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

A. Increased AP diameter

Explanation:

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.

tell their parents and make sure she gets from a counselor or therapist. be supportive and be there for her. be a kind and good friend. spend time with her to make her feel like she's not alone. i'm not a professional but i really hope they stays strong.

i think it's the first one because doctors aren't the ones who get rid of the old needles. most of them time it's not even doctors who give you shots, it's nurses.