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Clinical Med > Chest and thorax > Flashcards

Chest and thorax Flashcards

1
Q

What is the normal range for diaphragmatic excursion

A

3-5 cm

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2
Q

True or false: the diaphragm is usually higher on the left side

A

True

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3
Q

What sounds are the highest in pitch and intensity

A

bronchial sounds

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4
Q

What sounds are low-oitched, low intensity sounds of healthy lungs?

A

vesicular sounds

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5
Q

True or false: crackles usually clear with coughing?

A

False

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6
Q

When in the breathing cycle are crackles heard?

A

With inspiration

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7
Q

What are rhonchi?

A

wheezes usually heard with expiration

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8
Q

When in the breathing cycle are wheezes usually heard?

A

continuously

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9
Q

True or false: a higher pitched wheeze usually indicates a less severe obstruction

A

False–higher = worse

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10
Q

What a friction rubs indicative of?

A

Inflammation

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11
Q

How is bronchophony tested?

A

having patient say “99”. this will look for consolidation

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12
Q

When is egophony tested?

A

looking for consolidation

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13
Q

What are the three tests that you can perform for consolidation?

A

egophony
bronchophony
Whispered pectoriloquy

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14
Q

What are cheyne-stokes patterns?

A

alternating period of apnea and hypernea, periodic breathing

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15
Q

What are Kussmaul’s respiration?

A

very deep, gasping and rapid breathing seen in metabolic acidosis

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16
Q

What are grunting respirations?

A

Short and explosive sounds, more common in children but also in adults as a sign of respiratory muscle fatigue

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17
Q

What are adventitous breath sounds?

A

abnormal breath sounds auscultated such as crackles, rhonchi, wheezes, and friction rub

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18
Q

Define: atelectasis?

A

incomplete expansion of the lungs

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19
Q

true or false: patients with a barrel chest also have some degree of kyphosis

A

true

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20
Q

Define: biot respirations

A

irregularly respiration varying in depth an interrupted by intervals of apnea that lacks a repetitive pattern

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21
Q

Define: bronchiectasis

A

chronic dilation of the bronchi or bronchoiles caused by repeated infections or bronchial obstructions

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22
Q

Define: Bronchitis

A

inflammation of the large airways.

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23
Q

Define: Bronchophony

A

tissue (greater clarity and increased loudness of the spoken word)

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24
Q

Define: Bronchiolitis

A

inflammation of the bronchioles

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25
Q

What are the three normal breath sounds?

A
  1. Vesicular
  2. Tubular
  3. Bronchovesicular
26
Q

What are vesicular breath sounds?

A

heard over most of the lung fields; low pitch, soft and short expirations

27
Q

What are tubular breath sounds?

A

heard only over trachea, high pitch; loud and long expirations, sometimes a bit longer than
inspiration

28
Q

What are Bronchovesicular breath sounds?

A

heard over main bronchus area and over upper right posterior lung field;
medium pitch; expiration equals inspiration

29
Q

Define: Pectoriloquy

A

a striking transmission of voice sounds through the pulmonary structures, so that they are
clearly audible through the stethoscope; commonly occurs from lung consolidation.

30
Q

Define: Pectus carinatum

A

forward protrusion of the chest

31
Q

What are the principle muscles used in inspiration?

A

External intercostals

Diaphragm

32
Q

What part of the chest do you use in quiet respiration?

A

Passive recoil of the diaphragm

33
Q

What are the muscles used in active, expiration?

A

Internal intercostals
Abdominal muscles
Obliques

34
Q

What are the muscles used in activeinspiration?

A

SCM

Scalenes

35
Q

About what phsycial landmark do the bronchi split?

A

Sternal angle

36
Q

The lung exists down to which vertebra?

A

T10

37
Q

How far does the diaphragm move?

A

4-5 cm

38
Q

What are the four steps of the physical exam?

A
  1. Look
  2. Listen
  3. Palpate
  4. Percuss
39
Q

To get flail chest, what must happen?

A

Break two portions of three ribs

40
Q

What palpation sounds are characterisitcs of COPD?

A

Hyperresonant.

41
Q

What are the breath sounds of a COPD patient?

A

Distant with delayed expiratory phase and scattered expiratory wheezes

42
Q

Will fremitus be increased or decrease in patient with COPD?

A

Decreased

43
Q

Will the diaphragm move more or less in a patient with COPD?

A

Less

44
Q

Will there be kyphosis in asthma?

A

No–flattening of it

45
Q

Will the lungs be resonant in asthma

A

Yes

46
Q

Will there be bronchophony, egophony, or whispered pectoriloquy in Asthma?

A

No

47
Q

Will there be diaphragmatic changes in asthma?

A

No

48
Q

When (in the breath cycle) do wheezes usually occur with asthma?

A

Expiration

49
Q

What should be the top thing on your differential if you see a patient with asymmetric chest movement?

A

Pneumothorax

50
Q

Will the lung be more or less resonant in pneumothorax?

A

More

51
Q

Will breath sounds be decreased or increased in penumothorax?

A

Decreased throughout

52
Q

Will there be diaphragamatic excursion changes in pneumothorax?

A

Yes, decreased on the affected side

53
Q

Which breath sounds are continuous?

A

Wheezes and rhonchi

54
Q

Which breath sounds are discontinuous?

A

Crackles

55
Q

What do wheezes indicate?

A

Narrowed airway

56
Q

What do rhonchi indicate?

A

Secretions in large airways

57
Q

What do crackles indicate?

A

either abnormalities of the lung, or inspissated secretions (if able to clear)

58
Q

What is the pitch different between wheezes and rhonchi?

A

Rhonchi are low

Wheezes are high

59
Q

Where is the oblique fissue of the right lung found with inspiration (relative to the ribcage)

A

Right 5th rib along the sternum, traveling to the 6th rib at the midclavicular line

60
Q

Where is the transverse fissure found in either lung with inspiration (relative to the ribcage)?

A

4th rib at the midclavicular line

Clinical Med (30 decks)

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