A 65 year old smoker presents for eval of dyspnea. He has a 100 pack year history of tobacco use. The dyspnea is exacerbated by
exertion. He denies fever or chills, he has not had recent contact with anyone who is sick. You diagnose chronic COPD. On exam of the thorax you would expect to find: a) increased AP diameter
b) decreased AP diameter
c) No change in AP diameter
d) Pectus excavatum
a) increased AP diameter
In a normal adult male the anteroposterior (AP) diameter of his cervical canal has a mean value of 17-18 mm at vertebral levels C3-5. The lower cervical canal measures 12-14 mm. An adult male without spinal stenosis has a diameter of 16-17 mm in the upper and middle cervical levels.
Increased Anterior Posterior Diameter or Barrel chested appearance can result from air trapping and it sometimes occurs with advanced Or chronic COPD. Xray Scanning on the right also demonstrates the increased A-P diameter along with flattening of the diaphragms.
It is called Barrel chest the Increased A-P diameter of the chest wall is the shaped like a barrel, and it most often associated with emphysema.
This is what the Examining the thoracic will reveal in that patient.
If the child’s urine output decreases to less than 100ml/24
hr and the creatinine clearance is 69 ml/min, plus an irregular apical pulse
with a diagnosis of acute renal failure, the serum level requires immediate
intervention is a potassium 6.1 mEq/L.
