19: Pulmonary Breath Sounds Flashcards
three cases that may have tracheal displacement
- pneumothorax
- pleural effusion
- severe atelectasis
signs of respiratory distress on inspection
- accessory muscle use (SCM, scalenes)
- Retractions (supraclavicular retractions)
- inability to speak in full sentences
- tripod positioning
- abdomen paradoxical movement with breaths
causes of nail clubbing
bronchiectasis, congenital heart disease, pulmonary fibrosis, CF, lung abscess, malig
causes of unilateral chest expansion
- fibrosis
- pleural effusion
- lobar PNA
- pleural pain
- unilateral bronchial obstruction
- paralysis of hemidiaphragm
tactile fremitus
palpable vibrations from patient speaking
what does it mean if tactile fremitus is increased vs locally decreased vs globally decreased
- increased: consolidated tissue like PNA
- locally decreased: pleural effusion, pneumothorax, neoplasms
- globally decreased: high pitched voice, thick chest wall, obstructed bronchus, COPD, fibrosis
why is lack of wheezing in an asthmatic pt an ominous sign
could be so severe that almost no air is moving thru
symp levels of the lungs
T1-7
332 rule in intubation
- 3 fingers between upper/lower teeth with open mouth
- 3 fingers between mental angle and hyoid bone
- 2 fingers between floor of mandible to thyroid notch
LEMON airway assessment
- Look externally (trauma, big teeth, beard, large tongue)
- evaluate 332
- mallampati score >3
- obstruction (epiglottitis, peritonsillar abscess, trauma)
- neck mobility
indications for intubation
- respiratory failure
- apnea
- reduced consciousness GCS < 8
- airway injury
- high risk for aspiration
- general anesthesia
major contraindication of intubation
laryngeal fracture
Most common inflammatory dz of the lung + MC chronic dz in childhood in resource-rich countries
Asthma
Confirming asthma dx requires what three elements?
- Variable expiratory airflow limitation on spirometry
- Reversible obstruction
- Exclude other dxs
Six types of drugs used in asthma and COPD**
- SABA
- LABA
- SAMA (short acting muscarinic agents)
- inhaled corticosteroids
- Systemic corticosteroids
- Leukotriene R antagonist