Anatomy of Upper Limb by Sameh Doss

By Sameh Doss

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Moving all four limbs Renal Nil of note MSK Nil of note Microbiology None available Patient position Slumped lying in bed Observation Obese man with barrel shaped chest and large abdomen. Colour – flushed. Breathing through an open mouth. Predominately a shallow, apical breathing pattern with increased use of accessory muscles. Also demonstrating in-drawing of his lower chest wall on inspiration. Active expiration Auscultation Quiet BS generally with end expiratory polyphonic wheeze throughout Palpation Decreased expansion bi-basally (right ¼ left).

G. g. g. airway suctioning). g. exacerbation of COPD, and those requiring critical care. Cardiothoracic surgery and paediatrics are other specialist clinical areas that physiotherapists are involved in providing respiratory care. However, it must be remembered that patients requiring such care may not be in these ward areas exclusively. Physiotherapists working in any clinical area may be required to undertake a respiratory assessment and provide respiratory care. For example, assessment of a stroke patient who has aspirated or an oncology patient who develops respiratory failure following chemotherapy.

38 Case study 4: Respiratory Medicine – COPD Patient .................... 41 Case study 5: Surgical Respiratory – Anterior Resection .............. 43 Case study 6: Surgical Respiratory – Division of Adhesions.......... 44 Case study 7: Surgical Respiratory – Hemicolectomy ................... 46 Case study 8: Surgical Respiratory – Bowel Resection................. 48 Case study 9: Intensive Care – Patient for Extubation.................. 50 Case study 10: Intensive Care – Surgical Patient ........................

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