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Wheeze

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Common cause of wheezing.
Understand mechanism of wheezing.

Publié dans : Santé & Médecine
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Wheeze

  1. 1. • Definition • Mechanism • Causes Izatty Lim 0308188 Batch 4
  2. 2.   Palpable and audible vibrations  Musical in character  Produced when airflow is restricted DEFINITION  The American Thoracic Society Committee Wheeze: High pitched continuous sounds with a dominant frequency of 400 Hz or more.
  3. 3.   MC: expiratory wheeze  Typically reflect lower airway obstruction  MC found with asthma & bronchiolitis  Other causes: CHF & foreign body aspiration  http://www.stethographics.com/main/physiology_ls_wheeze.html  https://www.youtube.com/watch?v=BvnphT1QnNY WHEEZE Polyphonic Monophonic Various pitch Single- pitch sound Widespread narrowing of airways Narrowing of larger airways Asthma Tracheomalacia, bronchomalacia
  4. 4.  Airway Narrowing  Bronchoconstriction  Mucosal edema  External compression  Partial obstruction by  tumor  foreign body  tenacious secretion MECHANISM  Wheeze  Generated by vibrations/oscillations of nearly closed airway walls  Air passing through narrowed portion at high velocity  ↓ gas pressure and flow  Airway pressure slightly ↑ and barely reopens airway lumen  Alternating between nearly closed and nearly open  fluttering of the airway walls and a musical, ‘continuous’ sound.  Wheeze  Generated by vibrations/oscillations of nearly closed airway walls  Air passing through narrowed portion at high velocity  ↓ gas pressure and flow  Airway pressure slightly ↑ and barely reopens airway lumen  Alternating between nearly closed and nearly open  fluttering of the airway walls and a musical, ‘continuous’ sound.  Wheeze  Generated by vibrations/oscillations of nearly closed airway walls  Air passing through narrowed portion at high velocity  ↓ gas pressure and flow  Airway pressure slightly ↑ and barely reopens airway lumen  Alternating between nearly closed and nearly open  fluttering of the airway walls and a musical, ‘continuous’ sound.  Wheeze  Generated by vibrations/oscillations of nearly closed airway walls  Air passing through narrowed portion at high velocity  ↓ gas pressure and flow  Airway pressure slightly ↑ and barely reopens airway lumen  Alternating between nearly closed and nearly open  fluttering of the airway walls and a musical, ‘continuous’ sound.
  5. 5.
  6. 6.  Toy trumpet  sound is produced by a vibrating reed.  Pitch • dependent on the mass and elasticity of the airway walls & on the flow velocity.  Wheeze production model  collapsible tube • the fluttering of airways walls & fluid together, induced by a critical airflow velocity.  Many circumstances are suitable for the production of continuous adventitious lung sounds. Thus, wheezes can be heard in several diseases, not only asthma. MECHANISM
  7. 7.   Viral infection  Asthma  Foreign body aspiration  Cystic fibrosis  Anatomic abnormalities  Tracheomalacia, bronchomalacia  Mediastinal mass  Congenital heart disease (R to L shunt)  GERD  Anaphylaxis Causes of Wheeze
  8. 8.  www.aafp.org/aafp
  9. 9.  Done! Thank you.
  10. 10.   N M, al et. Wheezes. - PubMed [Internet]. 1995 [cited 2015 Jun 21]. Available from: http://www.ncbi.nlm.nih.gov/m/pubmed/8620967/  O’Brien N, Gill D, Hickey D. Paediatric Clinical Examination Made Easy. Edinburgh: Churchill Livingstone Elsevier; 2007.  Zorc JJ, editor. Schwartz’s clinical handbook of pediatrics. Philadelphia: Lippincott Williams and Wilkins; 2008.  Lissauer, Tom, Graham Clayden, and Alan Craft. Illustrated Textbook Of Paediatrics. Edinburgh: Mosby, 2012. Print.  Weiss LN. The Diagnosis of Wheezing in Children - American Family Physician [Internet]. [cited 2015 Jun 21]. Available from: http://www.aafp.org/afp/2008/0415/p1109.html References

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