Physical examination of copd ppt. HX of any Kind of Hypoxia .

Physical examination of copd ppt Likely diagnoses suggested by specific physical examination findings. The physical examination section describes inspection techniques like observing breathing patterns, palpation methods for chest abnormalities, percussion sounds over the lungs, and auscultation of breath sounds, rales, and other May 19, 2015 · The document summarizes the examination of the respiratory system. Nov 16, 2015 · Clinical features such as cough, expectoration, chest pain, hemoptysis and dyspnea are cardinal symptoms of pulmonary tuberculosis. By taking into account the clinical characteristics and epidemiological factors the differential may be narrowed down. 10% of all emergency COPD admissions are undiagnosed at point of admission. Sep 12, 2017 · Diagnosis involves medical history, physical exam, blood tests, electrocardiogram, echocardiogram and other cardiac imaging. Read less Apr 22, 2017 · Physical examination revealed dyspnea, tachycardia, and abnormal lab results. Sep 6, 2024 · Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease characterized by obstructed airflow from the lungs. However, physical examination is still important for diagnoses that can only be made at the bedside. 1. Pathophysiology involves airway inflammation, remodeling, and hyperresponsiveness. This powerpoint contains precise details on This medical presentation titled ""Chronic Obstructive Pulmonary Disease (COPD)"" describes COPD and tells us about chronic bronchitis, COPD causes, pathophysiology of chronic bronchitis and emphysema, emphysema pathophysiology, emphysema clinical manifestations, chronic bronchitis pathophysiology, chronic bronchitis clinical manifestations, COPD complications, COPD collaborative care, and more. Physical exam may reveal wheezing and prolonged expiration. . Dec 2, 2020 · The purposes of physical examination are then outlined, which include understanding a client's physical and mental well-being, detecting diseases early, and determining treatment needs. Feb 3, 2024 · COPD exacerbations involve a sudden worsening of symptoms, often triggered by infections or environmental factors. Treatment focuses on managing the underlying lung condition, giving diuretics and vasodilators, and may involve oxygen therapy or lung transplantation in severe cases. Sep 28, 2015 · Risk factors include cystic fibrosis, chronic obstructive pulmonary disease (COPD), asthma, diabetes, heart failure, a history of smoking, a poor ability to cough such as following a stroke, and a weak immune system. The four basic examination techniques - inspection, palpation, percussion, and auscultation - are then described at a high level. Jul 20, 2014 · History and Physical Examination of Respiratory System. This powerpoint contains precise details on Jul 3, 2015 · This document outlines principles for taking a patient's history and conducting a physical examination. Management involves medication like bronchodilators and corticosteroids, avoidance of triggers, and nursing care including monitoring, positioning, administering treatments, and Others can mimic COPD due to the overlap in symptoms and physical findings. Diagnosis involves patient history, physical exam, and sometimes chest X-rays Jan 6, 2018 · Diagnosis involves physical exam, imaging like echocardiogram and chest x-ray, and assessing pulmonary pressures. It includes sections for collecting information on the patient's chief complaints, medical history, subjective examination involving the history of present illness and associated symptoms, as well as an objective examination involving vital signs, physical inspection, palpation, percussion, and Dec 17, 2016 · 3. ABG results show respiratory acidosis. Later sections focus on asthma, covering etiology, risk factors, physical exam findings, investigations such as spirometry, and classifications of asthma exacerbations. Oct 6, 2016 · This document provides an overview of evidence-based physical diagnosis. The examination involves observing the patient's breathing patterns and chest shape, feeling the trachea, apex beat, and chest expansion, tapping to assess percussion notes, and listening for breath sounds, adventitious sounds like rhonchi or crackles, and Jun 12, 2020 · GENERAL PHYSICAL EXAMINATION: A middle aged man sitting on bed with mask on face, having iv branula on right hand, fully oriented in time place and person, having vitals pulse: 88/mint BP: 120/70 RR: 21/min Temp: A/F SPO2 : 90% with o2 inhalation 6/12/2020 4 Sep 23, 2015 · Physical exam may reveal signs of pulmonary hypertension like a loud pulmonary component to S2, as well as a tapping apex, opening snap, and mid-diastolic rumble on