4. Respiratory examination Flashcards
RESP: OUTSIDE STATION
LOOK
FEEL
TAP
LISTEN - 99
RESP: INTRO: EXPLAIN
I’ve been asked to do a resp exam. This will involve me LOOKING at your hands and face, examining your chest and listening to lung sounds with my stethoscope. LOOK, FEEL, TAP, LISTEN
INPECTION: general and attached:
Sputum pot, medication (inhaler)
Supplemental oxygen, nebuliser
RESPIRATORY: INSPECT: PT.
Pt.
Comfortable at rest, no wheeze, stridor, SOB
accessory muscle use (COPD, pleural effusion, pneumothorax)
Skin
Cyanosed, pallor, sweaty (pink puffer: emphysema. Blue bloater: CB)
RESP: INSPECTION: HANDS
Warmth, CRT, clubbing, asterixis
Cyanosis, Koilonychia, leukonychia, tar staining
Pulse, resp. pattern
RESP: INSPECTION: EYES, MOUTH, NECK, CHEST
LOOK: EYES
Conjunctival pallor (anaemia), Horner’s (ptosis, anhidrosis) (Pancoast tumour, lung apex)
LOOK: MOUTH
Central cyanosis under tongue (hypoxia)
NECK
JVP raised in:
Cor pulmonale
RS HF
trachea: Deviation: Tension pneumothorax
chest: Scars, hyperinflation, pectus excavatum, barrel chest (emphysema)
PERCUSSION:
Resonant means:
Dull:
Hype-resonance:
Resonant: normal.
Dull: pleural effusion, pneumonia, lung collapse.
Hyper-resonance: pneumothorax, emphysema
unilateral reduced expansion present in which conditions?
bilateral reduced expansion present in which conditions?
unilateral: pneumothorax, pleural effusion, pneumonia
Bilateral: COPD, Asthma
AUSCULTATION:
absent/ quiet breath sounds present in which conditions?
Air or fluid in or around the lungs
pneumonia, heart failure, pleural effusion, pneumothorax, emphysema
AUSCULTATION:
sounds associated with bronchial obstruction
wheeze, stridor, rhonchi
AUSCULTATION:
wheeze associated with:
stridor:
rhonchi:
- Wheeze: asthma, COPD
- Stridor: (less high-pitched wheeze) Upper
airway obstruction - Rhonchi: (snoring): CB
AUSCULTATION:
sounds associated with alveoli problem:
course crackles
fine crackles
AUSCULTATION
course crackles
fine crackles
- Course crackles/ crepitations/ rales:
Pneumonia, pulmonary oedema - Fine crackles/crepitations:
PF
AUSCULTATION:
vocal resonance
normal =
increased in which conditions?
decreased in which conditions?
Normal = vibration. Increased: pneumonia, tumor, consolidation. Decreased: P. effus, pneumotho
BACK PALPATION:
enlarged cervical lymph nodes could indicate:
infection, lung cancer
