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Respiratory > Chapter 2 Physical Exam > Flashcards

Chapter 2 Physical Exam Flashcards

1
Q

Angle of Louis correlates to what rib?

A

Second rib

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2
Q

Usually no more than 90 degrees, with ribs inserted at 45-degree angles

A

Costal angle

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3
Q

Vertebrae prominences are what two bony processes?

A

C7 and T1

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4
Q

In pregnant women, what causes the ligaments of the rib cage to relax, and the chest expansion to increase

A

Estrogen increase

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5
Q

Pregnant:

An increase in the lateral diameter of ___ cm.

An increase in circumference of ______ cm.

A

2 cm

5-7 cm

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6
Q

Pregnant:

Major work of breathing is done by:

A

The diaphragm

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7
Q

Type of breathing

Pregnant women have:

A

Deeper breathing and slightly increased rate of respirations

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8
Q

Results from loss of muscle strength in thorax and diaphragm, coupled with a decreased lung resiliency.

A

Barrel chest

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9
Q

Alveoli in older adults

A

Less elastic and more fibrous

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10
Q

Aging mucous membranes become:

A

Drier

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11
Q

(Number of years smoking) x (Number of packs smoked per day)

A

Pack years

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12
Q

Hobbies that could cause respiratory problems

A

Owning pigeons

Parrots or other animals

Woodworking

Welding

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13
Q

Sequence of steps in examination of the chest and lungs

A

Inspection, Palpation, Percussion, Auscultation

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14
Q

What lighting is used to highlight chest movement?

A

Tangential lighting

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15
Q

Inferior border of lungs cross at what rib?

A

6th rib

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16
Q

Best place to listen to the R middle Lobe

A

5th intercostal space, Anterior Axillary

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17
Q

Indicative of prolonged respiratory/cardiac distress

A

Clubbing of the fingernails

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18
Q

Odor:

Sweet Smell

A

Diabetic ketoacidosis

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19
Q

Odor:

Ammonia

A

Uremia

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20
Q

Odor:

Musty fish

A

Hepatic failure

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21
Q

Odor:

Foul/putrid

A

Respiratory infection

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22
Q

Odor:

Foul/feculent

A

Intestinal obstruction/diverticulum

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23
Q

Odor:

Halitosis

A

Gingivitis, Vincent’s angina

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24
Q

Odor:

Cinnamon

A

Tuberculosis

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25
Q

Ratio of respirations to heartbeats is approximately:

A

1:4

26
Q

So the patient does not mislead you, count the respiratory rate while:

A

Holding the radial artery

27
Q

Breathing:

Chest goes up, belly goes down and vice versa

A

Paradoxical breathing

28
Q

Absence of spontaneous respirations

A

Apnea

29
Q

Feeling or sensation that one cannot breath well enough. Distict sensations include effort/work, chest tightness, and air hunger.

A

Dyspnea

30
Q

Grave condition in which breathing stops and will not spontaneously start again unless resuscitative measures are immediately instituted.

A

Secondary Apnea

31
Q

Shortness of breath that begins or increases when the patient lies down; ask whether the patient needs to sleep on more than one pillow and whether that helps.

A

Orthopnea

32
Q

Sudden onset of shortness of breath after a period of sleep; sitting upright is helpful.

A

Paroxysmal nocturnal dyspnea

33
Q

Dyspnea increase in the upright posture

A

Platypnea

34
Q

Persistent respiratory rate faster than 20 and approaching 25 breaths per minute

A

Tachypnea

35
Q

Rate slower than 12 breaths per minute.

May indicate neurologic or electrolyte disturbance, infection or a sensible response to protect against the pain of pleurisy.

A

Bradypnea

36
Q

A regular periodic pattern of breathing, with intervals of apnea followed by crescendo/decrescendo

A

Cheyne Stokes Respirations

37
Q

Somewhat irregular respirations varying in depth and interrupted by intervals of apnea but lacking the repetitive pattern of periodic respirations of Cheyne Stokes

A

Biot Respirations

38
Q

Respirations greater than 20 and deep

A

Hyperpnea

39
Q

Rapid, deep and labored respiratory pattern associated with metabolic acidosis

A

Kussmaul breathing

40
Q

Regular comfortable breathing at a rate of 12-20 breaths per minute

A

Eupnea

41
Q

Percuss at intervals of

A

4-5cm

42
Q

Diaphragm is usually higher on what side?

A

Right (because of the liver)

43
Q

Length of diaphragmatic excursion is usually:

A

3-6cm

44
Q

Breath sounds can be characterized same as percussion notes:

A

Intensity, pitch, quality, and duration

45
Q

Greater clarity and increased loudness of spoken sounds during auscultation, can be seen with what test?

A

Bronchophony

46
Q

Test for whispered sounds, normally will not be heard or completely unintelligible

A

Whispered pectoriloquy

47
Q

Consolidation is present and the patient speaks the letter “e”, what is actually auscultated is “a”

A

Egophony

48
Q

Decreased tactile or vocal fremitus is associated with:

A

Emphysema

49
Q

Lateral curvature/deviation of the spine

A

Scoliosis

50
Q

Excessive curvature of the lumbar spine

A

Lordosis

51
Q

Hyper-resonance indicates:

A

Hyperinflation of the lungs

52
Q

Dullness indicates:

A

Lung consolidation

53
Q

Costal angle can reach up to ____ degrees in pregnancy

A

103

54
Q

A persistent cough may be the only manifestation. Peak expiratory flow rates should be obtained before and after nebulizer treatments to verify improved lung function.

A

Asthma

55
Q

Inflammatory process involving the pleural and parietal pleura

The resultant rub can be heard and felt during exam

A

Pleurisy

56
Q

Diminished breath sounds and dullness to percussion occur over the area of consolidation.

Involvement of the right lower lobe can stimulate the tenth and eleventh thoracic nerves to cause right lower quadrant pain and simulate abdominal pain

A

Pneumonia

57
Q

Presence of air or gas in the pleural space

Positive coin click can help diagnose, place a coin over the suspicious area in the chest, and while listening to the opposite side, have someone strike the coin with the edge of another.

A positive finding is when you hear a clear click.

A

Pneumothorax

58
Q

A collection of purulent exudates in the pleural space

A

Empyema

59
Q

Both characterized by dullness heard on percussion

A

Pleural effusion and lobar pneumonia

60
Q

A condition where pH levels of the entire body has decreased (increased hydrogen ion concentration) which will trigger increased respiratory rate.

A

Metabolic acidosis

61
Q

An autosomal recessive disorder of the exocrine glands involving the lungs, pancreas and sweat glands.

Characterized by abnormally thick mucus and subsequent pulmonary infections.

A

Cystic Fibrosis

Respiratory (5 decks)

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