In patients with chronic obstructive pulmonary disease, what is a common finding during a physical exam?

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In patients with chronic obstructive pulmonary disease (COPD), prolonged expiration is a hallmark physical exam finding. This occurs due to airway obstruction, which is characteristic of COPD. The disease process leads to changes in the lung’s elastic recoil and primarily affects the ability to exhale air efficiently. This results in a longer duration of time taken to expel air from the lungs compared to inhalation.

Prolonged expiration is typically observed as a delay in the expiratory phase of respiration, often demonstrated during auscultation or observation of the respiratory pattern. This prolonged phase can be attributed to obstructed airways, trapping of air as a result of alveolar collapse, and limited flow rates during forced expiration. In patients with severe COPD, this may manifest as a noticeable effort during breathing and may even present with a paradoxical respiratory pattern in advanced cases.

The other findings associated with COPD, such as wheezing or crackles, may also be present but are not as universally characteristic or prominent as prolonged expiration. Decreased breath sounds can occur due to various reasons, including hyperinflation, but again, do not distinctly capture the essence of COPD as effectively as prolonged expiration does. Therefore, prolonged expiration is the most indicative finding associated with COPD during a physical exam

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