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Patient Assessment > Chest > Flashcards

Chest Flashcards

1
Q

What area corresponds to the second rib?

A

manubriosternal junction - angle of louis

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2
Q

Who has chest that are AP=transverse in size?

A

infants

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3
Q

What is SOB with sitting up?

A

platypnea

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4
Q

What causes barrel chest in geriatrics?

A

loss of muscle strength, losee of lung resiliency

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5
Q

What are symptoms that mean chest pain is not from the heart?

A

There is a constant achiness that lasts all day.
It does not radiate.
It is made worse by pressing on the chest wall.
It is a fleeting, needle-like jab that lasts only a few seconds.
It is situated in the shoulders or between the shoulder blades in the back.
Think of the heart but, importantly, in such circumstances, also think of other possibilities in the chest

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6
Q

What family hx do you want for chest/lung complaint?

A 
Tuberculosis 
 Cystic fibrosis 
 Emphysema 
 	Allergy, asthma, atopic dermatitis 
 Malignancy 
 Bronchiectasis 
 Bronchitis 
 Clotting disorders (risk of pulmonary embolism)
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7
Q

How do you calculate pack year?

A

Number of years of smoking X Number of packs smoked per day

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8
Q

What is in india, indonesia, south africa, nigeria?

A

TB

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9
Q

What is in midwest?

A

histo

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10
Q

What is in southwest?

A

coccidioidmycosis

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11
Q

What is in southwest asia, africa, caribbean?

A

schistosomiasis

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12
Q

What is a life threatening emergency that occurs when sternum or rib fractures, becoming detached from the rest of the chest and causing loss of stability of the thoracic cage. Can cause respiratory failure?

A

flail chest

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13
Q

What is the normal resp rate?

A

10-14/min up to 20

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14
Q

What is SOB when lying down?

A

orthopnea

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15
Q

Regular and comfortable at a rate of 12-20

A

normal

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16
Q

slower than 12 breaths per min

A

bradypnea

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17
Q

faster than 20 breaths per min

A

tachypnea

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18
Q

faster than 20/min, deep breathing

A

hyperventilation

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19
Q

freuqently interspersed deeper breaths

A

sighing

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20
Q

increasing difficulty getting breath out?

A

air trapping

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21
Q

varying peroids of increasing depth interspersed with apnea

A

cheyne-stokes

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22
Q

rapid, deep, labored

A

kussmaul

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23
Q

irregularly interspersed peroids of apnea in disorganized sequence of breaths

A

biot

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24
Q

significant disorganized with irregular varying depths of respiration

A

ataxic

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25
Q

What causes an increase in resp?

A

acidosis, CNS lesion (pons), anxiety, aspirin poisoning, oxygen need (hypoxemia), pain

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26
Q

What causes decrease in resp?

A

alkalosis, CNS (cerebrum), MG, narcotic overdoses, obesity

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27
Q

What would the breathing be like for a cerebral brain damage pt?

A

cheyne stokes resp

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28
Q

What are peripheral clues to CV/pulm issues?

A 
Cyanosis of lips and nails especially
Breath - malodorous
Lips – pursed
Nares - flared
Nails – clubbing
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29
Q

What does ammonia breath mean?

A

uremia

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30
Q

What is the normal costal angle?

A

90

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31
Q

Where is tactile fremitus best felt?

A

bifurcation of bronchi

32
Q

What contracts on inspiration?

A

SCM

33
Q

What retracts on inspiration

A

clavicule, intercostals

34
Q

When is costal angle widened?

A

pregnancy

35
Q

Where does the examiner percuss for diaphragmatic excusion?

A

scapular line

36
Q

What are low intensity sounds heard over healthy lung fields?

A

vesicular

37
Q

What breath sounds are heard over trachea, are high intensity and pitch?

A

bronchial

38
Q

What is rales now called?

A

crackles

39
Q

In what position is the hammans sign best heard?

A

LLD

40
Q

What can cause deviation of trachea away from affected side?

