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PCM 1 Final > DSA- Lower Respiratory Tract Exam > Flashcards

DSA- Lower Respiratory Tract Exam Flashcards

1
Q

Hypopnea

A

Decreased depth and rate of respiration

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2
Q

Bradypnea

A

regular rhythm but slower than normal rate ( RR<14/min)

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3
Q

Hyperpnea

A

increased depth and rate of respiration (exercise)

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4
Q

Tachypnea

A

rapid breathing ( RR> 20-25/ min)

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5
Q

Dyspnea

A

feeling short of breath

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6
Q

Hypoxia

A

deficiency in amount of O2 reaching tissues

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7
Q

Hypoxemia

A

oxygen deficiency in arterial blood

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8
Q

Apnea

A

no breathing

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9
Q

Atelectasis

A

collapse of lung tissue that affects the alveoli from normal O2 absorption

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10
Q

Pleximeter Finger

A

hyperextended middle finger of non-dominated hand in percussion

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11
Q

plexor finger

A

“tapping” finger, dominant hand , for percussion

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12
Q

Landmarks of chest (11)

A
  • Supraclavicular: above clavicles
  • infraclavicular: below clavicles
  • interscapular: between scapulae
  • infrascapular: below scapulae
  • bases of lungs: lowermost portions
  • upper, middle, lower lung fields
  • vetebral line
  • scapular line
  • right anterior axillary line
  • right midclavicular line
  • midsternal line
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13
Q

Sternal Angle

A

Angle of Louis

- 2nd ribs join sternum

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14
Q

Needle Thoracentesis

A
  • decompression

- 2nd intercostal space, midclavicular line

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15
Q

Chest tube Insertion

- location

A
  • 4th and 5th intercostal space (anterior to midaxillary line)
  • 5th intercostal space- inferior to nipple
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16
Q

Neurovascular bundle

A
  • runs along inferior margins of each rib

- chest tubes need to be placed OVER superior margin of rib to avoid bundle

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17
Q

Pulse Oximetry

- reasons for bad waveform

A
  • measures peripheral arterial oxygen saturation ( SpO2)
  • “fifth vital sign”

uses red and infrared light to measure fraction of oxygenated hemoglobin (absorbs infrared> red) and deoxygenated blood ( absorbs red > infrared)

bad waveform causes
- improper placement, hypoperfusion, hypothermia, motion artifact

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18
Q

End Tidal CO2

A
  • concentration of CO2 in exhaled air at end of respiration
  • measures ventilation

Normal PETCO2= 35-40 mmHg
Normal PaCO2= 35-45 mmhG

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19
Q

Incentive Spirometer (IS)

A
  • device used to help you keep your lungs healthy after surgery or when you have a lung illness, such as pneumonia
  • teaches you how to take slow deep breaths
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20
Q

Atelectasis

A
  • loss of lung volume due to collapse of lung tissue (alveoli)
  • can be seen post-surgery

Treatment: use IS

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21
Q

Pulmonary Function Test (PFT)

A
  • noninvasive
  • show how well lungs are working
  • diagnose certain lung disorders (obstructive vs Restrictive)
22
Q

Spirometry

A
  • aka PFT
  • measure lung function
  • amount and speed of air inhaled and exhaled
  • diagnose condition (obstructive vs restrictive)
23
Q

Accessory Muscle in Respiration( 6)

A
  • Sternomastoids
  • Scalenes
  • Inspiratory intercostals
  • expiratory intercoastals
  • diaphragm
  • external obliques
  • expiratory abdominals
24
Q

Cyanosis

A

signs of hypoxia

  • nail bed
  • perioral
25
Q

Tracheal Deviation seen in ( 4)

A
  • pneumothorax (tension and nontension)
  • Pleural effusion
  • Atelectasis
  • Mass
26
Q

Clubbing

- causes

A
  • congenital heart disease
  • interstitial lung disease
  • bronchiectasis
  • pulmonary fibrosis
  • cystic fibrosis
  • lung abscess
  • malignancy (lung cancer)
  • inflammatory bowel disease
27
Q

Pectus Excavatum

A
  • funnel chest

- depression in lower portion in sternum

28
Q

Pectus Carinatum

A
  • pigeon chest
  • sternum displaced anterior (increased AP diameter)
  • adjacent costal cartilage are depressed
29
Q