cardiac auscultation. Initial labs help classify anemia as macrocytic, microcytic or normocytic. Chest X-ray confirms right lower lobe pneumonia. Physical Examination Pulmonary Tuberculosis. May 6, 2018 · The document provides an overview of the history, physical examination, and cardinal symptoms in pulmonary medicine. Oct 31, 2024 · Physical examination might reveal enlargement of the involved organ (splenomegaly or hepatomegaly). Apr 22, 2017 · Physical examination revealed dyspnea, tachycardia, and abnormal lab results. Nov 27, 2012 · It is multifactorial, with predisposing factors including heredity and excitatory factors such as allergens, infections, environmental irritants, and emotional stress. Adventitious lung sounds like crackles and wheezes are classified based on characteristics like location and cause. Taking a thorough history and performing a detailed physical exam are important for accurately diagnosing cardiovascular conditions. Nov 5, 2019 · History and Physical Examination of Respiratory System. Using known likelihood ratios for various physical examination maneuvers can be combined with known individual risk factors and symptoms to adjust a patient’s Apr 5, 2019 · History and Physical Examination of Respiratory System. Outline Routine Diagnostic Tests used to Confirm the Cor Pulmonale Diagnosis. It discusses how diagnosis has evolved from being based primarily on physical examination findings a century ago to now often relying on technological tests. History and Physical Examination of Respiratory System. Exacerbations can lead to hospitalizations and contribute to disease progression. In more advanced disease, physical features commonly found are hyperinflation of the chest, reduced chest expansion, hyperresonance to percussion, soft breath Physical examination findings depend on the site of the tuberculosis infection and the most common physical examination findings are fever, decreased breath sounds, tachypnea and tachycardia. Lung Sounds Chest Pain. Dec 21, 2017 · Dyspnea, or shortness of breath, is a common symptom that can be caused by many cardiac and pulmonary conditions. Oct 27, 2014 · COPD (Chronic obstructive Pulmonary Disease) PowerPoint Presentation -aslam. May 14, 2017 · The document summarizes the examination of the respiratory system. The four main techniques of physical examination - inspection, palpation, percussion, and auscultation - are described. ***Pulmonary – primary and referred Primary – parietal pleura, major airway, chest wall, diaphragm, mediastinal Referred to – ant: upper abdominal wall - base of the neck and Slideshow 1384036 by candy Feb 9, 2018 · After investigations, he was diagnosed with chronic obstructive pulmonary disease (COPD). 2 Physical examination The sensitivity of physical examination for detecting mild to moderate COPD is poor (Badgett 1993). Echocardiography can determine the severity of mitral stenosis and assess %PDF-1. Chest Trauma. Nov 12, 2014 · This document provides information about performing a physical examination. It also discusses types of dyspnea and provides a diagnostic algorithm. The summary Nov 12, 2015 · 1. Respiratory distress or dyspnea. 4. Chest X-ray found consolidation. Apr 12, 2018 · Chronic obstructive pulmonary disease (COPD) is defined as a lung condition characterized by airflow limitation that is not fully reversible. Hallmark symptom - Dyspnea Chronic productive cough Minor hemoptysis pink puffer blue bloater. The disease may be classified by where it was acquired with community, hospital, or health care associated pneumonia. Oct 11, 2012 · It discusses obtaining a complete history from the parent or caretaker, including chief complaint, present illness, past medical history, developmental history, and family/social history. COPD in Relation to Its Component Disease Processes – A free PowerPoint PPT presentation (displayed as an HTML5 slide show) on PowerShow. Sputum examination by Ziehl-Neelsen staining is used to diagnose pulmonary tuberculosis. 14k views • 16 slides Dec 2, 2024 · The physical examination in patients with intrinsic lung disorders may yield distinguishing physical findings. May 18, 2012 · This document provides information on assessing the chest and lungs through physical examination. com - id: 73c8a4-Yjg2M 4 Chronic obstructive pulmonary disease (COPD) is defined as a disease state characterized by airflow limitation that is not fully reversible COPD includes emphysema, an anatomically defined condition characterized by destruction and enlargement of the lung alveoli; chronic bronchitis, a clinically defined condition with chronic cough and phlegm; and small airways disease, a condition in which Apr 28, 2014 · The absence of a comet-tail sign correctly ruled out heart failure–related dyspnea even in patients with a history of heart failure. It is typically caused by long-term exposure to irritating gases or particulate matter from cigarette smoke. 