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Rhinomanometry - Wikipedia

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class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Method used in evaluation of respiratory function of the nasal cavity</div> <style data-mw-deduplicate="TemplateStyles:r1251242444">.mw-parser-output .ambox{border:1px solid #a2a9b1;border-left:10px solid #36c;background-color:#fbfbfb;box-sizing:border-box}.mw-parser-output .ambox+link+.ambox,.mw-parser-output .ambox+link+style+.ambox,.mw-parser-output .ambox+link+link+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+style+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+link+.ambox{margin-top:-1px}html body.mediawiki .mw-parser-output .ambox.mbox-small-left{margin:4px 1em 4px 0;overflow:hidden;width:238px;border-collapse:collapse;font-size:88%;line-height:1.25em}.mw-parser-output .ambox-speedy{border-left:10px solid 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title="Wikipedia:Primary sources">primary sources</a></b>.<span class="hide-when-compact"> Please review the contents of the article and <a class="external text" href="https://en.wikipedia.org/w/index.php?title=Rhinomanometry&amp;action=edit">add the appropriate references</a> if you can. Unsourced or poorly sourced material may be challenged and <a href="/wiki/Wikipedia:Verifiability#Burden_of_evidence" title="Wikipedia:Verifiability">removed</a>. <small><span class="plainlinks"><i>Find sources:</i>&#160;<a rel="nofollow" class="external text" href="https://www.google.com/search?as_eq=wikipedia&amp;q=%22Rhinomanometry%22">"Rhinomanometry"</a>&#160;–&#160;<a rel="nofollow" class="external text" href="https://www.google.com/search?tbm=nws&amp;q=%22Rhinomanometry%22+-wikipedia&amp;tbs=ar:1">news</a>&#160;<b>·</b> <a rel="nofollow" class="external text" href="https://www.google.com/search?&amp;q=%22Rhinomanometry%22&amp;tbs=bkt:s&amp;tbm=bks">newspapers</a>&#160;<b>·</b> <a rel="nofollow" class="external text" href="https://www.google.com/search?tbs=bks:1&amp;q=%22Rhinomanometry%22+-wikipedia">books</a>&#160;<b>·</b> <a rel="nofollow" class="external text" href="https://scholar.google.com/scholar?q=%22Rhinomanometry%22">scholar</a>&#160;<b>·</b> <a rel="nofollow" class="external text" href="https://www.jstor.org/action/doBasicSearch?Query=%22Rhinomanometry%22&amp;acc=on&amp;wc=on">JSTOR</a></span></small></span> <span class="date-container"><i>(<span class="date">December 2018</span>)</i></span></div></td><td class="mbox-imageright"><div class="mbox-image-div"><span typeof="mw:File"><span><img src="//upload.wikimedia.org/wikipedia/commons/thumb/a/ae/Star_of_life.svg/52px-Star_of_life.svg.png" decoding="async" width="52" height="50" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/a/ae/Star_of_life.svg/77px-Star_of_life.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/a/ae/Star_of_life.svg/103px-Star_of_life.svg.png 2x" data-file-width="198" data-file-height="192" /></span></span></div></td></tr></tbody></table> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical intervention</div> <style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox"><tbody><tr><th colspan="2" class="infobox-above" style="background-color: lightblue">Rhinomanometry</th></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/ICD-9-CM_Volume_3" title="ICD-9-CM Volume 3">ICD-9-CM</a></th><td class="infobox-data"><a rel="nofollow" class="external text" href="http://icd9cm.chrisendres.com/index.php?srchtype=procs&amp;srchtext=89.12&amp;Submit=Search&amp;action=search">89.12</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a></th><td class="infobox-data"><span class="reflink plainlinks nourlexpansion"><a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D025363">D025363</a></span></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/OPS-301" title="OPS-301">OPS-301&#160;code</a></th><td class="infobox-data"><a rel="nofollow" class="external text" href="http://www.icd-code.de/ops/code/1-245.html">1-245</a></td></tr><tr class="noprint"><td colspan="2" class="infobox-full-data"><div style="text-align: right;">&#91;<a href="https://www.wikidata.org/wiki/Q2148116" class="extiw" title="d:Q2148116">edit on Wikidata</a>]</div></td></tr></tbody></table> <p><b>Rhinomanometry</b> is a form of <a href="/wiki/Pressure_measurement" title="Pressure measurement">manometry</a> used in evaluation of the <a href="/wiki/Nasal_cavity" title="Nasal cavity">nasal cavity</a>. Rhinomanometry is a standard diagnostic tool aiming to objectively evaluate the respiratory function of the nose. It measures pressure and flow during normal inspiration and expiration through the nose. Increased pressure during respiration is a result