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Patient Assessment > Chapter 8 The Lungs > Flashcards

Chapter 8 The Lungs Flashcards

1
Q

Chest pain- myocardium

A

Angina pectoris, myocardial infarction

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2
Q

Chest pain- pericardium

A

Pericarditis

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3
Q

Chest pain- aorta

A

Dissecting aorta aneurysm

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4
Q

Chest pain- the trachea and large bronchi

A

Bronchitis

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5
Q

Chest pain- the parietal pleura

A

pericarditis, pneumonia

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6
Q

Chest pain- the chest wall, including the musculoskeletal system and skin

A

Costochonditis, herpes zoster

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7
Q

Chest pain- the esophagus

A

Reflux esophagitis, esophageal spasm

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8
Q

Chest pain- extrathoracic structures such as the neck, gallbladder, and stomach

A

Cervical arthritis, biliary colic, gastritis

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9
Q

Angina pectoris

A

a clenched fist over the sternum

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10
Q

Musculoskeletal pain

A

finger pointing to tender area on the chest wall

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11
Q

Cyanosis

A

Hypoxia

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12
Q

Audible stridor

A

high-pitched wheeze, a sign of airway obstruction in the larynx or trachea

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13
Q

AP diameter

A

May increase in COPD

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14
Q

Decreased or absent fremitus

A

COPD, bronchial obstruction, pleural effusion, fibrosis (pleural thickening), pneumothorax, tumor

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15
Q

Dullness to percussion

A

indicate lobar pneumonia, pleural effusion, hemothorax (blood), or empyema (pus), fibrous tissue, or tumor

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16
Q

Hyperresonance

A

COPD, large pneumothorax

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17
Q

Diaphragmatic excursion

A

diaphragmatic paralysis, pleural effusion, atelectasis, or normal variant

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18
Q

Vesicular auscultation

A

soft/low pitched; inspiratory>expiratory sounds

19
Q

Bronchovesicular auscultation

A

moderate; inspiratory/expiratory sounds equal in length

20
Q

Bronchial auscultation

A

louder or higher in pitch, with short silence (gap) between inspiratory and expiratory sounds; expiratory>inspiratory sounds

21
Q

Late inspiratory crackles

A

fibrosis or CHF

22
Q

Early inspiratory crackles

A

seen in asthma, chronic bronchitis (appear after the start of insiration)

23
Q

Expiratory crackles

A

Could reflect bronchiectasis

24
Q

Wheezes (high-pitched)

A

suggest narrow airways (partial obstruction), as in asthma, COPD, and bronchitis

25
Q

Rhonchi (low-pitched)

A

suggest secretions in large airways

26
Q

COPD- s/s & diagnosis

A

Findings include wheezing, hx of smoking, age, and decreased breath sounds. Diagnosis requires pulmonary function test such as spirometry. Persons with severe COPD may prefer to sit leaning forward with lips pursed during exhalation and arms supported on their knees

27
Q

Bronchophany

A

when a normal lung becomes airless, transmitted voice sounds will change

28
Q

Egophany

A

changes sound of a whispered “ee” to an “ay” as in lobar consolidation from pneumonia

29
Q

Whispered pectoriloquy

A

when whispered numbers are clearer and louder than expected

30
Q

Dullness

A

replaces resonance when fluid or solid tissue replaces air-containing lung or occupies the pleural space.

31
Q

Pleural effusion

A

Because pleural fluid usually sinks to the lowest part of the pleural space (posteriorly in a supine pt), only a very large effusion can be detected anteriorly.

32
Q

COPD

A

affected lung often displaces the upper border of the liver downward. It also lowers the level of diaphragmatic dullness posteriorly.

33
Q

Chronic Bronchitis- Physical findings

A 
Percussion note: Resonant
Trachea: Midline
Breath Sounds: Vesicular (normal) 
Adventitious Sounds: Wheezes or Rhonchi; scattered coarse crackles in early inspiration and expiration
Tactile Fremitus/Voice Sounds: Normal
38
Q

CHF (left sided)- physical findings

A 
Percussion note: Resonant
Trachea: Midline
Breath Sounds: Vesicular (normal) 
Adventitious Sounds: Late inspiratory crackles; possibly wheezes
Tactile Fremitus/Voice Sounds: Normal
43
Q

Diffuse lymphadeopathy

A

HIV, AIDS

44
Q

Consolidation- physical findings

A

Percussion note: Dull over the airless area
Trachea: Midline
Breath Sounds: Bronchial over the involved area
Adventitious Sounds: Late inspiratory crackles over the involved area
Tactile Fremitus/Voice Sounds: Increased over the involved area with bronchophony, egophony, and whispered pectroliloquy

48
Q

Atelectasis- physical findings

A

Percussion note: Dull over the airless area
Trachea: May be shifted toward involved sided
Breath Sounds: Usually absent when bronchial plug persists. Exceptions include RUL atelectasis, where adjacent tracheal sounds may be transmitted
Adventitious Sounds: None
Tactile Fremitus/Voice Sounds: Usually absent when the bronchial plug persists.

53
Q

Pleural Effusion- physical findings

A

Percussion note: Dull to flat over the fluid
Trachea: Shifted toward opposite side in a large effusion
Breath Sounds: Decreased to absent but bronchial breath sounds may be heard near top of large effusion
Adventitious Sounds: None except a possible pleural rub
Tactile Fremitus/Voice Sounds: Decreased to absent, but may be increased toward the top of a large effusion

58
Q

Pneumothorax- Physical findings

A

Percussion note: Hyperresonant or tympanic over the pleural air
Trachea: Shifted toward opposite side if much air
Breath Sounds: Decreased to absent over the pleural air
Adventitious Sounds: None, except a possible pleural rub
Tactile Fremitus/Voice Sounds: Decreased to absent over the pleural air

63
Q

COPD- Physical findings

A 
Percussion note: Diffusely hyperresonant
Trachea: Midline
Breath Sounds: Decreased or absent 
Adventitious Sounds: None, or the crackles, wheezes, and rhonchi of associated chronic bronchitis
Tactile Fremitus/Voice Sounds: Decreased
68
Q

Asthma- Physical findings

A

Percussion note: Resonant to diffusely hyperresonant
Trachea: Midline
Breath Sounds: Often obscured by wheezes
Adventitious Sounds: Wheezes, possibly crackles
Tactile Fremitus/Voice Sounds: Decreased

73
Q

CVA tenderness

A

Infection; kidney stones

74
Q

Lymphadenopathy

A

Found in breast cancer

75
Q

Causes of unilateral decrease or delay in chest expansion

A

chronic fibrosis, pleural effusion, lobar pneumonia, or bronchial obstruction

Patient Assessment (18 decks)

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