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PHYS grad > CVR 1 SOL > Flashcards

CVR 1 SOL Flashcards

1
Q

What is auscultation?

A

process of listening and interpreting the sounds produced within the thorax

part of full respiratory Ax

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2
Q

How breath sounds are generated:

By_____ air flow ​

As the air passes through progressively ____ airways during _____, turbulence and sound is generated​

Breath sounds are composed of ___(3) frequencies​

During expiration air moves from ___ to ___ airways so sound is only generated at the ____. The rest of _____ being quiet​

A

turbulent;
progressively smaller; during inspiration;

high, medium and low

smaller to larger; initial phase of expiration; expiration

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3
Q

most of the air circulate in the ___ respiratory tract (thus louder)​

A

upper

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4
Q

another name for normal breath sound

A

vesicular sounds

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5
Q

Normal breath sound:

The higher frequencies are attenuated by the ______

Normal breath sounds are heard during what phases?

There will be variation in normal breath sounds depending on (2)

A

normal aerated/inflated lung tissue​

throughout inspiration and during the initial part of expiration​

the thickness of the chest wall or body size ​

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6
Q

Attenuated =?

A

filtered out

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7
Q

Normal breath sounds is like?

A

Soft and low pitched​

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8
Q

Bronchial breath sounds are normal in ____ (2)
abnormal when heard ____

A

tracheal and large airways only;
heard over areas of consolidated lungs

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9
Q

Bronchial breath sounds is?

A

It is the sound transmitted through airless lung, which then cannot attenuate the higher frequencies​

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10
Q

Bronchial breath sounds: The sound heard is therefore much ___ in frequency, __ and ___

A

higher; loud; high pitched

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11
Q

Bronchial breath sounds: Heard throughout ___, with a short pause ___

A

both inspiration and expiration equally; between the two​

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12
Q

bronchial breathing Vs
vesicular breathing

A

bronchial breathing: heard over the tracheobronchial tree​

vesicular breathing: heard over the lung tissue​

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13
Q

Reasons for Reduced breath sounds: (5)

Reduction in the _____ Either can’t or won’t​ take a deep breath

When there is an increase in ___ i.e. emphysematous lungs​

Localised reduced breath sounds may be due to _____ by tumour or sputum/mucus plugs​

_____(2) in the pleural space will block sound transmission​

____ barrier i.e. obese

A

Initial generation of the sound;
sound attenuation;
an obstructed bronchus;
Air or fluid;
Acoustic

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14
Q

types of abnormal/added lung sounds (4)

A

wheeze
crackles
pleural rub
stridor

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15
Q

describe wheeze

A

blowing a musical horn

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16
Q

describe crackles

A

shoveling rocks/ small rocks popping

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17
Q

describe pleural rub

A

walking w a suitcase on old wooden floor

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18
Q

describe stridor

A

move a straw up and down; windshield wipers w/o rain

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19
Q

Wheezes:​
Generated by _____

They are normally heard on ___, and when it is more severe it will be heard during ____

A

airflow vibrating within a narrowed or compressed airway

expiration first​; inspiration

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20
Q

_____ wheeze is caused by single obstructed airways​

Polyphonic wheeze is caused by widespread disease

A

Monophonic; Polyphonic wheezes

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21
Q

Wheezes are common in what population (2)

A

Asthma & COPD

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22
Q

Crackles are caused by

A

(popping) opening of previously closed (collapsed) alveoli and small airways

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23
Q

2 types of Crackles

A

fine/rales
coarse/ rhonchi

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24
Q

_____ crackle tend to be loud, low pitched, tend to be heard during EARLY INSP and possibly exp. Fluid or sputum in the larger airways. Will often clear post cough or physio​

A

Coarse

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25
Q

____Crackle tend to be high pitched and heard at END INSP. Pulmonary oedema, pulmonary fibrosis, bronchiectasis.​

A

Fine

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26
Q

walking on fresh snow
Could be confused with crackles​
It occurs with each breath​
During inspiration and expiration​
Caused by inflammation, infection or a neoplasm​

A

Pleural Rub

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27
Q

how to diff Pleural Rub and Crackle

A

ask pt to cough

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28
Q

can hear w or w/o stethoscope
extremely loud sound during INSP and EXP

A

Stridor

29
Q

Stridor Suggests ___ obstruction

A

tracheal or laryngeal obstruction (upper airway narrowing)

30
Q

Where to begin with auscultation (anything)

A

Listen to external noise first​

Correct insertion of ear tips into your ear canal!​

Turn stethoscope on!​

Good positioning of patient if possible​

Stethoscope to touch bare skin​

Auscultate with the diaphragm of the stethoscope​

Ask the patient to breathe in and out through their mouth​

Listen to equal position on each side to allow you to compare the two​

Pick up on something? Listen to multiple cycles to identify wt you are hearing

31
Q

why ask pt to breath via mouth than nose?

