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A positive Pemberton's sign is indicative of superior vena cava syndrome (SVC), commonly the result of a mass in the mediastinum.Although the sign is most commonly described in patients with substernal goiters where the goiter "corks off" the thoracic inlet, [4] the maneuver is potentially useful in any patient with adenopathy, tumor, or fibrosis involving the mediastinum.
The sign is an imaging finding using a 3.5–7.5 MHz ultrasound probe in the fourth and fifth intercostal spaces in the anterior clavicular line using the M-Mode of the machine. This finding is seen in the M-mode tracing as pleura and lung being indistinguishable as linear hyperechogenic lines and is fairly reliable for diagnosis of a pneumothorax.
In order to listen to the lungs from the back the patient is asked to move their arms forward to prevent the scapulae (shoulder blades) from obstructing the upper lung fields. These fields are intended to correlate with the lung lobes and are thus tested on the anterior (front) and posterior (back) chest walls.
A ventilation/perfusion lung scan, also called a V/Q lung scan, or ventilation/perfusion scintigraphy, is a type of medical imaging using scintigraphy and medical isotopes to evaluate the circulation of air and blood within a patient's lungs, [1] [2] in order to determine the ventilation/perfusion ratio.
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Spontaneous subcutaneous emphysema is thought to result from increased pressures in the lung that cause alveoli to rupture. [5] In spontaneous subcutaneous emphysema, air travels from the ruptured alveoli into the interstitium and along the blood vessels of the lung, into the mediastinum and from there into the tissues of the neck or head. [5]