners Features, Congenital anomalies

Systemic Examination

Respiratory System:

Upper Respiratory Tract
  • Ear, Nose (polyps, postnasal drip, DNS)
  • Throat (tonsils, oral hygiene, nicotine stain)
Inspection
  • Chest symmetry, Pectus excavatum/Carinatum
  • Shape of chest
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  • Respiratory movements - equal / decreased
  • Tracheal position / Trail sign
  • Signs of volume loss – shoulder droop/wasting (supra/infra clavicular)/Nipple position/ Spino scapular distance/ Rib crowding/Intercostal spaces
  • Intercostal space indrawing / Hoover's sign/Respiratory paradox/ Respiratory alternans
  • Accessary muscles of respiration
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  • Apical impulse
  • Dilated veins/Scars/Sinuses/Visible pulsations/Skin
Palpation
  • Inspiratory findings confirmed
  • Tracheal position
  • Apical impulse
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  • Rib crowding
  • Chest wall tenderness/ Crepitus / SC emphysema/ Nodules / LNE
  • Harrison's sulcus / Hoover's sign
Measurements
Chest Circumference Expansion Hemithorax Hemithorax expansion Spino Scapular Distance Antero-Posterior Diameter Transverse Diameter
Right
Left
Supra Clavicular Infra Clavicular Mammary Axillary Infra Axillary Supra Scapular Inter Scapular Infra Scapular
Respiratory Movement
Rt
Lt
Percussion
Rt
Lt
Kronig's Isthmus Rt
Lt
Percussion over clavicle Rt
Lt
Percussion over Traube Space
Liver Dullness, Tidal Percussion
Auscultation
Supra Clavicular Infra Clavicular Mammary Axillary Infra Axillary Supra Scapular Inter Scapular Infra Scapular
Air Entry Rt
Lt
VF, VR Rt
Lt
VBS Rt
Lt
Bronchial Breathing Rt
Lt
Wheeze/ Rhonchi Rt
Lt
Crackles Rt
Lt
Whispering Pectroloquy
Aegophony
Pleural Rub

Cardio-Vascular System

  • Apical Impulse
  • Precardial bulge, Parasternal heave
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  • Palpable sounds, Thrill
  • S1,S2,S3,S4
  • Murmurs

Abdomen

  • Symmetry/Distension
  • All quadrants moves with respiration
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  • Soft, Tenderness, Liver, Spleen, Any mass, Bowel sounds, Hernial orifices

Central Nervous System

  • Consciousness,Orientation
  • FND, Horner's Syndrome, Planters

Summary after Examination

Diagnosis/DD

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Investigation

Treatment

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