of increased resistance to airflow through nasal passages (nasal blockage), while increased flow, which means the speed of airstream, is related to better patency. Nasal obstruction leads to increased values of nasal resistance. Rhinomanometry may be used to measure only one nostril at a time (anterior rhinomanometry) or both nostrils simultaneously (posterior rhinomanometry). </p><p>In anterior rhinomanometry, the patient is asked to blow his nose, sit in an upright position, and the pressure sensing tube is placed in one nostril, while the contralateral nostril is left opened. The patient places a mask which is connected to the device tightly onto his face. Unilateral measurements are performed to detect any asymmetry or abnormality in nasal airway resistance. When the measurements are performed before and after the application of a nasal decongestant spray, the differences in resistance can be attributed to nasal mucosal congestion. If there is no significant improvement after decongestant, anatomical abnormality, like deformity of cartilage or bone within nasal cavity is suspected. However, such measurements allow only to detect in which side of the nose there is obstruction, not the location within the nasal cavity, which can be detected by <a href="/wiki/Acoustic_rhinometry" title="Acoustic rhinometry">acoustic rhinometry</a> or endoscopy. Anterior rhinomanometry is more commonly used and it is often recommended for its easy technique. However, it should be stressed that controlled ambient temperature and humidity, tight seal of the facial mask, contralateral nostril closure and prevention of mouth breathing are essential for reproducible results. Patients' complaints of nasal obstruction are not always confirmed by these objective measurements. Posterior rhinomanometry should be done by more experienced technicians and very good collaboration of the patient is essential. </p><p>Rhinomanometry can be used to test nasal patency in basal conditions in order to differentiate between anatomical and mucosal abnormalities by performing a test with a decongestant. It can also be used to check impact of other treatments, like nasal steroid sprays, on objective nasal blockage. It is also used in challenge tests with allergen when nasal patency is measured before and after application of allergen onto the nasal mucosa. Increased resistance on rhinomanometry after allergen application is an objective mean in proving allergy to airborne allergens when other allergy tests fail. </p> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Rhinomanometry&amp;action=edit&amp;section=1" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Parker Davidson, K. Breathe through your nose don’t pay through it: The impact the healthcare industry has a nasal function and how we breathe. 2022. 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li a abbr{color:var(--color-base)!important}@media(prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}}@media print{.mw-parser-output .navbar{display:none!important}}</style><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Respiratory_system_procedures" title="Template:Respiratory system procedures"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Respiratory_system_procedures" title="Template talk:Respiratory system procedures"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Respiratory_system_procedures" title="Special:EditPage/Template:Respiratory system procedures"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Tests_and_procedures_involving_the_respiratory_system" style="font-size:114%;margin:0 4em">Tests and procedures involving the <a href="/wiki/Respiratory_system" title="Respiratory system">respiratory system</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Surgery" title="Surgery">Surgery</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Upper_respiratory_tract" class="mw-redirect" title="Upper respiratory tract">Upper RT</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <dl><dt><i><a href="/wiki/Human_nose" title="Human nose">nose</a></i></dt> <dd></dd> <dd><a href="/wiki/Rhinoplasty" title="Rhinoplasty">Rhinoplasty</a></dd> <dd><a href="/wiki/Septoplasty" title="Septoplasty">Septoplasty</a></dd> <dd><a href="/wiki/Somnoplasty" title="Somnoplasty">Somnoplasty</a></dd> <dd><a href="/wiki/Alarplasty" title="Alarplasty">Alarplasty</a></dd> <dd><a href="/wiki/Rhinectomy" title="Rhinectomy">Rhinectomy</a></dd> <dd><a class="mw-selflink selflink">Rhinomanometry</a></dd> <dd><a href="/wiki/Acoustic_rhinometry" title="Acoustic rhinometry">Acoustic rhinometry</a></dd></dl> <dl><dt><i><a href="/wiki/Paranasal_sinuses" title="Paranasal sinuses">sinus</a></i></dt> <dd></dd> <dd><a