Appareil Respiratoire

Présentation au sujet: "Appareil Respiratoire"— Transcription de la présentation:

1 Appareil Respiratoire
Examen Clinique Examens paracliniques

2

3

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

5 Sèche, grasse, quinteuse
Muqueuse, purulente, muco-p, purulente Effort, repos Ronflement, somnolence Dysphagie, dysphonie

6 Dyspnée

7 Hémoptysie Conduite à tenir diagnostique
( O2 + réparation masse sanguine + GLYPRESSINE 1

8                                                                      

9 Expectoration muqueuse expectoration muco-purulente
                                                                     Expectoration muqueuse  expectoration muco-purulente Expectoration purulente Expectoration séreuse                             Moule bronchique Hémoptysie

10

11 État de conscience, agitation, confusion
                                                                                                                                État de conscience, agitation, confusion FR: Polypnée, bradypnée Cicatrices, déformations, cyphoscoliose

12

13

14

15

16

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

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

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

20

21

22

23

24

25 Ponction sous scanner

26

27

28

29

30

31

32

33

34

35

36

37

38

39

40

41

42 8 steps

43 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 Click to continue From the head

44 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 Click to continue

45 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 Click to continue From the head

46 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 Click to continue

47 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 Click to continue

48 Step 4c: Left-right-neutral
Click to continue 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

49 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 Click to continue

50 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 Click to continue

51 Exploration de la plèvre
Ponction pleurale Trocard de Boutin ou d’Abrahms Drainage thoracique Trocard de monod, drain monté, introducteur Thoracoscopie

52 Ponction pleurale Anestheésie locale aseptie

53 Drainage thoracique

54

55 Thoracoscopie

56 Exploration fonctionnelle respiratoire
                                         

57 Spirométrie

58 Boucle débit-volume

59 Explorations fonctionnelles respiratoires
Boucle débit volume ou spirométrie VEMS, CV, VEMS/CV CPT RVA Gaz du sang PaO2, PaCO2, pH, RA, SaO2 Test métacholine Épreuve d’effort Polysomnographie

60 polysomnographie

61

62 Abcés

63 Pneumonie

64 Pneumonie

65 pneumonie

66

67                                                    

68

69 pleurésie

70 pneumothorax

71

72

73 cancer

74

75

76 emphysème