#2: Pulmonary H&P Flashcards
The spine is deviated posteriorly
Kyphosis
The spine is deviated laterally
Scoliosis
Prominent eternal protrusion aka “Pigeon Chest”
Pectus carinatum
Indentation of the lower sternum above the diploid aka “Funnel Chest”
Pectus excavatum
Normal A/P to Transverse Diameter Ratio:
1:2
Describe “Barrel Chest” characteristic findings: (6)
1- ribs are more horizontal 2- the spine somewhat kyphotic 3- sternal angle more prominent 4- trachea may be posteriorly displaced 5- AP diameter is increased 6- occurs from long-standing compromised respiration
SOB that increases in the upright position
Platypnea
Rapid, deep, and labored breathing
Kussmaul respiration’s
Varying periods of increasing depth interspersed with apnea
Cheyne-Stokes respirations
Factors that increase respiration rate: (7)
1- pain 2- exercise 3- metabolic acidosis 4- ASA poisoning 5- hypoxemia 6- Anxiety 7- CNS lesions of the pons
Factors that decrease respiration rate: (6)
1- metabolic alkalosis 2- extreme obesity 3- excellent fitness 4- CNS lesions of the cerebrum 5- narcotic OD 6- MG
MC type of respirations at all ages:
Thoracic respiration
This population may typically display abdominal respiration
Very young infants
Vibration sensation of the chest wall that results from speech/verbalizations
Tactile fremitus
Tactile fremitus is best palpated here:
2nd ICS (where the bronchi typically bifurcate)
Factors contributing to decreased or absent tactile fremitus: (4)
1- bronchial obstruction
2- emphysema
3- excess air in the lungs
4- pleural thickening or effusion
Factors contributing to increased tactile fremitus (coarser): (4)
- occurs with the presence of a solid mass or fluids 1- tumor 2- lung consolidation 3- heavy bronchial secretions 4- compressed lung
What would you expect to see in an obstructive retraction?
- In one of the bronchi (MC Right 2/2 to its broader lumen and more vertical placement)
- U/L retraction
- no suprasternal notch involvement
T/F: the trachea has a normal crepitus feeling with palpation
True
Crepitus indicates:
Air in the subQ tissues
Coarse, grating vibration associated w/ inspiration (inflammation of the pleural surfaces)
Pleural friction rub
