Bates Tables- Lungs and Thorax Flashcards
What chest pains are retrosternal?
Angina Pectoris, Myocardial Infarction, Pericarditis, Reflex Esophagitis, Diffuse Esophageal Spasm
What are the 3 types of persistent chest pain?
Pericarditis, Dissecting Aortic Aneurysm, Pleuritic Pain
What is pericarditis?
Irritation of parietal pleura adjacent to the pericardium
What two chest pains are described as sharp and knife-like?
Pericarditis, Pleuritic Pain
Where is pain felt in Dissecting Aortic Aneurysm?
Anterior chest, radiating to the neck, back, or abdomen
Define tracheobronchitis
Inflammation of trachea and large bronchi
Where is tracheobronchitis pain?
Upper sternal or on either side of the sternum
What 2 types of chest pain are described as stabbing, sticking, or dull, aching?
Chest Wall Pain (Costochondritis) and Anxiety
What is a diffuse esophageal spasm?
Motor dysfunction of the esophageal muscle
What two chest pains feel like burning?
Tracheobronchitis and Reflex Esophagitis
What chest pain is usually 1-3 minutes but up to 10 min?
Angina Pectoris
The factors that aggravate this kind of chest pain are deep inspiration, coughing, movements of the trunk
pleuritic pain
What are factors that aggravate diffuse esophageal spasms?
swallowing of food or cold liquid; emotional stress
Chest wall Pain (costochrondritis) is aggravated by….
movement of chest, trunk, arms
Coughing aggravates this type of chest pain.
Tracheobronchitis
Also associated with Pericarditis, Pleuritic pain
Breathing, changing position, coughing, lying down, sometimes swallowing aggravate what type of chest pain?
pericarditis
What type of chest pain will nitroglycerin and rest alleviate?
Angina Pectoris
What is reflux esophagitis?
inflammation of the esophageal mucosa by reflux of gastric acid
What alleviates tracheobronchitis?
lying on the involved side
What chest pain will be alleviated by sitting forward?
pericarditis
Reflex esophagitis can be relieved by…
antacids, sometimes belching
What two chest pains have symptoms of dyspnea, nausea, and sweating?
Angina Pectoris and Myocardial infarction
Hypertension can aggravate this type of chest pain
Dissecting Aortic Aneurysm
What are associated conditions of pericarditis?
seen in autoimmune disorders, post-myocardial infarction, viral infection, chest irradiation
What chest pain has cough as a symptom, and is also aggravated by coughing?
tracheobronchitis
What are symptoms of anxiety?
breathlessness, palpitations, weakness, anxiety
What chest pain has symptoms of regurgitation and dysphagia?
reflex esophagitis
What is the symptom of diffuse esophageal spasm?
dysphagia
What are symptoms of anxiety with hyperventilation?
sighing, lightheadedness, numbness or tingling of the hands and feet, palpitations, chest pain
What is the setting of Left-sided heart failure?
history of heart disease or its predisposing factors
What is the timing of chronic bronchitis?
chronic productive cough followed by slowly progressive dyspnea
What aggravates COPD?
exertion
What is a spontaneous pneumothorax?
leakage of air into pleural space through blebs on visceral pleura, with resulting partial or complete collapse of the lung
What two dyspnea conditions have a sudden onset of dyspnea?
spontaneous pneumothorax and acute pulmonary embolism
What is inflammation of lung parenchyma from the respiratory bronchioles to the alveoli?
pneumonia
What aggravates asthma?
allergens, irritants, respiratory infections, exercise, and emotion
Symptoms of this type of dyspnea are cough, orthopnea, paroxysmal nocturnal dyspnea, and sometimes wheezing
Left-sided heart failure
What is the setting of an acute pulmonary embolism?
postpartum or postoperative periods, prolonged bed rest, heart failure, chronic lung disease, fractures of hip/leg, deep vein thrombosis
What type of dyspnea has symptoms of a cough with scant mucoid sputum?
COPD
What are the symptoms of pneumonia?
pleuritic pain, cough, sputum, fever
What two acute inflammations have a dry cough that may become productive?
laryngitis, tracheobronchitis
What type of cough is mycoplasma and viral pneumonias?
dry hacking cough that often becomes productive with mucoid sputum
What acute inflammation has sputum that is mucoid or purulent and can be blood-streaked, pinkish, or rusty?
bacterial pneumonias
What four inflammations have a chronic cough?
postnasal drip, chronic bronchitis, bronchiectasis, gastroesophageal reflux
What coughs can cause blood-streaked or bloody sputum?
chronic bronchitis, bronchiectasis, pulmonary tuberculosis, lung abscess, cancer of the lung
What has purulent sputum that is copious and foul-smelling?
bronchiectasis
What has a chronic cough especially at night or early in the morning?
gastroesophageal reflux
What two inflammations produce foul-smelling sputum?
bronchiectasis, lung abscess
What specific bacterial pneumonia causes sticky, red, and jellylike sputum?
