|
Examination of the patient with respiratory disease |
|
¨ Respiratory disease may cause the patient to be short of breath or tachypnoeic (breathing quickly) at rest or on minimal exertion e.g. walking into the surgery. ¨ The patient may be using their accessory muscles of respiration. ¨ In patients who retain carbon dioxide, the radial pulse at the wrist may feel very full and 'bounding' and carbon dioxide retainers may also have a flapping tremor of the hands when they are held outstretched.
1. Intra-oral examination may reveal that patients using corticosteroid inhalers are predisposed to developing oral/pharyngeal candidosis 2. Patients using beta 2 agonists and antimuscarinic agents often will have a dry mouth. 3. More uncommon oral findings on examination may be a hyperpigmentation of the soft palate in lung cancer, or even bony metastases from lung cancer in the jaws. Chronic ulcers of the dorsum of tongue may rarely be an oral manifestation of TB. 4. Cervical lymphadenopathy from TB may also be evident, but the more common lymphadenopathy secondary to a URTI should be considered first.
Pulse Oximeter
The pulse oximeter gives a guide to the efficiency of oxygenation of blood It measures the pulse rate and oxygen saturation. The sensor, placed usually on a fingertip contains two Light Emitting Diodes (LEDs), one red measuring the amount of oxygenated haemoglobin, the other infrared, measuring the total haemoglobin. The oxygen saturation is the amount of oxygen carried in the blood relative to the maximum possible amount. There is a linear relationship between oxygen in the blood and the arterial oxygen saturation. Pulse oximetry does not necessarily indicate normal ventilation, since the saturation can appear normal if supplemental oxygen is being used.
Ref: British Dental Journal 14 June 2003; Volume 194, No. 11
|
|
The patient's colour may give an early clue as to their condition e.g. the pink puffer or blue bloated patient with COAD. The patient may be centrally cyanosed with a bluish hue to the tongue/lips. This is seen when there is a deoxygenated haemoglobin concentration greater than 5 grams per decilitre. |