00:00
Wheezing, what about this? This is a
expiratory sound. Wheezing
is often audible to the patient
especially in asthma. Wheezing is to be distinguished,
differentiated from stridor. Highlight
your head, stridor. Which is an inspiratory
sound best heard in the upper airways. Is
that clear? So, the wheezing, for example,
if it’s asthma, more or less a lower type
of generation and the patient would be able
to hear it and the stridor would be an inspiratory
and to you that should indicate an upper
respiratory issue. Stridor deserves immediate
medical attention because this is the upper
airway and the fact that you might actually
have the upper airway that is now become closed.
00:47
And if that’s the case, what’s one of
the first things that you do when a patient
comes in with emergency in the ER? ABC – Airway,
bronchi or breathing and number 3 would be
your circulation.
01:00
Wheezing pearls, we’ll do the same thing
here as well. These are important, look for
the description. Symmetric polyphonic. Meaning
to say several sounds and a musical wheeze,
you’re thinking about asthma. Unilateral
wheezing, this is usually formed by the aspiration,
you tell me. If say, they have a child that
ends up.. Well the age old question, is maybe a
peanut or some kind of food particle, maybe
even a toy. Well, of the two
lungs, which one are you more likely to go
into? The right lung because of less of an
angle and it will directly deposit, depending
as to the position. For example, if it’s
sitting up type of position then it will be
post your basal segment of the right lower
lobe, so on and so forth.
01:42
Things that you talked about in anatomy. Unilateral
wheezing, maybe PE. When you have a PE
from a DVT, a pulmonary embolus. Wow,
that’s scary. Mean to say that your patient
is going to have rapid shallow breathing,
hypoxia will still be present and airway tumours
or masses, might also present as unilateral.
02:03
Wheezes heard more without the stethoscope.
These are vocal cord type of dysfunctions.
02:07
So, wheezing, as I said, when it’s asthma
that the patient was expressing it. But, here,
without the stethoscope and hearing wheezing,
you’re thinking more along the upper airway
type of dysfunction. Wheezing after eating,
once again, aspiration and food allergy. Look
for these descriptions, please, in a stem
of a question or history of your patient so
that you can then move into the right differential
of pulmonary disease.