Ewart's Sign
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Ewart's Sign
Ewart's sign is a set of findings on physical examination in people with large collections of fluid around their heart (pericardial effusions). Dullness to percussion (described historically as "woody" in quality), egophony, and bronchial breath sounds may be appreciated at the inferior angle of the left scapula when the effusion is large enough to compress the left lower lobe of the lung, causing consolidation or atelectasis Atelectasis is the partial collapse or closure of a lung resulting in reduced or absence in gas exchange. It is usually unilateral, affecting part or all of one lung. It is a condition where the Pulmonary alveolus, alveoli are deflated down to l .... Eponym It was first described by William Ewart in 1896.W. Ewart: ''Practical aids in the diagnosis of pericardial effusion, in connection with the question as to surgical treatment.'' British Medical Journal, London, 1896, 1: 717-721. References Symptoms and signs: Cardiac {{med-sign-stub ...
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Physical Examination
In a physical examination, medical examination, clinical examination, or medical checkup, a medical practitioner examines a patient for any possible medical signs or symptoms of a Disease, medical condition. It generally consists of a series of questions about the patient's medical history followed by an examination based on the reported symptoms. Together, the medical history and the physical examination help to determine a medical diagnosis, diagnosis and devise the treatment plan. These data then become part of the medical record. Types Routine The ''routine physical'', also known as ''general medical examination'', ''periodic health evaluation'', ''annual physical'', ''comprehensive medical exam'', ''general health check'', ''preventive health examination'', ''medical check-up'', or simply ''medical'', is a physical examination performed on an asymptomatic patient for medical screening purposes. These are normally performed by a pediatrician, family practice physician, ...
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Pericardial Effusion
A pericardial effusion is an abnormal accumulation of fluid in the pericardial cavity. The pericardium is a two-part membrane surrounding the heart: the outer fibrous Connective tissue, connective membrane and an inner two-layered serous membrane. The two layers of the serous membrane enclose the pericardial cavity (the potential space) between them. This pericardial space contains a small amount of pericardial fluid, normally 15-50 mL in volume. The pericardium, specifically the pericardial fluid provides lubrication, maintains the anatomic position of the heart in the chest (levocardia), and also serves as a barrier to protect the heart from infection and inflammation in adjacent tissues and organs. By definition, a pericardial effusion occurs when the volume of fluid in the cavity exceeds the normal limit. If large enough, it can compress the heart, causing cardiac tamponade and obstructive shock. Some of the presenting symptoms are shortness of breath, chest pain, chest pressu ...
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Percussion (medicine)
Percussion is a technique of clinical examination. Overview Percussion is a method of tapping on a surface to determine the underlying structures, and is used in clinical examinations to assess the condition of the thorax or abdomen. It is one of the four methods of clinical examination, together with inspection, palpation, auscultation, and inquiry. It is done with the middle finger of one hand tapping on the middle finger of the other hand using a wrist action. The nonstriking finger (known as the pleximeter) is placed firmly on the body over tissue. When percussing boney areas such as the clavicle, the pleximeter can be omitted and the bone is tapped directly such as when percussing an apical cavitary lung lesion typical of tuberculosis. There are two types of percussion: direct, which uses only one or two fingers; and indirect, which uses only the middle/flexor finger. Broadly classifying, there are four types of percussion sounds: resonant, hyper-resonant, stony dull ...
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Egophony
Egophony (British English, aegophony) is an increased resonance of voice sounds heard when auscultating the lungs, often caused by lung consolidation and fibrosis. It is due to enhanced transmission of high-frequency sound across fluid, such as in abnormal lung tissue, with lower frequencies filtered out. It results in a high-pitched nasal or bleating quality in the affected person's voice. Technique While listening to the lungs with a stethoscope, the patient is asked to pronounce the modern English (more generally, post-Great Vowel Shift) long-E vowel sound. Interpretation Stethoscopic auscultation of a clear lung field during this articulation will detect a sound matching that received through normal hearing; that is, the sound articulated by the patient will be clearly transmitted through the lung field and heard unchanged by the clinician. When the lung field is consolidated (filled with liquid or other solid mass such as tumor or fungus ball), the patient's spoken English l ...
