2. Syndrome of increased airiness of lung tissue (emphysema)

REASONS: It occurs in COPD, bronchial asthma; as a result of involutional changes; the outcome of many chronic lung diseases; emphysema SYMPTOMS:

1. Dyspnea of an expiratory character, patients exhale with closed lips, puffing out their cheeks (puff - "pink puff");

2. Cyanosis, puffiness of the face ("blue swelling");

3. The chest is barrel-shaped;

4. The amplitude of the respiratory excursion of the lungs is reduced. Often, auxiliary muscles are involved in the act of breathing;

5. The weakening of voice trembling and increased resistance of the chest are palpated;

6. In comparative percussion - box sound;

7. With topographic percussion, the expansion of the boundaries of the lungs, both up and down, restriction of respiratory excursion of the lungs;

8. Difficulties in determining the percussion boundaries of the heart, reducing the zone of absolute dullness of the heart.

9. Tachycardia (in response to hypoxia);

10. During auscultation, weakened vesicular, so-called "cotton" breathing is heard. The nature of breathing changes depending on the disease leading to emphysema or a concomitant process;

11. Radiologically determined increased transparency of the pulmonary fields, decreased diaphragm mobility, low diaphragm position, horizontal position of the ribs;

12. A spirographic study reveals: a decrease in lung capacity (VC) and maximum pulmonary ventilation (MLV), as well as an increase in residual volume.

3. Broncho obstructive syndrome

REASONS: bronchial asthma, COPD, allergoses, systemic diseases of connective tissue, foreign

bodies, bronchial tumors.

SYMPTOMS:

1)expiratory dyspnea (difficulty and prolonged exhalation); with severe bronchial obstruction, expiratory dyspnea reaches a degree of suffocation. Choking that occurs as an attack is called asthma. At the end of an asthma attack, viscous viscous sputum usually coughs up.

2. Unproductive, sometimes soundless cough;

2. During an attack of suffocation, the chest is as if in a state of forced inspiration, the boundaries of the lungs expand, the intercostal spaces bulge. With a sufficiently long course of the disease, emphysema develops and the chest becomes barrel-shaped (see Syndrome of increased airiness of the lungs).

2. With an attack of suffocation, patients occupy a forced position sitting with an emphasis on their hands. The respiratory muscles are included in the act of breathing;

2. The symmetric restriction of respiratory excursions of both lungs is determined;

3. Weakening of voice trembling;

4. Boxed shade of percussion sound over all pulmonary fields;

2. Auscultatory: weakened vesicular breathing with prolonged expiration, a large number of dry wheezing, buzzing wheezing. In extremely severe cases, respiratory sounds are not heard at all. A so-called ―silent‖ or ―dumb‖ lung develops;

2. An X-ray examination reveals increased transparency of the pulmonary fields;При спирографическом исследовании уменьшается форсированная жизненная емкость легких (ФЖЕЛ) и снижается индекс Вотчала-Тиффно, объем форсированного выдоха за 1-ю секунду (ОФВ1).

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10. With peak flowmetry, the forced expiratory flow rate decreases (peak expiratory flow rate, PSV).