3 what should we know about the examination of the . If patients blow 150-200 mL or less, they are probably having a COPD exacerbation; higher flows indicate a probable CHF exacerbation. Physical ExamPhysical Exam in COPD • Early disease = normal exam • Common findings – Increased anteroposteriorchest diameter • “Barrel chest” – Bilaterally diminished breath sounds – Muscular wasting • During an exacerbation – Wheezing – Rhonchi – Cyanosis Mar 1, 2012 · Course Objectives Define Cor Pulmonale in the Chronic Obstructive Pulmonary Disease(COPD) Patient. COPD - Physical Findings. Physical access security is one of the most important aspects of keeping data safe. It emphasizes establishing rapport, listening to the patient, and obtaining a chronological history of present illness and symptoms. Wheezing is not an indicator of severity of disease and is often absent in stable, severe COPD. Inspiratory squeaks or scattered, late, inspiratory high-pitched rhonchi are frequently heard in patients with bronchiolitis. Is an umbrella term for several conditions: Emphysema Chronic Bronchitis Refractory asthma Various forms of bronchiectasis Dec 17, 2016 · 3. Apr 10, 2014 · Diagnosis involves physical exam, imaging like echocardiogram and chest x-ray, and assessing pulmonary pressures. Blood tests showed increased creatinine and C-reactive protein. Apr 11, 2014 · This document provides guidelines for performing a local chest examination, including inspection, palpation, percussion, and auscultation. Echocardiography can determine the severity of mitral stenosis and assess title: physical diagnosis the pulmonary exam 1 physical diagnosis - the pulmonary exam. Physical examination revealed a temperature of 100°F, low blood pressure and rapid pulse and breathing. Normal breath sounds and abnormal findings are defined. May 20, 2012 · Accelerated loss of lung function can be slowed Decline in loss of lung function can be reduced COPD is a long-term illness COPD worsens quickly with smoking COPD can cause arrhythmias COPD can cause pneumonia COPD can cause osteoporosis COPD, or chronic obstructive pulmonary disease, is a progressive disease that makes patient hard to breathe. C2. Identify Common Signs and Symptoms in the physical exam of the COPD Patient with the diagnosis of Cor Pulmonale. May 31, 2016 · Diagnosis is often based on the symptoms and physical examination. It describes inspecting the chest shape and movements, palpating the apex beat and trachea position, percussing the chest to compare resonance, and auscultating breath sounds including vesicular, bronchial, vocal resonance, and added sounds like rhonchi or crepitations. Jun 11, 2021 · Risk factors include cystic fibrosis, chronic obstructive pulmonary disease (COPD), asthma, diabetes, heart failure, a history of smoking, a poor ability to cough such as following a stroke, and a weak immune system. Define briefly Chronic Obstructive Pulmonary Disease. - HR > 115/min - HR > 115/min ASTHMA SEVERE ASTHMA: Physical Examination - HR > 115/min - RR > 30/min - Pulsus paradoxus > 10 mmHg - Unable to speak - Cyanosis - Silent chest change in mental status peak expiratory flow meter >200 L/min May 20, 2012 · Accelerated loss of lung function can be slowed Decline in loss of lung function can be reduced COPD is a long-term illness COPD worsens quickly with smoking COPD can cause arrhythmias COPD can cause pneumonia COPD can cause osteoporosis COPD, or chronic obstructive pulmonary disease, is a progressive disease that makes patient hard to breathe. Nov 1, 2019 · Bronchial asthma is classified as allergic or nonallergic and is diagnosed through patient history, physical examination, and tests such as pulmonary function tests. One crude bedside test for distinguishing COPD from CHF is peak expiratory flow. The physical examination section describes inspection techniques like observing breathing patterns, palpation methods for chest abnormalities, percussion sounds over the lungs, and auscultation of breath sounds, rales, and other Nov 23, 2020 · This document provides a template for conducting a cardio-respiratory assessment of a patient. Read less Apr 30, 2020 · his comprehensive PowerPoint presentation provides a detailed exploration of nursing assessment, the critical first step in the nursing process. Sep 24, 2014 · It is classified based on severity and triggers. Increased A-P Diameter. Oct 13, 2019 · The patient, a 40-year old female, presented with fever, chills, vomiting, diarrhea, abdominal pain and shortness of breath. 