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cardiorespiratory
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Drh. Dian Vidiastuti, MSi Diagnosa Klinik-PKH UB 2015
Inspeksi
Palpasi
Auskultasi
Pemantauan umum, Gejala Klinis
Lokasi (Precordium, Apex), Pulse rate, Blood
pressure
Heart rate, Suara jantung
Stethoscope
Doppler flow detector
Sphygmomanometer ECG
USG
Dyspneu
Syncope Peripheral
edema
Palpitasi
Evaluasi heart rate (HR) Suara jantung normal ‘Lub-Dub’ S1 Lub : penutupan mitral v dan trikuspid v, (awal sistole) S2 Dub : suara aortic v dan pulmonalis v (awal diastole)
• Sinus aritmia HR ↑ pd saat inspirasi
• Normal pd brachychepalic SINUS
ARRYTHMIA
• Slow Heart Rate <65 beat/mnt
• Systemic disease, intracranial press, drugs (transquilizer, morphine)
SINUS BRADYCARDI
• Increase HR >160 beat/mnt
• Stress, ↑ metab & O2 , pathology, drugs (ATS,eph,ketamin)
SINUS TACHYCARDIA
• Common pathological arrythmia in dog ATRIAL
FIBRILATION
• Produce by turbulent blood flow
• Heart disease (degeneration valve)
MURMURS
A. Femoralis, A. Coccygealis Predispotition factors :
Breed
Sex
Gestation, Partus, Lactation
Nervous Body size
Temperature
Activity
CRT < 2 s Gingiva, palmar, cutaneus
Systemic arterial BP is created by : 1. the pumping action of the heart, 2. circulating arterial blood volume, 3. the smooth muscle tone of blood vessel walls. Methode : Direct & Indirect Systolic & Diastolic
Doppler ultrasound Flow Detector
USG
Heart Structure
Congenital / Acquired heart disease
Size & functioning of heart
M mode echocardiogram
B mode Echocardiogram
Doppler ultrasound
Normal ECG 3 Leads
the number of times per minute that air is inhaled and exhaled
degree of chest movement : normal, shallow, deep
RESPIRATION SIGN
DYSPNEU
TACHYPNEA ORTHOPNEA
Breath sounds Planum Nasale
Nasal discharge :
Serouse/ Mucous, epistaksis
Sinus
Palpation Laryngitis catarrhalis frequent cough Pain Size and location change Auscultation Trachea Stridor
NORMAL RESP SOUND
• vesicular / bronchial
• soft, breezy/rustling sounds
ABNORMAL RESP SOUND
• Wheezes’ (continuous high pitched hissing heard more often on expiration) - occur with small airway diseases such as asthma
• ‘Rales/crackles’ (obstructed airway, more commonly on inspiration) may be heard when fluid in the lungs
• Rhonchi’ (musical sounds-low or high pitched)
• Stridor, upper airway obstruction
COTTON LIKE DENSITIES
PLEURAL EFUSSION
Since airway obstructions may impede oxygenation, ventilation
Pulse Oximeter) (normal : >95 %, anesth >90 %)
Arteri / venous Hypoventilation (PaCO2) >43 mmHg
(dogs), >36 mmHg (cats) respiratory acidosis
Waddell LS, Brown AJ. Hemodynamic monitoring. In Silverstein DC, Hopper K (eds): Small Animal Critical Care Medicine, 2nd ed. St. Louis: Elsevier, 2015
Walker et al, Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition
King L, Clarke D. Emergency care of the patient with acute respiratory distress. Veterinary Focus , Vol 20 No 2 ,2010