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PCM Midterm Spring 2020 > DSA Lower Respiratory Exam > Flashcards

DSA Lower Respiratory Exam Flashcards

1
Q

Hypopnea

A

decreased depth and rate of resp

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2
Q

Hypoxia

A

deficiency in the amt of O2 reaching tissues

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3
Q

Hypoxemia

A

O2 deficiency in arterial blood

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4
Q

Atelectasis

A

Collapse of lung tissue that affects alveoli from normal O2 absorption

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5
Q

Plexor finger

A

“tapping” finger, dominant hand for percussion

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6
Q

Anatomy -Sternal angle -Needle thoracentesis -Chest tube insertion -Neurovascular bundle -

A

-Sternal angle: 2nd rib joins sternum -Needle thoracentesis: 2nd ICS, midclavicular -Chest tube insertion: 4th ICS at mid or anterior axillary line or just sup to margin of 5th rib -Neurovascular bundle: runs in the inferior margins

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7
Q

Pulse Ox

A

-gives peripheral arterial O2 saturation level -Oxygenated Hb absorbs infrared and lets red light pass when deoxygenated blood absorbs red light -pulse ox measures ratio of red to infrared light -hypothermia might interfere because of vasoconstrictoin

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8
Q

End Tidal CO2 (EtCO2)

A

-Capnography: non-invasive measurement of partial pressure of CO2 in exhaled breath as [CO2]/time -[CO2] in exhaled air at end of resp

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9
Q

Clubbing of Fingernails

A
  • loss of normal angle between nail and nail fold (>180) -think THINK Chronic
  • Causes: CHD, Intersitital lung disease, bronchiectasis, pulmonary fibrosis, CF, lung absess, malicnancy
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10
Q

Tracheal Deviation

A
  • can indicate pneumothorax, pleural effusion, atelectasis, mass
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11
Q

Pectus Excavatum “funnel chest”

A
  • depression in lower pt of sternum
  • can compress heart and vessels and cause murmurs
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12
Q

Pectum Carinatum (Pigeon chest)

A
  • sternum displaced anteriorly (increase AP diameter)
  • adj costal cartilages depressed
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13
Q

Barrel Chest

A
  • increased AP diameter
  • seen in COPD
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14
Q

Chronic Bronchitis versus Emphysema

A

Chronic Bronchitis

  • daily productive cough for 3 mths in 2 consecutive years
  • overweight and cyanotic
  • elevated Hb
  • peripheral edema
  • rhonci and wheezing

Emphysema

  • older and thin
  • severe dyspnea
  • quiet chest
  • hyperinflation and flattened diaphragm
  • perm enlargement and destruction of airspaces
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15
Q

Chest Movement

  • Asymmetrical expansion
  • Retraction
  • Unilateral lagging
A
  • Asymmetrical expansion: pleural effusion
  • Retraction: severe asthma, COPD, UR obstruction
  • Unilateral lagging: pleural disease
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16
Q

Traumatic Flail Chest

A
  • mult. rib fractures result in paradoxical movements of thorax
  • on inspiration, injured areas cave inward and move outward in expiration
17
Q

Tactile Fremitus

A

Absent or Decreased

  • COPD
  • Pleural changes (fibrosis, effusions, air)

Increased

-pneumonia

18
Q

OSE

  • viscerosomatic lungs
  • OMM treatment options
A
  • viscerosomatic lungs: T2-7
  • OMM treatment options

doming diaphragm

rib raising

tapotement

thoracic pump

19
Q

Pathology of Percussion

  • dullness
  • generalized hyperresonance
  • unilateral hyperresonance suggests
  • tympanic
A

dullness: fluid replaces air

lobar pneuominia, pleural effusion, hemothorax

generalized hyperresonance: hyperinflate lungs

COPD, asthma

-unilateral hyperresonance suggests

large pneumothorax, COPD, emphysema

-tympanic

abdominal percussion

20
Q

Diaphragmatic Excursion

A
  1. pt exhales and holds it
  2. percuss level of diaphragm and mark
  3. pt inhales and holds it
  4. percuss and mark
  5. distance between 2

Normal: 3-5.5 cm

Asymmetry with one side higher than other: pleural effusion, high diaphragm secondary to atelectasis or phrenic nerve paralysis

21
Q

Stridor Common causes

A
  • narrowing of airway
  • croup
  • epiglottitis
  • UA foreign body
  • anaphylaxis
  • inspiratory sound
22
Q

Wheezing Causes

A
  • expiratory sound
  • rapid airflow through narrowed bronchial airway

Causes:

Reactive airway disease

Asthma

COPD

23
Q

Crackling Causes

A
  • inspiratory sound
  • small airway closed during expiration, popping open during inspiration
  • Causes:

pneumonia, CHF, atelectasis, pulmonary fibrosis, bronchiectasis, COPD, asthma

24
Q

Athelectasis

A

-loss of lung vol due to collapse of lung tissue

  • post surgical fever-> consider!!
  • inspired spirometry helps with atelectasis, treatment, prevention

-alveolar collapse not complete collapse

25
Q

Pulmonary Function Test (PFT) Plethysmography

A
  • non invasive
  • diagnose obstructive versus restrictive
26
Q

PFT Spirometry

A
  • measures lung function
  • amount and speed of air inhaled and exhaled
  • diagnose obstructive vs restrictive
27
Q

ABC (A-I) for Chest Xray Interpretation

A

Adequate/assessment of quality: position, inspiration, exposure

Airway: trachea midline

Bones and soft tissues: fractures, emphysema, osteoporosis

Cardiac Size

Diaphragms

Effusions

Field and Fissures

Foreign body

Great vessels

Gastric bubble

Hilar Masses

Impression

28
Q
A

Lung collapse pneumothorax!

29
Q

Diagnosis?

A

Cardiomegaly

30
Q

Diagnosis

A

Tracheal deviation

Kerley B lines: congestion

PCM Midterm Spring 2020 (9 decks)

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