Examination of bronchi and trachea
Last reviewed: 23.04.2024
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Trachea and bronchi belong to the lower respiratory tract and provide the function of external respiration, therefore the main sign of their diverse pathological states is often the lack of external respiration, which develops as a result of airway obstruction.
When examining a patient with an airway disease, the doctor first of all should evaluate the state of external respiration, for which he pays attention to the behavior and appearance of the patient, reveals signs of hypoxia and only after that begins anamnesis and special instrumental methods of research.
The behavior of the patient with the lower respiratory tract infection in a number of cases allows one to judge the nature of the disease or at least to determine the direction of the diagnostic search. With stenosis of the respiratory tract, as well as with other violations of the function of external respiration ( bronchial asthma, lung edema, atelectasis ), the patient, as a rule, assumes a forced sitting position with the support of the hands and slightly tilted forward body. The patient also takes this position when breathing is disrupted due to paralysis of the respiratory muscles (various myoplegic syndromes).
A definite value for the assessment of the patient's condition is the appearance of his face. For example, in earlier times, the notion of "venetian face", characteristic of patients suffering long-term tuberculosis of the lungs, appeared in the descriptions .
Such patients are characterized by clear pallor of the skin, sunken eyes with feverish shine and circles of blue, deep sad look of a doomed person. "Restless face" - open mouth, anxious wandering gaze, head raised, neck stretched. This type is typical for patients suffering from asthma attack, left ventricular heart failure or severe bronchopneumonia. "Cyanotic face" - cyanosis of the lips, nose, cheeks, pale cyanotic spots on the sides of the wings of the nose; these signs can have many causes: severe bronchopneumonia with bronchial obstruction and bronchioles, circulatory insufficiency, cardiopulmonary insufficiency. Cyanosis of the face also appears with tumors or diverticula of the esophagus, compressing the lower respiratory tract, with incomplete obstruction of the trachea or one of the main bronchi with a foreign body, with exudative pleurisy or severe ascites restricting respiratory lung excursions, etc.
A local study of the trachea and bronchi includes endoscopy and radiography. The first is carried out with the help of special optical instruments - bronchoscopes, the second - by the standard method of X-ray diagnostics.
From other methods of studying the tracheobronchial system, we mention x-ray, cytology, biopsy and gas mediastinoradiography.
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