31 Diagnosis of COPD – why does it matter? Early diagnosis in mild or moderate COPD - improve disease outcome and prevent progression. Apr 12, 2018 · Pulmonary rehabilitation is a comprehensive intervention based on a thorough patient assessment followed by patient tailored therapies that include, but are not limited to, exercise training, education, and behavior change, designed to improve the physical and psychological condition of people with chronic respiratory disease and to promote the long-term adherence to health-enhancing behaviors Feb 3, 2024 · COPD exacerbations involve a sudden worsening of symptoms, often triggered by infections or environmental factors. London, Churchill, 1969. Normal and abnormal findings are outlined. His medical history and physical exam reveal severe COPD and risk factors for exacerbation. HX of any Kind of Hypoxia – A free PowerPoint PPT presentation (displayed as an HTML5 slide show) on PowerShow. Physical examination found wheezing on auscultation of the lungs and decreased oxygen saturation. Diagnosis involves patient history, physical exam, and sometimes chest X-rays 14 ASTHMA SEVERE ASTHMA: Physical Examination. It defines a physical examination and outlines preparations, including preparing the patient and environment, as well as necessary equipment. It discusses the relevant anatomy, history taking, and examination techniques. failure – A free PowerPoint PPT presentation (displayed as an HTML5 slide show) on PowerShow. The document discusses COPD, including its types (chronic bronchitis and emphysema), pathology, evaluation, diagnosis, and physiotherapy management. Feb 6, 2012 · Areas to Cover Anatomy and Physiology Typical History Physical Examination Relevant Investigations Management COPD Summary 4. associate professor of medicine ; vanderbilt university school of medicine; 2 sleep blood vessels. Mar 13, 2017 · 1. Chest X-ray, blood tests, and culture of the sputum may help confirm the diagnosis. 14k views • 16 slides Mar 10, 2018 · The document provides details on differentiating dyspnea through history, physical exam, and investigations. COPD- pulmonary hyperinflation- the diaphragms are at the level of the eleventh posterior ribs and appear flat. Late diagnosis in severe disease - potential benefits of treatment greatly reduced and costs to healthcare system are high. Spirometry showed 62% of predicted FEV1. Physical examination may reveal decreased breath sounds, digital clubbing and lymphadenopathy. com - id: 73c8a4-Yjg2M. r michael rodriguez m. It covers essential techniques, including interviewing, physical examination, and health history gathering. Jan 28, 2025 · 1 Physical Access Security John Tucker November 11, 2023 CIS560 2 Introduction In the world of cyber security data breaches are occurring more and more at a rapid pace. Physical examination techniques for the shoulder including range of motion, strength, and special tests to identify injuries. Diagnostic Approach Initial assessment • History and physical examination (Signs & Symptoms) • Pulmonary function testing to assess airflow obstruction • Radiographic Jun 11, 2016 · The document provides an overview of the history, physical examination, and cardinal symptoms in pulmonary medicine. Physical examination findings of pulmonary tuberculosis include: [1] Appearance of the Patient. The goal is to obtain a thorough history and perform an examination of all body systems to identify any issues in the newborn. Recognize Standard Treatments used for COPD Patients May 31, 2016 · Diagnosis is often based on the symptoms and physical examination. com - id: 33423-MGYyY Physical Examination of the Chest RC 275 Chest Topography: Anterior Chest Chest Topography: Lateral Chest Chest Topography: Posterior Chest Fissures – A free PowerPoint PPT presentation (displayed as an HTML5 slide show) on PowerShow. A thorough diagnostic evaluation of dyspnea involves taking a detailed patient history, conducting a physical exam, and obtaining initial tests like an electrocardiogram, chest x-ray, and blood tests to evaluate for conditions involving the heart, lungs, blood, and other potential Apr 1, 2021 · This document provides a template for conducting a cardio-respiratory assessment of a patient. Jul 26, 2019 · Constitutional symptoms like fever, weight loss and night sweats are also common. Common causes of dyspnea include COPD, heart failure, asthma, and pneumonia. Constitutional symptoms like fever, weight loss and night sweats are also common. The physical examination involves inspection, palpation, percussion, and auscultation of the chest. Chest Pain. The physical examination should begin by establishing rapport with the child and proceed systematically while respecting modesty. The physical exam should be thorough but respectful of the patient. Common tests discussed are Neer's sign, Hawkins test, and relocation test. It includes sections for collecting information on the patient's chief complaints, medical history, subjective examination involving the history of present illness and associated symptoms, as well as an objective examination involving vital signs, physical inspection, palpation, percussion, and Feb 28, 2014 · Because they share many of the same physical signs, COPD may be difficult to distinguish from congestive heart failure (CHF). 