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CP Test 2 > B4-003 CV and Pulmonary Exam > Flashcards

B4-003 CV and Pulmonary Exam Flashcards

1
Q

most prominent posterior spinous process

A

C7

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2
Q

respiratory excursion assesses for

A

symmetrical expansion of lungs

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3
Q

vibratory sensation of speaking

A

tactile fremitus

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4
Q

incresed fremitus indicates

A
  • consolidation of lung tissue
  • pneumonia
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5
Q

decreased fremitus indicates

A
  • lung tissue not touching pleura
  • effusion or pneumothorax
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6
Q

bilateral decrease in fremitus indicates

A
  • COPD
  • air trapped
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7
Q

if you’re worried about phrenic nerve injury, where should you percuss?

A

diaphragm

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8
Q

heard best: over most of both lungs

A

vesicular

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9
Q

heard best: 1st and 2nd intercostal spaces anteriorly and between scapula

A

broncho vesicular

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10
Q

heard best: over manubrium

A

bronchial

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11
Q

heard best: over the trachea in neck

A

tracheal

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12
Q

inspiratory sounds last longer than expiratory sounds

A

vesicular

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13
Q

inspiratory and expiratory sounds are almost equal

2

A
  • bronchovesicular
  • tracheal
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14
Q

expiratory sounds last longer than inspiratory sounds

A

bronchial

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15
Q

intermittent, non musical, brief

A

crackles (rales)

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16
Q

sound like velcro

A

fine crackles

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17
Q

thought to be from closed airways popping open in inspiration

A

crackles

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18
Q

crackles may indicate

A
  • pulmonary fibrosis
  • CHF
  • pneumonia
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19
Q

sinusoidal, musical, prolonged

A

wheezes/ronchi

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20
Q

relatively high pitched with hissing or shrill quality

lung sound

A

wheezes

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21
Q

relatively low pitched with snoring quality

lung sound

A

ronchii

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22
Q
  • harsh sounds that diappear after coughing
  • indicate secretions
A

ronchi

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23
Q

heard without a stethoscope, indicates emergency

lung sound

A

stridor

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24
Q

inspiratory stridor indicates

A

supra-glottic obstruction

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25
Q

expiratory stridor suggets

A

lower tracheal obstruction

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26
Q

egophony indicates

A
  • consolidation of lung tissue
  • pneumonia
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27
Q

bronchophony indicates

A
  • consolidation
  • changes in clarity
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28
Q

JVD provides information about

A

pre load volume

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29
Q

feels like a “cat purring”

A

thrill

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30
Q

thrill or bruit at the carotid may indicate

A

artherosclerosis

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31
Q

rhythm to different amplitude beats indicating ventricular dysfunction

A

pulsus alterans

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32
Q

pulses paradoxus is assessed via

A

blood pressure cuff

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33
Q

pulsus paradoxus is a sign of

A

cardiac tamponade

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34
Q

best heard: right upper sternal border at 2nd intercostal space

A

aortic valve

35
Q

best heard: left upper sternal border at 2nd intercostal space

A

pulmonic valve

36
Q

best heard: left lower sternal border around 4th-5th intercostal space

A

tricuspid

37
Q

best heard: 5th intercostal space medial to mid clavicular line

A

mitral valve

38
Q

closure of tricuspid and mitral

A

s1

39
Q

closure of pulmonic and aortic

A

s2

40
Q
  • occurs between s1 and s2
  • rapid contracture
A

systole

41
Q
  • occurs between s2 and s1
  • slow filling
A

diastole

42
Q

split s2 is normal in

A

young people

43
Q

split s2 in older patients may indicate

A
  • pulmonary hypertension
  • bundle branch blocks
44
Q

loudest over apex with radiation to left axilla

A

mitral regurg

45
Q

diastolic decresendo

A

aortic regurg

46
Q

systolic cresendo-decresendo

A

aortic stenosis

47
Q

diastolic decresendo-cresendo

A

mitral stenosis

48
Q

systolic
holosystolic

A

mitral regurg

49
Q

soft, trained ear can detect

murmur grading

A

grade 1

50
Q

louder, most clinicians can detect

murmur grading

A

grade 2

51
Q

loud, most medical students can detect

murmur grading

A

grade 3

52
Q

associated with thrill

mumur grading

A

grade 4

53
Q

associated with thrill, may be able to hear with stethoscope just off chest

murmur grading

A

grade5

54
Q

associated with thrill, can hear without stethoscope

A

grade 6

55
Q
  • early diastolic filling from volume overload or systolic dysfunction
  • blood hitting ventricular wall
A

s3

56
Q

increased work of atria to overcome hypertrophic ventricular wall

A

s4

57
Q

s3 and s4 may be normal in

A

children/young adults

will quiet when sitting

58
Q

sign of chronic hypoxia

A

clubbing

59
Q

correct order for cardiac and pulmonary assessments

A

expose, look, feel, listen

60
Q

S1 should occur immediately before

A

right carotid pulsation

61
Q

S2 sould occur after

A

right carotid pulsation

62
Q

decreased intrathoracic pressure leading to increased pulmonary artery flow and delay in pulmonic valve closure

A

physiologic S2 split

normal finding in young people

63
Q
  • prolonged RV systole from an undiagnosed atrial septal defect
  • does not change with inspiration or expiration
A

pathologic S2 split

64
Q

sound of blood quickly decelerating after crossing the mitral valve

A

S3

ventricular gallop

65
Q

heart sound found in CHF or late pregnancy

A

S3

66
Q

heart sound caused by a hypertrophic left ventricle leading to increased atrial contraction

A

S4

67
Q

heart sound associated with hypertrophic cardiomyopathy

A

S4

68
Q

harsh systolic murmur that decreases in intensity when squatting

A

hypertrophic cardiomyopathy

69
Q

pulses should be assessed

A

bilaterally

70
Q

absent breath sounds with tympany to percussion over anterior chest and deviation of trachea

A

tension pneumothorax

71
Q

discontinous, fine sounds like velcro at end of inspiration

A

fine crackles

CHF

72
Q

high pitched, musical, continous sounds at end of expiration

A

wheezes

asthma

73
Q
  • loud, high pitched sound throughout inspiration over trachea
  • heard without stethoscope
A

stridor

tracheal obstruction

74
Q

bronchial sounds in the periphery indicate

A

lung consolidation

75
Q

manuever to bring heart closer to chest wall to fine PMI

A

lay patient on left side while you palpate

76
Q

palpating the anterior chest wall with the pall of your hand will help feel

A

thrills

77
Q

lower lobes are heard best

A

posterior back

78
Q

upper lobes are best heard

A

over anterior chest

79
Q

right middle lobe is best heard

A

over mid axillary line and
inferior right anterior chest

80
Q

heard over right sternal border at the 2nd intercostal space

A

aortic

81
Q

heard over left sternal border at 2nd intercostal space

A

pulmonic

82
Q

heard over left sternal border at the 4th intercostal space

A

tricuspid

83
Q

heard over apex at 5th intercostal space medial to midclavicular line

A

mitral

84
Q

aortic valve murmurs radiate to

A

carotid arteries

CP Test 2 (16 decks)

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