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Related Concept Videos

Physical Assessment of the Respiratory Tract II: Inspection01:27

Physical Assessment of the Respiratory Tract II: Inspection

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Physical assessment of the respiratory tract through inspection is a crucial step in understanding the patient's respiratory health. It provides insights into the functioning of the respiratory system, the musculoskeletal structure, and even the patient's nutritional status. This comprehensive approach involves observing several vital aspects: chest configuration, breathing patterns, respiratory rates, skin color, and use of accessory muscles.
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The chest configuration...
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Assessment of Ventilation II: Respiratory Depth and Rhythm01:29

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Respiratory Depth
Respiratory depth measures the volume of air inhaled or exhaled during a breath. It can vary from shallow to deep and typically remains consistent when a person is at rest or asleep. Occasionally, individuals will automatically inhale deeply, known as sighing, which inflates the lungs with more air than normal breathing.
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Alterations in Respiration II01:30

Alterations in Respiration II

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There are numerous types of normal and abnormal respiration. Based on ventilatory movements, breathing patterns are classified as regular, deep, or shallow. Examples include Biot's breathing, Cheyne-Stokes respiration, Kussmaul's breathing, hyperventilation, and hypoventilation. Each pattern is clinically significant and aids in evaluating patients.
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Electrocardiogram01:29

Electrocardiogram

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An electrocardiogram (ECG or EKG) is a critical diagnostic tool that records the electrical signals produced by the heart during each heartbeat. This recording is achieved through electrodes placed strategically on the arms, legs, and chest. The electrocardiograph amplifies these signals and produces 12 distinct tracings, offering a comprehensive understanding of the heart's electrical activity.
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
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Respiratory System Abnormal Finding II: Palpation and Auscultation01:31

Respiratory System Abnormal Finding II: Palpation and Auscultation

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In assessing respiratory abnormalities, palpation and auscultation are critical tools for detecting and interpreting various pathophysiological changes. These techniques provide insight into underlying disorders by evaluating tactile sensations and sounds produced by the respiratory system.
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Respiratory Volumes and Capacities I01:26

Respiratory Volumes and Capacities I

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Assessing the respiratory rate and rhythm for a complete minute is crucial for evaluating the breathing pattern. Even a minor increase in the patient's average respiratory rate, by as little as three to five breaths per minute, is an early and vital indicator of respiratory distress. Patients with a respiratory rate exceeding twenty-four breaths per minute require close monitoring to determine the physiological alterations. This careful observation is essential for prompt recognition and...
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Updated: Oct 1, 2025

Oxygenation-sensitive Cardiac MRI with Vasoactive Breathing Maneuvers for the Non-invasive Assessment of Coronary Microvascular Dysfunction
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Characterizing Sensitive Cardiac Substructure Excursion Due to Respiration.

Claudia R Miller1, Eric D Morris1, Ahmed I Ghanem2,3

  • 1Department of Radiation Oncology, University of California-Los Angeles, Los Angeles, California.

Advances in Radiation Oncology
|March 4, 2022
PubMed
Summary
This summary is machine-generated.

Radiation therapy planning requires precise targeting of cardiac substructures. This study shows significant respiratory motion in these structures, impacting dose delivery accuracy and patient safety.

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Area of Science:

  • Radiotherapy Physics
  • Medical Imaging
  • Cardiovascular Anatomy

Background:

  • Whole-heart radiation dose metrics inadequately predict cardiac morbidity.
  • Individual cardiac substructures exhibit greater sensitivity to radiation dose variations.
  • Understanding respiratory excursion of cardiac substructures is crucial for safety margin design.

Purpose of the Study:

  • To quantify the respiratory-induced motion and dosimetric variations of cardiac substructures.
  • To inform the design of more robust safety margins in radiation therapy planning.
  • To improve the accuracy of radiation delivery to thoracic cancer patients.

Main Methods:

  • Utilized 4-phase 4D CT and MRI for 11 thoracic cancer patients.
  • Contoured 13 cardiac substructures on end-exhale 4D CT.
  • Applied deformable image registration to assess motion across respiratory phases.
  • Evaluated mean and maximum radiation doses to substructures.

Main Results:

  • Significant displacements (>5 mm) observed in superior-inferior axis (64.5%) and other axes.
  • Inferior vena cava and right coronary artery showed largest displacements (up to 17.9 mm).
  • Left anterior descending artery Dmean varied significantly with respiration (3.03 ± 1.75 Gy).
  • Whole-heart dose metrics showed minimal variation (<0.5 Gy) across breathing phases.

Conclusions:

  • Cardiac substructures exhibit substantial intrafraction displacement during respiration.
  • Local dose changes in substructures are more critical than whole-heart metrics.
  • Generating margins for cardiac substructures can enhance treatment planning and cardiac sparing.
  • Accounting for respiratory motion improves radiation therapy quality for thoracic treatments.