Crepitus and its species

Crepitus - a phenomenon that can be detected by means of listening (as a stethoscope, and just the ear, at a distance) or probing, he looks like a crackling or crunching easy. There are three types crepitations: alveolar (you can hear only the stethoscope), subcutaneous and bone (the crepitus is usually detected at a palpation of the affected area of ​​the body). All kinds crepitations can be identified only by a physician (alveolar - internist or pediatrician, and subcutaneous and bone - traumatologist or surgeon), but patients should know what he is talking about some form of crepitations.

Alveolar crepitus

Alveolar crackling refers to a high-frequency abnormal respiratory noise. It can be heard by listening to the lungs using a phonendoscope, with alveolar crepitus is characteristic manifestations, reminding sound that occurs when kneading fingers bundle of hair around the ear.

To listen to the alveolar crepitations Dr. firmly pressed against the skin stethoscope, reducing the audibility of low frequency sounds, including sounds from the interaction with the membrane of the skin phonendoscope. If the chest auscultation there are places in the hair, they moisten with water or grease, because the friction of dry hair Dry hair: how to restore hair vitality?   It can simulate crepitus.

Crepitus best auscultated at the height of inspiration (often only at the height of a deep breath). There she was on the unfolding razlipaniya or more humid than usual walls of the alveoli (sacs at the ends of the smallest bronchi or bronchioles, which are their own lung tissue) and listen to the sound as a short "flash" or "explosion".

Crepitus has a constant composition and homogeneous caliber sounds, do not change the process of respiration, or after coughing. Sometimes it is difficult to distinguish from crepitus finely moist rales arising from the presence of mucus in the small bronchi. But unlike crepitations wheezing often heterogeneous in size (since there are in the bronchi of different diameters), are heard at the outset of inspiration, sometimes even against the backdrop of an exhalation, longer-sounding and often vary in the number and size after coughing.

Sometimes crepitus reminds pleural rub in its inflammation (pleurisy). But pleural rub rougher timbre, duration is more audible in both phases of breathing and sound like someone you know (just under the membrane phonendoscope).

Most often alveolar crepitus is a sign of acute inflammation in the lungs (pneumonia). It occurs in the phase of emergence and dispersal of mucus (exudate) in the alveoli. In acute focal pneumonia with non-simultaneous inflammation of individual sections of the lung crepitus may be auscultated for several days. When lobar (with the defeat of a segment or lobe of the lung), it is listened only at the beginning of the disease, then it disappears and reappears in the stage of resolution of pneumonia when absorbed exudate. Crepitus can long auscultated in patients with damage to the alveoli with systemic connective tissue diseases, such as systemic lupus erythematosus Systemic lupus erythematosus - a woman's disease .

Similar to the mechanism of formation of crepitus are wheezing, listens with a deep breath of the sleeping areas of the lungs of weakened, long lie, particularly the elderly. Unlike true crepitations, wheezing from the unfolding sleeping areas of the lung disappear after a few deep breaths.

Subcutaneous and bone crepitus

Subcutaneous crepitus - a phenomenon that can be detected by means of probing, he heard a distinctive crunch and crackle. Palpable (palpated) areas of the body, containing in the subcutaneous fat accumulation of free gas bubbles. To observe such phenomena, for example, gas gangrene, when the infection develops in the subcutaneous tissue without access of oxygen to form a gas. Air can get under the skin in wounds (subcutaneous emphysema), and due to rupture of hollow viscera. Sometimes the air is introduced into the various areas of the body for therapeutic purposes (e.g., in the treatment of tuberculosis).

Bone crepitation - the feeling or the sound of crunching by mutual friction in the area of ​​the fracture fragments. This is usually revealed crepitus in probing the fracture and can be heard in the distance.

Crepitus - a major diagnostic feature that indicates that the patient requires urgent medical assistance.

Galina Romanenko

How dangerous mountain sickness

In most cases, altitude sickness does not endanger human health, and symptoms usually disappear after a descent to a normal, usual height. However, at the same time the potential threat of altitude sickness to health can not be underestimated: in severe cases, altitude sickness can significantly disrupt the function of the lungs or cause swelling Prevention and treatment of edema - it is important to understand the root cause   brain, which in turn leads to death. Possible complications of altitude sickness, cause significant damage to health and potentially lead to death, you can include coma, pulmonary edema (fluid in the lungs), brain edema.

It is best when it detects the first signs of altitude sickness seek medical help - even after returning to a normal state of health has improved height. Immediately care physicians required in cases where an attack of altitude sickness is accompanied by significant violations of breath, coughing up blood, confusion (the inability to understand and respond to what is happening).

How to prevent

The main methods of prevention of altitude sickness when climbing at high altitude:

• Climbing should be gradually
• Climbing every hundred meters after reaching a height of two thousand four hundred meters above sea level, it is necessary to make a halt for one or two days
• If possible, you need to stop for the night at low altitude
• During the ascent need to carefully monitor the appearance of the first symptoms of altitude sickness in time to return to normal height

Rising to a height of more than three thousand meters above sea level, it is necessary to take a supply of oxygen for several days.

If you climb to a higher altitude will be fast, to prevent the appearance of signs of altitude sickness, you can use acetazolamide - a drug that helps the body to quickly adapt to high altitude and light suppresses the symptoms of altitude sickness. Acetazolamide should be taken the day before the ascent and over the next two days. During the ascent need to drink plenty of fluids, avoid alcohol consumption and eat more carbohydrates. In diseases of the cardiovascular system and lungs, as well as anemia Anemia - when you do not have enough blood , Reduces the level of oxygen in the blood, from climbing to great heights it is recommended to give up.