A

thyroid enlargment, pleural effusion

41
Q

What way does the trachea deviate in pneumothorax?

A

either

42
Q

: a crackly or crinkly sensation, a gentle, bubbly feeling, rubbing hair next to the ear, or sound when Velcro is pulled apart.

A

Crackles

43
Q

caused by inflammation of the pleural surfaces. Think of it as the feel of leather rubbing on leather.

A

pleural friction rub

44
Q

mucous moving through airways (simple congestion), or with plugging

A

rhonchi

45
Q

air in the subcutaneous tissue from a rupture somewhere in the respiratory system or by infection with a gas-producing organism

A

crepitus

46
Q

What are the most useful findings for pleural effusion?

A

tactile fremitus and dullness to percussion

47
Q

How can you evaluate tactile fremitus?

A

palmar surface, hand or finger tips, ulnar side of hands

48
Q

What is egophony?

A

say eeh and ayy

49
Q

When is bronchophony clearer?

A

airless or consildated lungs - lobar pneumonia/ pleural effusion

50
Q

What causes increased tactile fremitus?

A

lobar pneumonia of pleural effusion

51
Q

Where do you put your hands in thoracic expansion?

A

xiphoid process front

10th rib in back

52
Q

What is normal percussion?

A

resonance

53
Q

What is hyperresonance related to?

A

emphysema, pneumothorax, asthma

54
Q

What is dullness of perscussion related to?

A

pneumonia, atelectasis, pleural effusion, pneumothoax, asthma

55
Q

What are some percussion errors?

A

Failing to exert firm pressure with the finger placed on the skin surface
Failing to separate the hammer finger from other fingers
Snapping downward from the elbow or shoulder rather than from the wrist
Tapping by moving just the hammer finger rather than the whole hand
Striking with the finger pad rather than the fingertip of the hammer finger
Failing to trim the fingernail of the hammer finger

56
Q

What is the diaphragm for?

A

high pitched

57
Q

What is the bell for?

A

low pitched

58
Q

If you strongly suspect pathologic condition, what do you do with chest auscultation?

A

start at lung bases

59
Q

What causes crackles?

A

bronchitis, resp infection, pulm edema, atelectasis, fibrosis, CHF

60
Q

What causes wheezes?

A

asthma, pulm edema, bronchitis, CHF

61
Q

What causes rhonchus?

A

bronchitis

62
Q

What causes pleural rub?

A

pneumonia, pulmonary infarct

63
Q

What causes stridor?

A

after extubation, pertussis, croup, epiglottis, aspiration

64
Q

high pitched, discrete, discontinuous crackling or popping sounds heard during end of inspiration; not cleared by cough. Can sound like Velcro being pulled apart.

A

Fine crackles

65
Q

Lower, more moist sound heard during mid-stage of inspiration; not cleared by cough

A

Medium crackles

66
Q

loud, bubbly noise heard during inspiration; not cleared by cough.

A

coarse crakcles

67
Q

Loud, low, coarse sounds, like a snore, most often heard continuously during inspiration or expiration; coughing may clear the sound (usually means mucous accumulation in trachea or large bronchi).

A

rhonchi

68
Q

Musical noise sounding like a squeak; most often heard continuously during inspiration or expiration; usually louder during expiration

A

Wheeze

69
Q

Dry rubbing, creaking or grating sound, usually caused by inflammation of pleural surfaces; heard during inspiration or expiration; loudest over lower lateral anterior surface. Can sound like walking on fresh snow.

A

pleural friction rub

70
Q

a loud, high pitched sound heard during inspiration, but may occur throughout the entire respiratory cycle.

A

stridor

71
Q

What is something to note about back percussion?

A

dont do it over scapula, have pt lean forward

72
Q

What side is the diaphragm usually higher?

A

right

73
Q

What is normal diaphragmatic excusion?

A

3-5 cm

74
Q

When is diaphragm motion absent?

A

phrenic nerve palsy

75
Q

Where do you listen for middle lobe of right and lingula of left?

A

axillae

Patient Assessment (23 decks)

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