Cardio/Resp Flashcards
Vertical Axis
Counting down ribs and intercostal spaces
Circumference of the Chest Measurment
series of vertical lines as landmarks
Anterior Circumference of Chest Measurements
Posterior Circumference of Chest Lines
Lateral Circumference of Chest Lines
Supraclavicular
Above the Clavicles
Infraclavicular
Below the Clavicle
Interscapular
Between the scapulae
Infrascapular
Below the scapulae
Which lung has 3 lobes
Right Lung
Anterior lung fields
Anterior Respiratory Ausculation Points
Right Lateral Lung Fields
Left Lateral Lung Fields
Posterior Lung Fields
Posterior Respiratory Auscultation Points
Accessory Muscles of the Neck
Sternomastoid Muscle
Accessory Muscles of the Chest
Intercostal Muscles
Gestures:
Clenched fist over sternum
suggests angina pectoris
Gestures:
Finger pointing to tender area
Suggests muscoloskeletal pain
Gestures:
hand moving from neck to epigastric area
Suggests heartburn
7 attributes of symptom complaint
Location
Quality
Severity
Timing
Setting in which it occurs
Alleviating/Aggrevating factors
Accompanying symptoms
Most frequent cause of chest pain in children
Anxiety
How should you rate shortness of breath
In relation to daily activities
Breathing difficulty in Anxiety Patients
“can’t get enough air”
tingling aroung lips/extremities (paresthesia)
Cardiac related cough
sign of left sided heart failure
Acute cough duration
Less than 3 weeks
Subacute cough duration
3-8 weeks
Chronic cough duration
More than 8 weeks
Most common cause of acute cough
Viral Upper Respiratory Infections
Mucoid Sputum
Translucent, white, or gray
Purulent Sputum
Yellow or Green
Foul smelling sputum
Present in anaerobc lung abcess
Patient position for examining posterior thorax
Sitting with arms crossed over chest and hands resting on opposite shoulders
Patient position for examining anterior thorax
Supine
Thorax assessment techniques
Inspect
Palpate
Percuss
Auscultate
Normal repiratory rate for healthy adult
14-20
Stridor
High-pitched wheeze
Sign of upper airway obstruction
Lateral displacement of trachea
Occurs in pneumothorax, plueral effusions, or atelectasis
AP diameter
Shape of chest from front to back
Observed assymetric chest expansion
Pleural effusion
Observed retraction
Severe asthma
COPD
Upper airway obstruction
Posterior Palpation for chest expansion
Raise a small skin fold between your fingers, ask patient to take deep breath, and watch for equal expansion of hands
Fremitus
Vibrations felt in thorax when patient is speaking
Technique for detecting tactile fremitus
Use the ball of your palm
Have patient repeat “99”
Feel for symmetry of both sides
Anterior palpation points for tactile fremitus
Posterior palpation points for tactile fremitus
Typical findings:
Tactile Fremitus
More prominent interscapularly than in lower lung fields
disapears below diaphragm
Often more prominent on right than left
Findings:
Asymetric decreased fremitus
Unilateral pleural effusion
pneumothorax
Neoplasm
Decreased transmission of low frequency sounds
Findings:
Asymetric increased fremitus
Unilateral pneumonia
increased transmission through consolidated tissue
What does percussion determine
If tissues are air-filled, fluid-filled, or solid
Percussion technique
Place top joint of middle finger on surface and tap it quickly with the tip of your other middle finger. Movement comes from wrist, not fingers
Percussion sounds:
Flat
Intensity: Soft
Pitch: High
Duration: short
Location example: thigh
Percussion sounds:
Dull
Intensity: Medium
Pitch: Medium
Duration: Medium
Location Example: Liver
Percussion Sounds:
Resonant
Intensity: Loud
Pitch: Low
Duration: Long
Location examply: Healthy lung
Percussion Sound:
Hyperresonant
Intensity: Very loud
Pitch: Lower
Durantion: Longer
Location example: Shouldn’t be one
Percusiion sound:
Tympanitic
Intesity: Loud
Pitch: High
Duration: Longer
Location example: Gastric air bubble or puffed out cheek
Percussion points of posterior thorax
Percussion with consolidation or fluid
Dullness rather than resonance
Lobar pneumonia
Alveoli are filled with fluid and blood
Dull percussion
Pleural effusion
Pleural accumulations of serous fluid
Dull percussion sounds
Hemothorax
Pleural accumulation of blood
Dull percussion
Empyema
Pleural accumulation of pus
Dull percussion
Percussion in presence of fibrous tissue or tumor
Dull percussion
Oserved generalized hyperresonance
Hyperinflated lungs of COPD or asthma
Observed unilateral hyperresonance
Suggests large pneumothorax or air filled bulla
Technique to identify diaphragmatic location
Percuss the area you expect to be dull then move upward until sound changes from dull to resonant. This is level of diaphragm
Noted abnormally high diaphragm level
Suggests pleural effusion, atelectasis, or phrenic nerve paralysis
Estimate diaphragmatic excursion
DIstance between level of dullness on full expiration and level of dullness on full inspiration (normal is about 3-5.5 cm)
Vesicular breath sounds
Soft, low pitched sound heard over most lung fields. Lasts through entire inhalation and fades about 1/3 of the way into exhilation
Broncho-vesicular sounds
Inspiratory ad expiratory sounds are about equal in length, pitch, and intensity