Occupational lung disease physical examination

Occupational lung disease Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Occupational lung disease from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Occupational lung disease physical examination On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Occupational lung disease physical examination

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Occupational lung disease physical examination

CDC on Occupational lung disease physical examination

Occupational lung disease physical examination in the news

Blogs on Occupational lung disease physical examination

Directions to Hospitals Treating Coalworker's pneumoconiosis

Risk calculators and risk factors for Occupational lung disease physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]

## Overview[edit | edit source]

Patients with occupational lung disease usually appear fatigued and short of breath. Physical examination of patients with occupational lung disease is usually remarkable for bronchial breathing, increased vocal resonance, and fine crepitations.

## Physical Examination[edit | edit source]

### Appearance of the Patient[edit | edit source]

Patients with occupational lung disease usually appear fatigued and short of breath.[1][2][3]

### Vital Signs[edit | edit source]

* Low grade fever may be noted
* Tachypnea
* Pulsus paradoxus
* Pulse wave volume decreases with inspiration

### Skin[edit | edit source]

* Tar staining on fingers from cigarettes
* Joint swelling and tenderness
* Features of rheumatological disease
* Scarring on chest wall may be noted from previous operations
* May be in mid-axillary line and indicates a chest tube placement, or horizontal postero-lateral scars from lobectomy

### HEENT[edit | edit source]

* Conjunctival pallor
* Inflamed nares

### Neck[edit | edit source]

* Jugular venous distension
* Suggests pulmonary hypertension
* Lymphadenopathy

### Lungs[edit | edit source]

* Increased chest expansion
* Barrel chest suggests COPD
* Lungs are hyperresonant
* Fine crackles upon auscultation of the lung bases or apices, unilaterally or bilaterally
* Rhonchi
* Bronchial breath sounds
* Expiratory wheezing with normal or delayed expiratory phase
* Wheezing may be present
* Egophony present
* Bronchophony present
* Increased tactile fremitus

### Heart[edit | edit source]

* Cardiovascular examination of patients with occupational lung disease is usually normal
* Right ventricular heave may be noted in cor pulmonale

### Neuromuscular[edit | edit source]

Horner's syndrome may be noted, and may indicate malignancy

### Extremities[edit | edit source]

* Clubbing
* Peripheral or central cyanosis
* Pitting/non-pitting edema of the upper or lower extremities

## References[edit | edit source]

1. ↑ Raghu G, Collard HR, Egan JJ, Martinez FJ, Behr J, Brown KK, Colby TV, Cordier JF, Flaherty KR, Lasky JA, Lynch DA, Ryu JH, Swigris JJ, Wells AU, Ancochea J, Bouros D, Carvalho C, Costabel U, Ebina M, Hansell DM, Johkoh T, Kim DS, King TE, Kondoh Y, Myers J, Müller NL, Nicholson AG, Richeldi L, Selman M, Dudden RF, Griss BS, Protzko SL, Schünemann HJ (2011). "An official ATS/ERS/JRS/ALAT statement: idiopathic pulmonary fibrosis: evidence-based guidelines for diagnosis and management". Am. J. Respir. Crit. Care Med. 183 (6): 788–824. doi:10.1164/rccm.2009-040GL. PMC 5450933. PMID 21471066.
2. ↑ Bradley B, Branley HM, Egan JJ, Greaves MS, Hansell DM, Harrison NK, Hirani N, Hubbard R, Lake F, Millar AB, Wallace WA, Wells AU, Whyte MK, Wilsher ML (2008). "Interstitial lung disease guideline: the British Thoracic Society in collaboration with the Thoracic Society of Australia and New Zealand and the Irish Thoracic Society". Thorax. 63 Suppl 5: v1–58. doi:10.1136/thx.2008.101691. PMID 18757459.
3. ↑ Steele MP, Speer MC, Loyd JE, Brown KK, Herron A, Slifer SH, Burch LH, Wahidi MM, Phillips JA, Sporn TA, McAdams HP, Schwarz MI, Schwartz DA (2005). "Clinical and pathologic features of familial interstitial pneumonia". Am. J. Respir. Crit. Care Med. 172 (9): 1146–52. doi:10.1164/rccm.200408-1104OC. PMC 2718398. PMID 16109978.