A

generate less turbulence

32
Q

sound from apex vs base
L vs R
same or diff

A

diff
same

33
Q

Def ventilation

A

mvmt of air in and out of the lungs

34
Q

Def respiration

A

occurrence of gas exchange

35
Q

ventilation and respiration involve which 2 systems?

A

CVS and neurological system

36
Q

Def external respiration

A

gas exchange b//w env and bloodstream

37
Q

Def gas transport

A

transportation of O2 and CO2 to/form the lungs in the blood

38
Q

Def internal respiration

A

mvmt of O2 from the blood to the cells and CO2 from the cells to the blood

39
Q

Factors affecting ventilation

A

weak muscles of ventilation
neurological problem - messages not getting to muscles from brain.
skeletal problem.
pain.
blockage in the main airway.

40
Q

Factors affecting external respiration (4)

A

air getting into the lungs but not where it needs to be for gas exchange.
partial lung collapse.
atelectasis (lungs not expanding)
bronchospasm

41
Q

Factors affecting Gas Transport (3)

A

blood clots in the pulmonary circulation.
low levels of Hb.
consolidated lung - dense lung tissue due to pneumonia.

42
Q

Factors affecting internal respiration (3)

A

reduced circulation.
blood clots in the peripheral circulation.
narrowed arteries

43
Q

functions of nasal cavity (7)

A

1st line of defence - protect the LRT.
moistens/humidifies
filters.
slow breath
warm airs
increase turbulence
produce mucus

44
Q

cilia is on what cells

A

mucosal epithelial cells

45
Q

function of goblet cells

A

mucus production

46
Q

why nasal cavity is highly vascularized?

A

warms the air

47
Q

function of conchae in nasal cavity

A

increase SA, turbulence, help ensure most of air comes into contact with mucus membrane

48
Q

sinuses function

A

resonation for vocalisation

49
Q

pharynx function

A

passageway for air and food/drink

50
Q

larynx contain (2)

A

epiglottis
vocal folds & voice box

51
Q

function of epiglottis

A

prevents aspiration/food from entering airways

52
Q

vocal folds and voice box function

A

voice and cough

53
Q

trachea bifurcates at ?

A

t4/5
right is more acute - increased risk aspiration

54
Q

function of C shaped cartilage rings

A

stability and prevent trachea from collapsing

55
Q

CXR: sputum is not ___?

A

radio opaque

56
Q

lv of absorption of x-ray (high/low)

blackest =
whitest =

A

low
high

57
Q

CXR: PA vs AP imaging meaning?

A

PA - x-ray go from posterior to anterior (closest to detection plate)

58
Q

CXR: why PA imaging gold standard?

A

scapular is out of the way
PA - true representation of heart
AP - enlarged heart (when pt can’t stand erect)

59
Q

CXR: what is silhouette sign?

A

loss of the expected interface normally created by 2 structures of different density.

no boundary can be seen b//w 2 structures of similar density

60
Q

CXR: 3 borders where silhouette sign can occur

A

heart borders
costophrenic angles
diaphragms

61
Q

CXR: RIP =?

A

rotation
inspiration
penetration

62
Q

CXR: Penetration/ Exposure? Under or over exposed? How to identify this?

A

underexposed = white
overexposed = black

63
Q

ABCDE

A

airway
breathing
circulation
disability
exposure

64
Q

CXR: what indicate good exposure

A

see spine through the heart

65
Q

CXR: indication of good penetration

A

rib 6-7 ant dissect w diaphragm at mid-clavicular line

66
Q

CXR: indication of sufficient inflation (ant/post view)

A

ant 6-7 ribs dissect the diaphragm
post 9-10 ribs
> = hyperinflation
< = insufficient inflation

67
Q

CXR: how to determine if there’s rotation

A

check if the clavicle ends equal distance from the spinous processes

68
Q
A

PHYS grad (15 decks)

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