Page 724 - First Aid for the USMLE Step 1 2020, Thirtieth edition [MedicalBooksVN.com]_Neat

680 seCtioN iii RespiRatoRy ` RESPIRATORY—PAThOlOgY RespiRatoRy ` RESPIRATORY—PAThOlOgY

Physical findings in select lung diseases
AbNORmAlITY bREATh SOUNDS PERCUSSION FREmITUS TRAChEAl DEVIATION
Pleural effusion  Dull  None if small
Away from side of lesion
if large
Atelectasis  Dull  Toward side of lesion
Simple pneumothorax  Hyperresonant  None
Tension  Hyperresonant  Away from side of lesion
pneumothorax
Consolidation Bronchial breath sounds; Dull  None
(lobar pneumonia, late inspiratory crackles,
pulmonary edema) egophony, whispered
pectoriloquy

Atelectasis Alveolar collapse (right upper lobe collapse against mediastinum in A ). Multiple causes:
A ƒ Obstructive—airway obstruction prevents new air from reaching distal airways, old air is
resorbed (eg, foreign body, mucous plug, tumor)
RUL
ƒ Compressive—external compression on lung decreases lung volumes (eg, space-occupying
lesion, pleural effusion)
ƒ Contraction (cicatrization)—scarring of lung parenchyma that distorts alveoli (eg, sarcoidosis)
ƒ Adhesive—due to lack of surfactant (eg, NRDS in premature babies)

Obstructive Compressive Contraction Adhesive

Obstruction
Pleura

Lung
parenchyma
Pleural e usion, Scarring
air, tumor

FAS1_2019_16-Respiratory.indd 680 11/8/19 7:34 AM