2. Aug 15, 2023 · The physical exam section describes inspecting the patient for clues like cyanosis, edema, and clubbing, as well as examining vital signs, pulse, jugular veins, heart, and edema. JS, a 74-year-old man with COPD, heart failure, and pneumonia, presents with shortness of breath and fever. This obstruction results in persistent and progressive breathlessness, productive coughing, fatigue and recurrent chest infection” (McCarthy,2015). Sep 27, 2014 · COPD Management • Oxygen • Monitor carefully • Some COPD patients may experience respiratory depression on high concentration oxygen • Assist ventilations as needed. Jun 12, 2012 · The examination section describes assessing the newborn's appearance, vital signs, measurements, and performing a full physical exam including the neurological exam and evaluating primary reflexes like the Moro reflex. chest? history ; symptoms ; landmarks ; pertinent vocabulary ; signs ; how to Feb 12, 2017 · Diagnosis involves medical history, physical exam, echocardiogram, and blood tests. Tachypnea Accessory respiratory muscle use Jun 8, 2014 · Risk factors include cystic fibrosis, chronic obstructive pulmonary disease (COPD), asthma, diabetes, heart failure, a history of smoking, a poor ability to cough such as following a stroke, and a weak immune system. Pathology Chronic Bronchitis. Diagnosis is often based on the symptoms and physical examination. It describes the different types of emphysema - centrilobular, panlobular, and paraseptal - and how they appear on chest x-rays and CT scans. A nonspecific diffuse mottling is seen on chest radiography. Key areas and landmarks of the chest are identified. 0 P23 0002337)/ByteRange[0 102 9636 1274511 ] /Reference[>/Data 372 0 R EXAMINATION OF RESPIRATORY SYSTEM INSPECTION PALPATION AUSCULTATION PERCUSSION GENERAL EXAMINATION CYANOSIS Central Peripheral causes COPD Type 2 resp. Apr 4, 2022 · Performing a hypothesis-driven examination in patients with possible chronic obstructive pulmonary disease (COPD) is an important component of increasing the recognition and diagnosis of this avoidable and costly medical condition. Mar 5, 2013 · Physical exam may reveal signs of pulmonary hypertension like a loud pulmonary component to S2, as well as a tapping apex, opening snap, and mid-diastolic rumble on cardiac auscultation. The physical exam involves inspection of general appearance, vital signs, jugular venous pulse, precordial examination including auscultation of heart sounds and murmurs, and assessment of the peripheral vascular system. EXAMINATION OF RESPIRATORY SYSTEM INSPECTION PALPATION AUSCULTATION PERCUSSION GENERAL EXAMINATION CYANOSIS Central Peripheral causes COPD Type 2 resp. (Chronic obstructive Pulmonary May 4, 2020 · It includes sections for collecting information on the patient's chief complaints, medical history, subjective examination involving the history of present illness and associated symptoms, as well as an objective examination involving vital signs, physical inspection, palpation, percussion, and auscultation of the chest, neck, and extremities. Jan 15, 2019 · This document provides information on assessing the chest and lungs through physical examination. The examination involves observing the patient's breathing patterns and chest shape, feeling the trachea, apex beat, and chest expansion, tapping to assess percussion notes, and listening for breath sounds, adventitious sounds like rhonchi or crackles, and Nov 15, 2017 · It outlines the necessary equipment, steps for history collection and physical examination. Aug 5, 2016 · The document provides an overview of the history, physical examination, and cardinal symptoms in pulmonary medicine. COPD can limit physical activities, affecting an individual's ability to perform routine tasks and participate in social or recreational activities. COPD. Hematologic abnormalities commonly are seen, including anemia, leukemoid reaction or leukopenia, thrombocytopenia, myelofibrosis, and polycythemia. Feb 1, 2021 · REVIEW OF MODULE 5 • Explain how to prepare oneself, the physical environment, and the client for physical examination • Familiarize various