Chest and Lung

Question 1

orthopnea

Answer 1

shortness of breath begins or increases when lying down

Question 2

paraoxysmal

Answer 2

sudden onset of shortness of breath after period of sleep

Question 3

platypnea

Answer 3

dyspnea increases in upright position

Question 4

Pigeon chest (pectus carinatum)

Answer 4

sternal protrusion

Question 5

funnel chest (pectus excavatum)

Answer 5

indentation of lower sternum above xiphoid process

Question 6

atelectasis

Answer 6

complete or partial collapse of lung; would result in diminished breath sounds

Question 7

hyperventilation

Answer 7

breathing fast (tachypnea) and deep

Question 8

kussmaul breathing

Answer 8

rapid, deep, labored

• Associated with metabolic acidosis

Question 9

hypopnea

Answer 9

abnormally shallow respirations

Question 10

Cheyne-Stokes respirations

Answer 10

periodic breathing: varying periods of increasing depth with interspersed periods of apnea

Question 11

biot

Answer 11

irregularity interspersed periods of apnea in a disorganized sequence of breaths

Question 12

ataxic

Answer 12

significant disorganization with irregular and varying depths of respiration

Question 13

stridor

Answer 13

breathing that occurs with obstruction high in chest; lower pitch than wheeze (during inspection - not with stethoscope)

Question 14

paradoxic breathing

Answer 14

lower thorax drawn in on inspiration and out on expiration

• Develops with weakened diaphragm, obstructive airway disease, or during sleep in event of upper airway obstruction

Question 15

unilateral retraction

Answer 15

foreign body in bronchus

Question 16

retraction of lower chest

Answer 16

occurs with asthma and bronchitis

Question 17

diseases clubbing is associated with

Answer 17

emphysema, lung cancer, cyanosis of congenital heart disease, cystic fibrosis

Question 18

crepitus

Answer 18

crackly ort crinkly sensation that can be felt and heard
o Indicated air in subcutaneous tissue from rupture somewhere in respiratory system or by infection with gas-producing organisms
- can indicate cracked rib (when palpated)

Question 19

tactile fremitus

Answer 19

vibration of chest wall resulting from speech or other verbalizations (felt with palpatation)

increase: fluids or solid mass
decrease: more air; pleural effusion or bronchial obstruction

Question 20

pleural effusion

Answer 20

fluid in lungs; dullness to chest percussion

Question 21

hints for mediastinal mass

Answer 21

trachea compressed, sounds or stridor, difficulty breathing, lean forward to relieve compression

Question 22

resonance

Answer 22

normal sounds that can be heard over all areas of lung

Question 23

Hyperresonance

Answer 23

associated with hyperinflation (may indicate emphysema, pneumothoracx, or asthma) - trapped air!

Question 24

dullness or flatness with resonance

Answer 24

suggests pneumonia, atelectasis, pleural effusion, pneumothorax, asthma - liquid; diminished air exchange!

Question 25

part of stethoscope for listening to lungs

Answer 25

diaphragm

Question 26

three classifications of breath sounds

Answer 26

o Vesicular: low pitched, low-intensity sounds heard over healthy tissue
o Bronchovesicular: heard over major bronchi and typically moderate in pitch and intensity
• Abnormal if heard over peripheral lung tissue
o Bronchial (tubular): highest in pitch and intensity; typically only heard over trachea
• Abnormal if heard over peripheral lung tissue

Question 27

amphoric breathing

Answer 27

resembles noise made by blowing across mouth of bottle

• Heard with large, relatively stiff-walled pulmonary cavity or a tension pheumothorax with bronchopleural fistula

Question 28

cavernous breathing

Answer 28

sounds like coming from a cavern; heard over pulmonary cavity with rigid wall

Question 29

crackles

Answer 29

discontinuous; typically during inspiration; caused by disruptive passage of air through small airways

Question 30

rhonchi

Answer 30

loud, low coarse sounds like a snore; most often heard continuously during inspiration and expiration; most pronounced during

Question 31

wheezes

Answer 31

musical noise sounding like a squeak; most often heard continuously during inspiration and expiration; usually louder during expiration; continuous

Question 32

pleural friction rub

Answer 32

dry, rubbing or grating sound caused by inflammation of pleural surfaces; heard during inspiration or expiration; loudest over lower, lateral, anterior surface

Question 33

mediastinal crunch (Hamman sign)

Answer 33

found with mediastinal emphysema
• Variety of sounds: loud crackles, clicking, gurgling (heard over precordium)
• Sounds are synchronous with heartbeat

Question 34

sibilant

Answer 34

high pitched

Question 35

sonorous

Answer 35

low-pitched

Question 36

bronchophony

Answer 36

say “99” over all fields

• greater clarity and increased loudness of spoken sounds
  o If bronchophony is extreme, even whisper may be heard clearly with stethoscope

Question 37

egophony

Answer 37

say “eeee”

increased loudness and greater nasal quality of sound
o Resulting form any type of lung tissue consolidation

Question 38

symptom of pulmonary tuberculosis

Answer 38

night sweats

Question 39

grunting in children

Answer 39

sound of respiratory distress

Question 40

kyphosis

Answer 40

extreme flexion of thoracic vertebrae

Question 41

giubbus

Answer 41

extreme kyphosis

Question 42

pectoriloquy

Answer 42

when a whisper can be heard clearly (bronchophony)