Compentancy 2

Question 1

anterior upper (apical) segment

Answer 1

seated up
percussion on upper chest

Question 2

posterior apical segment

Answer 2

seated up hunched forward
percussion on posterior upper chest/back

Question 3

anterior segments

Answer 3

supine
mid chest percussion

Question 4

right posterior

Answer 4

prone right side slightly elevated
R upper back

Question 5

left posterior segment

Answer 5

prone but elevated HOB w/ L slightly elevated
L upper back

Question 6

right middle lobe

Answer 6

trendelenburg R slightly elevated
mid lower chest percussion

Question 7

left lingular

Answer 7

trendelenburg L slightly elevated
lower L lung percussion

Question 8

ant segment lower (basal)

Answer 8

slightly increased trendelenburg
percussion middle chest

Question 9

R lateral basal seg

Answer 9

inc trendelenburg on L side (R up)
R lower back/side percussion

Question 10

L lateral basal segment

Answer 10

inc trendelenburg on R side (L up)
L lower back/side percussion

Question 11

posterior basal segments

Answer 11

prone inc trendelenburg pillow under stomach
lower lung percussion

Question 12

superior segments

Answer 12

prone pillow under stomach
mid back percussion

Question 13

active cycle of breathing

Answer 13

1) Start with relaxed diaphragmatic breathing (20-30 seconds) in sitting
2) Perform 3-4 deep breaths with added thoracic expansion
a) May add inspiratory hold of 1-3 sec
3) Relaxed exhalation
4) May follow with huffs or FET as secretions move into large airways
5) Relaxed, controlled breathing
6) Repeat cycle 2-4 times

Question 14

autogenic drainage

Answer 14

Staged breathing at different lung volumes:
1) Start with small tidal breaths from ERV in sitting
a) repeated until secretions are felt gathering in the airways (10 – 20 breaths)
b) the cough is suppressed,
2) A larger tidal volume is taken for another series of 10 - 20 breaths
3) Followed by a series of larger (approaching VC) breaths
4) Followed by several huff or coughs to expectorate sputum

Question 15

vesicular sounds
if diminished
if prolonged

Answer 15

heard over most of the peripheral lung fields
If diminished→ reduced ventilation
If prolonged exhalation→ airway obstruction

Question 16

what are you assessing for in lung asculatation

Answer 16

quality
amount
sound

Question 17

crackles
when is it heard
what does it show

Answer 17

Heard toward end inhalation
Fluid in airways (pneumonia) or interstitial lung disease (fibrosis)

Question 18

wheeze
when is it heard
noise and what it means

Answer 18

continuous sounds, heard on exhalation
Fine/High pitched→ narrowing of airways (bronchospasm)
Coarse/Low pitched (rhonchi) → Fluid (mucous) in larger airways

Question 19

mediate percussion
hypo
hyper
resonant

Answer 19

Hyporesonant/Dull sound = fluid/mucous (pleural effusion or pneumonia)

Hyperresonant= air trapping, drum-like sound (COPD)

Resonant= normal, air-filled lung

Question 20

elicited sounds

Answer 20

assess the ability of the lungs to transmit sound produced by the voice; used to help confirm pathology related to loss of alveolar air

Question 21

eliced sounds
99
normal
abnormal

Answer 21

normal - muffled 99
abnormal - clear, nasal 99

bronchophony

Question 22

elicited sounds
whisper 123
normal
abnormal

Answer 22

normal - barely audible
abnormal - hear the 123

pectoriloquy

Question 23

elicited sounds
say eeee
normal
abnormal

Answer 23

normal - hear muffled eeee
abnormal - change eee to aaaa, nasal aaa

egophony

Question 24

when to use segmental breathing

Answer 24

restriction - not expanding well

Question 25

anterior and posterior auscultation

Answer 25

Question 26

if breathing is airy then it could be

Answer 26

PNX or emphazema
if PNX airy on outside