Clinical diagnostic criteria on lung syndromes

	Dyspnea	Cough	Sputum	Systemic symptoms	Inspection	Palpation	Percussion	Auscultation
Bronchial asthma	difficult breathing	dry, non-productive cough and viscous mucus	Thicker white mucus due to release of maximum WBC.	- shortness of breath - cough (worse at night) - wheezing (high-pitched whistling sound) - typically with exhalation	- wheezing or whistling (Which mean inflammation) - nose and throat for swelling and drainage that could be caused by allergies. - Expiratory Dyspnea - Cyanosis - Changes in form of intercostals, supraclavicular, subcostals and Sternal Retraction - Barrel Chest & Elevated chest	- decrease in symmetrically chest wall expansion. - decrease in vocal fermitis	- Resonance (Hyper or Normal) - Acute Emphysema	- Checking the sounds of the lungs - course crackle, grunting wheezes - Normal or Reduce Breath sound
COPD	Dyspnea on Exertion (Mild Dyspnea) - due to lung damage	Chronic Cough (Prominent) with sputum for at least 3 months	clear or gray colored - Copious and purulent sputum	- Respiratory insufficiency & Inflammation - Chest tightness (Barrel Chest) - Weight loss - cor pulmonel common - osteoporosis - Depression	- barrel chest - chronic hyperinflatin (leads to loss of lung elasticity) - respiratory insufficiency - Wheezing during normal breathing - Chronic smoking - repeated chest infection - Dyspnea - cough	- cyanosis - clubbing - edema - Decreased fermitus vocalis - Decreases chest expansion bilaterally	- Hyperresonant -  Dimination of the area of absolute cardiac dullness - Depressed Diaphragm	- Prolonged Expiration - reduced breath sound - crackle sound with wheezing during normal respiration -
Pneumonia  (congestion stage)	Dyspnea on Breathing	Dry Cough	Bacterial Sputum	- fever - shortness of breath - dyspnea - chest pain - Cough without color	- Cough - Chest Pain - Cyanopathy - clubbing - cyanosis - Parallel shape chest	- Increased Fermitis	- Dullness	- Decrease Breath Sound
Pneumonia  (“red hepatization” stage)	Dyspnea is not obvious	Dry cough with hemoptysis	Enhancement Rusty Sputum	- fever - shortness of breath - dyspnea - chest pain - Cough without color	- Cough - Chest Pain - Cyanopathy - clubbing - cyanosis	- Increased fermitis	- Dullness	- diminished or Decreased breath sounds and bronchial breathing
Pneumonia  (“gray hepatization”)	Dyspnea is not obvious	Dry Cough	Enhancement Gray Sputum - mucus purulent sputum	- fever - shortness of breath - dyspnea - chest pain - Cough without color	- Cough - Chest Pain - Cyanopathy - clubbing - cyanosis	- Increased fermitis	- Dullness	- Decrease Breath Sound
Emphysema	“breathlessness” or “dyspnea. harder to breathe	Dry or produces mucus (chronic cough)	daily cough and mucus (sputum)	- weight loss, - skeletal muscle dysfunction, - an increased risk of cardiovascular disease, - osteoporosis - shortness of breath. - frequent lung infections. - difficulty eating. - confusion or memory loss due to oxygen deprivation. - fatigue and increased sleepiness.	- barrel chest, - diffuse or focal wheezing, - diffusely diminished breath sounds, - hyper resonance upon percussion, prolonged expiration, - hyperinflation on chest radiographs.	- Decrease Fermitis - chest expansion decreased	- Hyper - Resonant	- Diminished or decreased Vesicular Breath Sound
Hydrothorax	Mixed Dyspnea - shortness of breath, or difficult, labored breathing	Mild or Dry non-productive cough	Mucous sputum is clear or translucent and viscous	- cough, - shortness of breath, - hypoxemia, - chest pain - fatigue.	- Dyspnea - Mild non-productive cough - Chest pain	- Decrease tactile fremitus - Tracheal deviation (Away from the affected side) - Contralateral	- Stony Dull - Reduced ipsilaterally	- Decrease Vesicular Breathing Sound over fluid - Sounds like Crackles on the upper edge of effusion - Pleural friction rub - Muffled vocal Resonance
Pneumothorax	Extreme Dyspnea	dry cough	Thick sputum plugspredisposing to ventilation difficulty	- Cough - Anxiety - Sharp or stabbing pain - Cyanosis - shortness of breath	- Increase Jugular Vein Pressure in tension - Dyspnoea - Hx of trauma - shortness of breath	- Decrease tactile fremitus - Decrease chest expansion - Unilateral - Tracheal Deviation if tension - Contralateral - Radiating to ipsilateral shoulder	Hyper - Resonant	- Decrease or Absent Breath sound - Added sound
Pulmonary edema	paroxysmal nocturnal dyspnea or Extreme shortness of breath or difficulty breathing (dyspnea)	dry cough. Coughing up blood or bloody froth	pink, frothy sputum (Mucus that contains bubbles and is foamy).	- Difficulty breathing when lying down - Coughing up blood or bloody froth	- level of distress, - use of accessory muscles, - respiratory position, - chest structure, respiratory pattern, and - other clues outside of the chest.	- Reduced side of the effusion - Trachea pushed to another side	- Stony Dull	- MID - late inspiratory fine crackles - More coarse then fibrosis. (Do not clear on coughing)