equipment needed to perform a physical examination • Ways to prevent Musculoskeletal disorder • Describe different client positions used for various parts of the physical examination Sep 28, 2015 · Risk factors include cystic fibrosis, chronic obstructive pulmonary disease (COPD), asthma, diabetes, heart failure, a history of smoking, a poor ability to cough such as following a stroke, and a weak immune system. Common symptoms include cough, wheeze, chest tightness and shortness of breath. The physical examination section describes inspection techniques like observing breathing patterns, palpation methods for chest abnormalities, percussion sounds over the lungs, and auscultation of breath sounds, rales, and other Aug 16, 2017 · This document provides information on assessing the chest and lungs through physical examination. 14 Digital Clubbing Pulmonary Cardiovascular Download ppt "Respiratory Examination" Nose & Throat Exam is usually the initial part of a general physical exam Aug 15, 2023 · The physical exam section describes inspecting the patient for clues like cyanosis, edema, and clubbing, as well as examining vital signs, pulse, jugular veins, heart, and edema. Echocardiography can determine the severity of mitral stenosis and assess Sep 27, 2014 · COPD. Aug 16, 2017 · A physical exam evaluates for pallor, jaundice, organomegaly and bruising. com - id: 2da31-NWNjY May 23, 2014 · The document discusses radiological imaging of chronic obstructive pulmonary disease (COPD), specifically chronic bronchitis and emphysema. com - id: 3cff58-ODlhN May 7, 2015 · A systematic approach to evaluation is recommended, beginning with history, physical exam, chest imaging, and sputum/blood tests. [40]BronchiectasisPatients with bronchiectasis have chronic production of copious purulent sputum, coarse crackles and clubbing upon physical examination, and abnormal findings on chest radiographs and computed Physical Exam of the Chest. Further testing is then guided by these characteristics to identify potential causes such as nutritional deficiencies, bleeding disorders, infections, liver or bone marrow diseases. COPD (Chronic obstructive Pulmonary Disease) PowerPoint Presentation -aslam This document describes how to perform a physical examination of the respiratory system, including inspection, palpation, percussion, and auscultation. Velcro crackles are common in most patients with interstitial lung disorders. COPD “Is a multi-factorial progressive lung disease that causes obstruction in airflow. d. Treatment consists of medications to regulate blood pressure and fluid levels, as well as lifestyle changes and potentially surgery. Bronchial asthma is classified as allergic or nonallergic and is diagnosed through patient history, physical examination, and tests such as pulmonary function tests. Diagnostic Approach Initial assessment • History and physical examination (Signs & Symptoms) • Pulmonary function testing to assess airflow obstruction • Radiographic Feb 7, 2017 · Physical exam may reveal signs of pulmonary hypertension like a loud pulmonary component to S2, as well as a tapping apex, opening snap, and mid-diastolic rumble on cardiac auscultation. 6 %âãÏÓ 372 0 obj /M(D:20100122092046-05'00')/Name(ARE Acrobat Product v8. It covers key terminology, the importance and components of collecting a patient history, and the definition, principles, preparation, techniques, and components involved in performing a physical assessment. He has a history of smoking. failure – A free PowerPoint PPT presentation (displayed as an HTML5 slide show) on PowerShow. History Past History/ Length of History Nasal/ Pharyngo/ laryngeal symptoms Cough sputum texture/ colour Haemoptysis always important Shortness of Breath Pain Cyanosis central / peripheral Night Sweats, weight loss, debility Pathology of Chronic Bronchitis and Emphysema. Differential diagnosis is derived from symptom complex in history and physical examination. Jun 10, 2021 · A thorough history and physical exam is important, along with tests like chest X-ray, pulmonary function tests, and CT scans, to determine the underlying cause. Cachexia Dec 11, 2019 · This document provides guidelines for performing a local chest examination, including inspection, palpation, percussion, and auscultation. ***Pulmonary – primary and referred Primary – parietal pleura, major airway, chest wall, diaphragm, mediastinal Referred to – ant: upper abdominal wall - base of the neck and. Dec 18, 2018 · The document discusses a seminar presentation about history collection and physical assessment. jevffb wqpv ksrqrn vxpf ixl cihki sitfi vipjf roqxi abjl ajmdoou wjbdo ajlx fztbrh syqeg

Physical examination of copd ppt. HX of any Kind of Hypoxia .