In a coin test, a coin held against the chest is tapped by another coin on the side where the hydropneumothroax is suspected.
A stethoscope is placed on the back to listen to breath sounds and the sound of the coins.
If a tinkling sound is heard, test is positive for hydropneumothorax
Polysomnography is type of sleep study.Its a level 1 sleep study.
It is done in sleep lab and observed in real time by Registered Polysomnography Technologist.
Fishman's 5 th edition
Split pleura sign is a Contrast enhanced CT finding in which there is enhancement of the thickened inner visceral pleura and outer parietal pleura separated by pleural fluid
It is seen with Empyema in a setting of bacterial pneumonia
This is due to fibrin deposition in the visceral and parietal pleura as empyema progresses
References:
Kraus G. The Split Pleura Sign. Radiology. 2007;243(1):297-8.
This test can be done in sitting or supine position. The diaphragm of the stethoscope is placed at the midpoint of the sternum. The chest wall at point equidistant to the left and right of the instrument is scratched with fingers. When the side containing pneumothorax is scratched, the sound is heard louder.
Massive hemoptysis is blood loss of 400 mL in 24 hours or 100–150 mL expectorated at one time.
The causes of massive hemoptysis are Bronchiectasis, Bronchogenic Carcinoma,Eroding Tuberculous cavity,Rasmussen's aneurysm,mycetoma
Reference: Harrison's principles of internal medicine(20th edition)
1)Pleuritic pain
It is caused by inflammation of pleura commonly by infection of underlying pleura.Sharp and stabbing pain aggrevated on deep breathing or coughing
2) Musculoskeletal pain
Pain can occur after prolonged bouts of coughing.
Referance :Hutchison 24 th edition
Bronchovesicular breath sounds are medium pitched.
Both inspiration and expiration heard.
No pause in between.
Often heard over upper third of anterior chest wall.
Measurement of distance between the inferior angle of scapula and the closest horizontal spinous process of the thoracic spine
Skodaic resonance is a high pitched sound elicited by percussion over a cavity just above the level of pleural effusion.
A.Chest wall
-Boils, Lipoma, Fibroma
B.Ribs and Cartilage
-Osteomyelitis, Costochondritis
C.Pleura
-Encysted pleural effusion, Epyema necessitans
D.CVS
-Enlargement of cardiac chamber, Aortic aneurysm
E.Lungs
-Actinomycosis of lung and chest wall
F.Swelling in pectoral area
-Subpectoral abcess, Pectoral major tendon rupture, Post pectoral implant procedure, Post pacemaker implantation, Pectoral muscle rupture with hematoma
G.Others
-Bony prominence, Surgical emphysema
