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Appareil Respiratoire

Appareil Respiratoire. Examen Clinique Examens paracliniques. Asthme, eczema, rhinite et médicts, aliments. Professionnels et habitat. +++. : Tabagisme en PA. Sèche, grasse, quinteuse. Muqueuse, purulente, muco-p, purulente. Effort, repos. Ronflement, somnolence. Dysphagie, dysphonie.

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Appareil Respiratoire

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  1. Appareil Respiratoire • Examen Clinique • Examens paracliniques

  2. Asthme, eczema, rhinite et médicts, aliments Professionnels et habitat +++ :Tabagisme en PA

  3. Sèche, grasse, quinteuse Muqueuse, purulente, muco-p, purulente Effort, repos • Ronflement, somnolence • Dysphagie, dysphonie

  4. Dyspnée

  5. HémoptysieConduite à tenir diagnostique ( O2 + réparation masse sanguine + GLYPRESSINE 1

  6. Expectoration Expectoration muqueuse  expectoration muco-purulente Expectoration purulente Expectoration séreuse Moule bronchique Hémoptysie

  7. État de conscience, agitation, confusion • FR: Polypnée, bradypnée Cicatrices, déformations, cyphoscoliose

  8. Bulleux ou sous crépitants http://www.med.ucla.edu/wilkes/lungintro.htm • SpO2

  9. Type Temps Caractère Site respiratoire RONCHUS I + E Grave, Mobile Bronche SIBILANT i + E Aigu, Mobile Bronche SOUS CREPITANT I + e Bulleux, Humide Bronchiole CREPITANT I (fin) Fin, sec Alvéole FROTTEMENT I + E Superficiel, 0 en apnée Plèvre SOUFFLE TUBAIRE I + e Intense, Rude Parenchyme condensé SOUFFLE PLEURETIQUE i + E Voilé, Lointain Pleurésie

  10. Signes immédiats de gravité • Troubles de la conscience • Polypnée extrême ou bradypnée avec pauses respiratoires • Cyanose, sueurs, hypotension

  11. Ponction sous scanner

  12. http://bronchoscopy.org/ 8 steps

  13. Click to continue Step 1: nose to larynx • The scope is advanced from the nose to the larynx . This step includes local anesthesia. Click HERE to view video From the head

  14. Click to continue Step 2: larynx to subglottis • From the larynx the trachea is entered to the subglottic area. If from the head: once the vocal cords are passed the scope is slightly flexed downwards. If from the front: once the vocal cords are passed the scope is slightly flexed upwards. Click HERE to view video From the front

  15. Click to continue Step 3: Follow the curve to the carina • The Trachea is not a “straight pipe”; It deviates posteriorly and slightly to the right when approaching the main carina. Click HERE to view video From the head

  16. Click to continue Step 4a: Carina to left main bronchus • From the neutral position the LMB is entered just by twisting the wrist to the left and advancing for 1 -2 cm. From head Click HERE to view video

  17. Click to continue Step 4b: Carina to right main bronchus • From the neutral position the RMB is entered just by twisting the wrist to the right and advancing the scope for 1 -2 cm. From head Click HERE to view video

  18. Click to continue Step 4c: Left-right-neutral • From the neutral position the left and right main bronchi are entered alternatively just by twisting the wrist and advancing the scope for few cm. From head Click HERE to view video

  19. Click to continue Step 5a: Down-up-left main bronchus • The scope is slowly advanced the pulled back up the LMB while always keeping it in the middle of the airway lumen. From the front Click HERE to view video

  20. Click to continue Step 5b: Down-up right main bronchus • The scope is slowly advanced down the RMB to RLL and pulled back upwards while always keeping it in the middle of the airway lumen. Click HERE to view video Click HERE to view video From the front

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