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Clin Med III - Exam 1 > 7B: Pulmonary Diagnostics > Flashcards

7B: Pulmonary Diagnostics Flashcards

1
Q

What are the standard views for a chest x-ray?

A

AP and lateral

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2
Q

How will air present on x-ray?

A

Dark

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3
Q

What does a high hemi-diaphragm suggest?

A

Large areas of atelectasis or low inflation

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4
Q

What does a flattened hemi-diaphragm suggest?

A

Overinflation

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5
Q

How do the R/L costophrenic angles differ?

A

Right cm higher than left

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6
Q

What are abnormal x-ray findings for COPD?

A

Enlarged lungs, flattened diaphragm, narrow mediastinum

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7
Q

What are abnormal x-ray findings for CF?

A

Overinflation, diffuse infection

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8
Q

What does this x-ray suggest?

A

COPD - lots of grey area

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9
Q

What does this x-ray suggest?

A

CF - white and patchy indicating fluid

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10
Q

What are abnormal x-ray findings for venous dilation?

A

Increased vascular markings

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11
Q

What are abnormal x-ray findings for pulmonary edema?

A

Central pattern of infiltrates with increased vascular margins (fluffy clouds)

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12
Q

What abnormal x-ray findings suggest infection?

A

Areas of white patches

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13
Q

What does this x-ray suggest?

A

Pulmonary edema - less air, more white space

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14
Q

What does this x-ray suggest?

A

Bronchiectasis - tree like

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15
Q

What is suggested if areas that should be dark are totally obliterated and white?

A

Consolidated pneumonia, ARDS, pneumothorax, atelectasis

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16
Q

What does this x-ray suggest?

A

Pneumonia - lower lobe completely filled with fluid

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17
Q

What does this x-ray suggest?

A

ARDS - all white and hazy, fluid everywhere

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18
Q

What does this x-ray suggest?

A

Pneumothorax - intubated and has no air in R lung

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19
Q

What does this x-ray suggest?

A

Atelectasis - no air

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20
Q

What does this x-ray suggest?

A

COVID - marble look

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21
Q

What happens to the mediastinum with pneumothorax?

A

Pushes mediastinum to contralateral side

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22
Q

What happens to the mediastinum with atelectasis?

A

Pulls mediastinum to ipsilateral side

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23
Q

What is bronchography?

A

Study of bronchial airways where you can see changes in bronchial walls and lumen - catheter is threaded down patient’s bronchi to evaluate

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24
Q

What is bronchography used for?

A

Congenital anomalies to monitor changes in progression of disease

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25
What is a bronchoscopy?
Viewing of airways using fiberoptics, camera goes into bronchus segments - general anesthesia
26
What does a V/Q scan study?
Regional ventilation, gas exchange, regional perfusion
27
What is the gold standard for diagnosing PE?
V/Q scan
28
How is a V/Q scan administered?
Pt breathes in xenon gas, holds their breath, then scan is taken
29
What does ABG measure?
pH, PaCO2, PaO2, HCO2, and BE (base excess)
30
What is BE?
Base excess - a measure of change in pH that is not related to respiration
31
What does PaCO2 show?
Adequacy of alveolar ventilation
32
What will hyperventilation cause on ABG?
CO2 decreased
33
What will hypoventilation cause on ABG?
CO2 increased
34
What level of CO2 is considered ventilatory failure?
> 55 mmHg
35
What happens with ventilatory failure?
Acute changes in pH, loss of alertness, coma if not treated
36
What four things should you consider with a ABG assessment?
1. Ventilatory status - pH 2. Relationship between pH and PaCO2 3. Alveolar ventilation 4. PaO2 - oxygenation status
37
If there is an inverse relationship between pH and PaCO2, what is suggested?
Respiratory problem
38
If there is not an inverse relationship between pH and PaCO2, what is suggested?
Metabolic problem
39
What are you observing for during a clinical chest exam?
- General appearance - Mediastinum position - Musculature - Bony thorax - Breathing dynamics
40
Describe purulent sputum?
Clear, usually chronic bronchitis
41
Describe blood tinged sputum
Red specs, TB or flu
42
Describe foul smelling sputum
Infection, often bronchiecstasis
43
Describe brassy sputum
Aneurysm, medical emergency
44
Describe frothy sputum
CHF
45
Describe hemoptysis sputum
Coughing up blood, pulmonary bleed, emergency
46
Describe thick green or yellow sputum
Infection
47
What are you assessing with rib excusion?
Symmetry, quality, amplitude to determine regional ventilation
48
What is fremitus?
Vibration of voice or from secretions
49
Why does hyporesonance indicate with fremitus?
Decreased air moving due to COPD, fluid, or lung collapse
50
What does hyperresonance indicate with fremitus?
Echo of air moving in lung, really only caused by consolidated pneumonia
51
What is mediate percussion?
Assess changes in lung density
52
What will make a flat sound with mediate percussion?
Viscera
53
What will make a dull sound with mediate percussion?
Muffled or filtered though increased density of tissue such as consolidation or tumor
54
What will make a hyperresonant sound with mediate percussion?
Open space
55
What is auscultation and what are you listening for?
Presence of absence of breath sounds - quality, symmetry, amplifications, relationship between inspiration and expiration, adventitia sounds
56
What are rales/crackles?
Discontinuous sounds like short bursts of popping
57
What do fine crackles at the end of inspiration indicate?
Sudden opening of small airways, CHF, pulmonary fibrosis, atelactasis
58
What do high pitched most crackles through the breath cycle indicate?
Fluid
59
What are wheezes?
Musical continuous notes, which may be heard during any phase of the breathing cycle - usually heard during expiration
60
What do wheezes indicate?
Indicative of airway obstruction due to either mucous or bronchoconstriction - could mean lesions, mass, compression of airway, inflammation, edema, increased secreations
61
What is phonation indicated for?
Consolidation
62
What is whispering pectoriloquy?
Whispered words are amplified when heard through the chest wall
63
What is egophony?
"E" comes out sounding like "A"
64
What is bronchophony?
"99" sound is amplified
65
How is phonation categorized?
Hypo, hyper, or normal resonsnace

Clin Med III - Exam 1 (21 decks)

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