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Breath Sounds
Respiratory sounds, also known as lung sounds or breath sounds, are the specific sounds generated by the movement of air through the respiratory system. These may be easily audible or identified through auscultation of the respiratory system through the lung fields with a stethoscope as well as from the spectral characteristics of lung sounds. These include normal breath sounds and added sounds such as crackles, wheezes, pleural friction rubs, stertor, and stridor. Description and classification of the sounds usually involve auscultation of the inspiratory and expiratory phases of the breath cycle, noting both the pitch (typically described as low (≤200 Hz), medium or high (≥400 Hz)) and intensity (soft, medium, loud or very loud) of the sounds heard. Normal breath sounds Normal breath sounds are classified as vesicular, bronchovesicular, bronchial or tracheal based on the anatomical location of auscultation. Normal breath sounds can also be identified by pat ...
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Scapula
The scapula (: scapulae or scapulas), also known as the shoulder blade, is the bone that connects the humerus (upper arm bone) with the clavicle (collar bone). Like their connected bones, the scapulae are paired, with each scapula on either side of the body being roughly a mirror image of the other. The name derives from the Classical Latin word for trowel or small shovel, which it was thought to resemble. In compound terms, the prefix omo- is used for the shoulder blade in medical terminology. This prefix is derived from ὦμος (ōmos), the Ancient Greek word for shoulder, and is cognate with the Latin , which in Latin signifies either the shoulder or the upper arm bone. The scapula forms the back of the shoulder girdle. In humans, it is a flat bone, roughly triangular in shape, placed on a posterolateral aspect of the thoracic cage. Structure The scapula is a thick, flat bone lying on the thoracic wall that provides an attachment for three groups of muscles: intrinsic, e ...
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Lung
The lungs are the primary Organ (biology), organs of the respiratory system in many animals, including humans. In mammals and most other tetrapods, two lungs are located near the Vertebral column, backbone on either side of the heart. Their function in the respiratory system is to extract oxygen from the atmosphere and transfer it into the bloodstream, and to release carbon dioxide from the bloodstream into the atmosphere, in a process of gas exchange. Respiration is driven by different muscular systems in different species. Mammals, reptiles and birds use their musculoskeletal systems to support and foster breathing. In early tetrapods, air was driven into the lungs by the pharyngeal muscles via buccal pumping, a mechanism still seen in amphibians. In humans, the primary muscle that drives breathing is the Thoracic diaphragm, diaphragm. The lungs also provide airflow that makes Animal communication#Auditory, vocalisation including speech possible. Humans have two lungs, a ri ...
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Atelectasis
Atelectasis is the partial collapse or closure of a lung resulting in reduced or absence in gas exchange. It is usually unilateral, affecting part or all of one lung. It is a condition where the Pulmonary alveolus, alveoli are deflated down to little or no volume, as distinct from pulmonary consolidation, in which they are filled with liquid. It is often referred to wikt:Appendix:Glossary#informal, informally as a collapsed lung, although more accurately it usually involves only a partial collapse, and that ambiguous term is also informally used for a fully collapsed lung caused by a pneumothorax. It is a very common finding in chest X-rays and other radiological studies, and may be caused by normal exhalation or by various medical conditions. Although frequently described as a ''collapse of lung tissue'', atelectasis is not synonymous with a pneumothorax, which is a more specific condition that can cause atelectasis. Acute atelectasis may occur as a post-operative complication ...
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William Ewart (physician)
William Ewart (26 December 1848, London – 11 August 1929, London) was an English physician remembered for Ewart's sign. Biography William Ewart was born in London to a French mother, and was educated partly in England and partly at the University of Paris. He studied medicine at St George's Hospital Medical School, his studies were interrupted by military service with the French Army in the War of 1870. After his military service Ewart qualified as a LRCS in 1871 and LRCP in 1872. He gained his M.B. in 1877 from Cambridge University. He worked at St George's Hospital and the Royal Brompton Hospital, becoming a Fellow of the Royal College of Physicians in 1881 and Doctor of Medicine in 1882. He retired in 1907. Ewart authored ''Gout and Goutiness and Their Treatment'', in 1897. The book was described by a reviewer in ''The British Medical Journal'' as a ''magnum opus'' on gout Gout ( ) is a form of inflammatory arthritis characterized by recurrent attacks of pa ...
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