chest wall examination

Chest wall examination is a key examination in chest examination, generally including nutritional status, skin, lymph nodes and skeletal muscle development. In addition, the focus is on vein, subcutaneous emphysema, chest wall tenderness, and intercostal space. Actively cooperate with the doctor's work. 1 Before the inspection, explain the purpose and essentials of the inspection to the inspected person, and obtain mutual cooperation; 2 the examinee should try to expose the chest above the waist, and the seat or supine position can be taken during the examination; Flat on the inspection site, there should be no gap between the palm and the chest wall; 4 inspection site on the chest wall on both sides of the lower part. Basic Information Specialist Category: Respiratory Examination Category: Other Inspections Applicable gender: whether men and women apply fasting: not fasting Tips: Poor rest, improper diet, excessive fatigue. Normal value There is no obvious vein in the chest wall of normal people, no subcutaneous emphysema, no tenderness in the chest wall, and no bulging in the intercostal space. Clinical significance Abnormal results When the collateral circulation is established after the blood flow in the superior vena cava or inferior vena cava is blocked, the chest wall vein filling or varicose veins can be seen. The lungs, trachea, or pleura are damaged or the gas escapes after the lesions accumulate in the subcutaneous tissue called subcutaneous emphysema. When suffering from diseases such as intercostal neuritis, costal cartilage inflammation, soft tissue inflammation, dermatomyositis, trauma and rib fracture, local tenderness may occur. Leukemia patients may have sternal tenderness. The intercostal space bulging is seen in a large number of patients with pleural effusion, pneumothorax and severe emphysema. The people who need to be examined have leukemia, pneumothorax, severe emphysema, subcutaneous emphysema and other people. Precautions Taboo before the examination: poor rest, improper diet, excessive fatigue. Requirements for inspection: Actively cooperate with the doctor's work. 1 Before the inspection, explain the purpose and essentials of the inspection to the inspected person, and obtain mutual cooperation; 2 the examinee should try to expose the chest above the waist, and the seat or supine position can be taken during the examination; Flat on the inspection site, there should be no gap between the palm and the chest wall; 4 inspection site on the chest wall on both sides of the lower part. Inspection process (a) vein There is no obvious vein visible in the chest wall of normal people. When the collateral circulation is established after the blood flow in the superior vena cava or inferior vena cava is blocked, the venous wall filling or varicose veins can be seen. When the superior vena cava is blocked, the venous blood flow direction is from top to bottom; when the inferior vena cava is blocked, the blood flow direction is from bottom to top. (two) subcutaneous emphysema The lungs, trachea, or pleura are damaged or the gas escapes after the lesions accumulate in the subcutaneous tissue called subcutaneous emphysema. At this time, the skin is pressed with a finger, and a feeling of bursting or snow can be felt. When a subcutaneous emphysema is pressed with a stethoscope, a similar sputum sound can be heard, that is, subcutaneous emphysema. Common in thoracic puncture, trauma, etc., occasionally in the gastrobacter infection. Severe gas can spread from the chest wall to the neck, ankle or other parts. (three) chest wall tenderness There is no tenderness in the chest wall of normal people, but in the case of diseases such as intercostal neuritis, costal cartilage inflammation, soft tissue inflammation, dermatomyositis, trauma and rib fracture, local tenderness may occur. Leukemia patients may have sternal tenderness. (4) Intercostal space Note the rib gap for dents or bulging. When the inspiratory gap is depressed, the airway is blocked, and the gas cannot enter the lung smoothly. The intercostal space bulging is seen in a large number of patients with pleural effusion, pneumothorax and severe emphysema. Not suitable for the crowd Inappropriate crowd: None.