href="/wiki/Sinusotomy" title="Sinusotomy">Sinusotomy</a></dd></dl> <dl><dt><i><a href="/wiki/Larynx" title="Larynx">larynx</a></i></dt> <dd></dd> <dd><a href="/wiki/Laryngoscopy" title="Laryngoscopy">Laryngoscopy</a></dd> <dd><a href="/wiki/Laryngectomy" title="Laryngectomy">Laryngectomy</a></dd> <dd><a href="/wiki/Laryngotomy" class="mw-redirect" title="Laryngotomy">Laryngotomy</a> <dl><dd><a href="/wiki/Thyrotomy" title="Thyrotomy">Thyrotomy</a></dd></dl></dd> <dd><a href="/wiki/Laryngotracheal_reconstruction" title="Laryngotracheal reconstruction">Laryngotracheal reconstruction</a></dd></dl> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Lower_respiratory_tract" class="mw-redirect" title="Lower respiratory tract">Lower RT</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <dl><dt><i><a href="/wiki/Vertebrate_trachea" class="mw-redirect" title="Vertebrate trachea">trachea</a></i></dt> <dd></dd> <dd><a href="/wiki/Cricothyrotomy" title="Cricothyrotomy">Cricothyrotomy</a></dd> <dd><a href="/wiki/Tracheo-oesophageal_puncture" class="mw-redirect" title="Tracheo-oesophageal puncture">Tracheoesophageal puncture</a></dd> <dd><a href="/wiki/Tracheotomy" title="Tracheotomy">Tracheotomy</a></dd></dl> <dl><dt><i><a href="/wiki/Bronchus" title="Bronchus">bronchus</a></i></dt> <dd></dd> <dd><a href="/wiki/Bronchoscopy" title="Bronchoscopy">Bronchoscopy</a></dd></dl> <dl><dt><i><a href="/wiki/Human_lung" class="mw-redirect" title="Human lung">lung</a></i></dt> <dd></dd> <dd><a href="/wiki/Pneumonectomy" title="Pneumonectomy">Pneumonectomy</a></dd> <dd><a href="/wiki/Lobectomy" title="Lobectomy">Lobectomy</a></dd> <dd><a href="/wiki/Wedge_resection" title="Wedge resection">Wedge resection</a></dd> <dd><a href="/wiki/Lung_transplantation" title="Lung transplantation">Transplantation</a></dd> <dd><a href="/wiki/Decortication_of_lung" class="mw-redirect" title="Decortication of lung">Decortication</a></dd> <dd><a href="/wiki/Heart%E2%80%93lung_transplant" title="Heart–lung transplant">Heart–lung transplant</a></dd></dl> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Thoracic_wall" title="Thoracic wall">Chest wall</a>, <a href="/wiki/Pleura" title="Pleura">pleura</a>,<br /><a href="/wiki/Mediastinum" title="Mediastinum">mediastinum</a>,<br />and <a href="/wiki/Thoracic_diaphragm" title="Thoracic diaphragm">diaphragm</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <dl><dt><i><a href="/wiki/Pleura" title="Pleura">pleura</a>/<a href="/wiki/Pleural_cavity" title="Pleural cavity">pleural cavity</a></i></dt> <dd></dd> <dd><a href="/wiki/Thoracentesis" title="Thoracentesis">Thoracentesis</a></dd> <dd><a href="/wiki/Pleurodesis" title="Pleurodesis">Pleurodesis</a></dd> <dd><a href="/wiki/Thoracoscopy" title="Thoracoscopy">Thoracoscopy</a></dd> <dd><a href="/wiki/Thoracotomy" title="Thoracotomy">Thoracotomy</a></dd> <dd><a href="/wiki/Chest_tube" title="Chest tube">Chest tube</a></dd></dl> <dl><dt><i><a href="/wiki/Mediastinum" title="Mediastinum">mediastinum</a></i></dt> <dd></dd> <dd><a href="/wiki/Mediastinoscopy" title="Mediastinoscopy">Mediastinoscopy</a></dd></dl> <dl><dd><a href="/wiki/Nuss_procedure" title="Nuss procedure">Nuss procedure</a></dd></dl> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Tests</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Medical_imaging" title="Medical imaging">Medical imaging</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Bronchography" title="Bronchography">Bronchography</a></li> <li><a href="/wiki/CT_pulmonary_angiogram" title="CT pulmonary angiogram">CT pulmonary angiogram</a></li> <li><a href="/wiki/High-resolution_computed_tomography" title="High-resolution computed tomography">High-resolution computed tomography</a></li> <li><a href="/wiki/Spiral_computed_tomography" class="mw-redirect" title="Spiral computed tomography">Spiral CT</a></li> <li><a href="/wiki/Ventilation/perfusion_scan" title="Ventilation/perfusion scan">Ventilation/perfusion scan</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Clinical_prediction_rule" title="Clinical prediction rule">Clinical prediction rule</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Pneumonia_severity_index" title="Pneumonia severity index">Pneumonia severity index</a></li> <li><a href="/wiki/CURB-65" title="CURB-65">CURB-65</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Lung_function_test" class="mw-redirect" title="Lung function test">Lung function test</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Body_plethysmography" class="mw-redirect" title="Body plethysmography">Body plethysmography</a></li> <li><a href="/wiki/Spirometry" title="Spirometry">Spirometry</a></li> <li><a href="/wiki/Bronchial_challenge_test" title="Bronchial challenge test">Bronchial