Klebsiella
Left ventricular failure or mitral stenosis produce what type of sputum?
pink frothy sputum once disorder has progressed
Name the disorder. It has a dry to productive cough with sputum that may be dark, bright red, or mixed with blood
Pulmonary emboli
What inflammation is associated with recurrent bronchopulmonary infections?
bronchiectasis
What are the symptoms and setting of a lung abscess?
a febrile illness; often poor dental hygiene and a prior episode of impaired consciousness
What inflammation has wheezing (espcially at night), early morning hoarseness, repeated attempts to clear throat?
gastroesophageal reflux
Identify the symptoms of mycoplasma and viral pneumonias
acute febrile illness with malaise, headache, and possibly dyspnea
identify the symptoms of bacterial pneumonias (including Klebsiella)
- an acute illness with chills, high fever, dyspnea, and chest pain (often preceded by acute upper respiratory infection)
- Klebsiella associated with older alcoholic men
What are later symptoms of pulmonary TB?
anorexia, weight loss, fatigue, fever, night sweats
What two conditions are associated with wheezing?
asthma and gastroesophageal reflux
What disorders are associated with smoking?
chronic bronchitis and lung cancer
Name the symptoms and setting of pulmonary emboli
dyspnea, anxiety, chest pain, fever; factors that predispose to deep venous thrombosis
What deformity of the thorax may cause murmurs by compressing the heart and great vessels?
funnel chest
What deformity of thorax if normal in infancy and occurs in aging and COPD?
barrel chest
What is thoracic kyphoscoliosis?
abnormal spinal curvatures and vertebral rotation that deforms the chest making it hard to interpret lung findings
Multiple rib fractures resulting in paradoxical movements of the thorax are a result of what thorax deformity?
traumatic flail chest
Describe the movement of the thorax with a traumatic flail chest
on inspiration the injured area caves inward and on expiration it moves outward
When doing an egophony test on an airless lung what would you hear?
spoken “ee” heard as “ay”
What is the normal lung sound for the whispered pectoriloquy test?
whispered words faint and indistinct
What state of the lung (normal or airless) would cause spoken words to be louder with the bronchophony test?
airless lung
When do you notice an increased tactile fremitus?
in airless lung
What are two explanations for crackles?
- when small airways pop open during inspiration after being deflated during expiration
- result from air bubbles flowing through secretions or lightly closed airways during respiration
What are causes of early inspiratory crackles?
chronic bronchitis and asthma
What is the lung sound that appears and ends soon after inspiration and is often coarse sounding?
early inspiratory crackles
What sound is associated with bronchiecstasis?
midinspiratory and expiratory crackles
Name the lung sound: being in 1st half of inspiration but continue into late inspiration; usually fine, profuse, and persist breath to breath, 1st appear at base of lungs
late inspiratory crackles
What are causes of wheezes?
asthma, chronic bronchitis, COPD, heart failure
What is stridor?
a wheeze entirely or predominantly inspiratory that indicates a partial obstruction of the larynx or trachea
The sound when air flow rapidly through bronchi that are narrowed nearly to the point of closure
wheeze
The lung sound is that low pitched with a snoring quality is…
rhonchi
A pleural rub sounds like…
creaking noises during expiration and is usually heard during both phases of respiration
What causes pleural rubs?
inflamed & roughened pleural surfaces grating against each other
What sound does a pleural rub resemble?
crackles
What are Mediastinal Crunch? Also called Hamman’s sign
series of precordial crackles synchronous with the heart beat but not respiration
What position is Mediastinal crunch (Hamman’s sign) best heard in?
left lateral position
Define consolidation
alveoli fill with fluid or blood cells as in pneumonia, pulmonary edema, or pulmonary hemorrhage
What chest disorders sound dull with percussion?
consolidation, atelectasis, pleural effusion
What chest disorders sound resonant with percussion?
normal, chronic bronchitis, early left sided heart failure
What chest disorders sound hyperresonant with percussion?
Pneumothorax, COPD, asthma