challenge test</a></li> <li><a href="/wiki/Capnography" title="Capnography">Capnography</a></li> <li><a href="/wiki/Diffusion_capacity" class="mw-redirect" title="Diffusion capacity">Diffusion capacity</a></li> <li><a href="/wiki/Impulse_oscillometry" title="Impulse oscillometry">Impulse oscillometry</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Cell_biology" title="Cell biology">Cytology</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Bronchoalveolar_lavage" title="Bronchoalveolar lavage">Bronchoalveolar lavage</a></li> <li><a href="/wiki/Nasopharyngeal_swab" title="Nasopharyngeal swab">Nasopharyngeal swab</a></li> <li><a href="/wiki/Sputum_culture" title="Sputum culture">Sputum culture</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Blood_gas_test" title="Blood gas test">Blood gas test</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other procedures</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th id="Oxygen_therapy" scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Oxygen_therapy" title="Oxygen therapy">Oxygen therapy</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Tracheal_intubation" title="Tracheal intubation">Intubation</a></li> <li><a href="/wiki/Surgical_airway_management" title="Surgical airway management">Surgical airway management</a></li> <li><a href="/wiki/Mechanical_ventilation" title="Mechanical ventilation">Mechanical ventilation</a> <ul><li><a href="/wiki/Negative_pressure_ventilator" title="Negative pressure ventilator">Negative pressure ventilator</a></li> <li><a href="/wiki/Positive_pressure_ventilation" class="mw-redirect" title="Positive pressure ventilation">Positive pressure ventilation</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Respiratory_therapy" class="mw-redirect" title="Respiratory therapy">Respiratory therapy</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Artificial_respiration" class="mw-redirect" title="Artificial respiration">Artificial respiration</a></li> <li><a href="/wiki/Cardiopulmonary_resuscitation" title="Cardiopulmonary resuscitation">CPR</a></li> <li><a href="/wiki/Hyperbaric_medicine" title="Hyperbaric medicine">Hyperbaric medicine</a></li> <li><a href="/wiki/Decompression_chamber" class="mw-redirect" title="Decompression chamber">Decompression chamber</a></li> <li><a href="/wiki/Heliox" title="Heliox">Heliox</a></li> <li><a href="/wiki/Nebulizer" title="Nebulizer">Nebulizer</a></li> <li><a href="/wiki/Postural_drainage" title="Postural drainage">Postural drainage</a></li> <li><a href="/wiki/Hyperinflation_therapy" title="Hyperinflation therapy">Hyperinflation therapy</a></li> <li><a href="/wiki/Pulmonary_hygiene" title="Pulmonary hygiene">Pulmonary hygiene</a></li> <li><a href="/wiki/Pulmonary_rehabilitation" title="Pulmonary rehabilitation">Pulmonary rehabilitation</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" 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srcset="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/15px-OOjs_UI_icon_edit-ltr-progressive.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/20px-OOjs_UI_icon_edit-ltr-progressive.svg.png 2x" data-file-width="20" data-file-height="20" /></a></span></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><ul><li><span class="uid"><a rel="nofollow" class="external text" href="https://d-nb.info/gnd/4199259-3">Germany</a></span></li></ul></div></td></tr></tbody></table></div> <p><br /> </p> <style data-mw-deduplicate="TemplateStyles:r1012311289">.mw-parser-output .asbox{position:relative;overflow:hidden}.mw-parser-output .asbox table{background:transparent}.mw-parser-output .asbox p{margin:0}.mw-parser-output .asbox p+p{margin-top:0.25em}.mw-parser-output .asbox-body{font-style:italic}.mw-parser-output .asbox-note{font-size:smaller}.mw-parser-output .asbox .navbar{position:absolute;top:-0.75em;right:1em;display:none}</style><div role="note" class="metadata plainlinks asbox stub"><table role="presentation"><tbody><tr class="noresize"><td><span typeof="mw:File"><a href="/wiki/File:A_nurse_and_a_surgeon,_both_wearing_gown_and_mask._Etching_b_Wellcome_L0028811.jpg" class="mw-file-description"><img alt="Stub icon" src="//upload.wikimedia.org/wikipedia/commons/thumb/5/5e/A_nurse_and_a_surgeon%2C_both_wearing_gown_and_mask._Etching_b_Wellcome_L0028811.jpg/25px-A_nurse_and_a_surgeon%2C_both_wearing_gown_and_mask._Etching_b_Wellcome_L0028811.jpg" decoding="async" width="25" height="35" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/5/5e/A_nurse_and_a_surgeon%2C_both_wearing_gown_and_mask._Etching_b_Wellcome_L0028811.jpg/38px-A_nurse_and_a_surgeon%2C_both_wearing_gown_and_mask._Etching_b_Wellcome_L0028811.jpg 1.5x, 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