Barrel Chest

A
  • increased AP diameter resembling barrel

- COPD

30
Q

Chronic Bronchitis

- symptoms

A
  • daily productive cough for more than 3 months
  • blue bloater

symptoms

  • overweight and cyanotic
  • elevated hemoglobin
  • peripheral edema
  • Rhonchi and wheezing
31
Q

Emphysema

- symptoms

A
  • pink puffer
  • pathologic diagnosis
  • permanent enlargement and destruction of airspaces distal to terminal bronchiole

Symptoms

  • older and thin
  • severe dyspnea
  • quiet chest
  • x ray hyperinflation with flattened diaphragm
32
Q

Traumatic Flail Chest

A
  • multiple rib fracture may result in paradoxical movements of thorax
  • inspiration -> injured area caves inward
  • expiration-> injured area moves outward
33
Q

Tactile Fremitus

- differentials if increased/decreased

A
  • Palpable vibration as patients says “99”

Decreased or absent

  • COPD
  • Pleural changes ( effusion, fibrosis, air, infiltrating tumor)

increased
- pneumonia ( consolidation)

34
Q

Percussion sounds

- differentials

A

Resonant= healthy lung

Dullness

  • fluid/ solid tissue in air-containing lungs
  • effusion
  • hemothorax
  • emphysema
  • fibrous tissue or tumor
  • pretty white in majority of x-ray

Hyperresonance

  • hyperinflated lungs
  • COPD or asthma
  • very black lungs on X-ray

Tympanic- abdominal percussion

35
Q

Abnormal sounds in respiratory ( 5)

A

1) rhonchi: coarse low-pitched, may be clear with cough
2) wheeze: whistling, high pitched bronchus
3) bronchial: coarse, loud, heard with consolidation
4) Rub: scratchy, high pitched
5) crackle: fine crackling, high pitched

36
Q

Adventitious vs normal (4) breath sounds

A

Normal

  • vesicular
  • Bronchovesicular
  • bronchial
  • tracheal

Adventitious

  • stridor
  • wheezes (rhonchi- low pitched wheezes)
  • crackles
37
Q

Stridor

A
  • generally an inspiratory sound
  • but can be expiratory or biphasic
  • result from a narrowing in upper airway

Causes

  • croup
  • epiglottis
  • upper airway foreign body
  • anaphylaxis
38
Q

Wheezing

A
  • generally an expiratory sound but can be inspiratory or biphasic
  • continuous musical sounds
  • caused by rapid airflow through a narrowed bronchial airway
  • RAD
  • Asthma
  • COPD
39
Q

Crackles

A
  • inspiratory sound
  • continuous musical sounds
  • caused by small airway closed during expiration
  • “popping” open during inspiration

Causes

  • pneumonia
  • CHF
  • Atelectasis
  • pulmonary fibrosis
  • brochiectasis
  • COPD
  • Asthma
40
Q

Vocal Resonance (normal vs abnormal(3) )

A

Normal
- words are muffled/indistinct

Abnormal

  • distinctness increases with lung consolidation (tumor, pneumonia effusions)
  • bronchophony- spoken words get louder
  • whispered pectoriloquy- whispered words are louder and cleared during auscultation
  • egophony- when patients says “ee” it sounds like “A” ( nasal and localized)
41
Q

Mnemonic for Chest X-Ray Interpretation (A-I) ( 2 a’s, 2f’s, 2g’s)

A
  • Adequate/ Assessment of quality (Pier)
  • Airway
  • Bones and soft tissues
  • Cardiac Size/valves
  • Diaphragms
  • Effusions/ Endotracheal tube/ EKG/ wires
  • Fields and Fissures
  • Foreign body
  • Great Vessels
  • Gastric Bubble
  • Hilar masses
  • Impression
42
Q

adequate/ assesment of quality (Pier)

A

Position- AP/Lateral
Inspiration- should see 10-11 ribs
Exposure
Rotation

43
Q

Airway

A

trachea midline, carina

44
Q

bones and soft tissues

A
  • osteopenia/osteoporosis
  • fractures/ metastatic lesion
  • subcutaneous emphysema
45
Q

Cardiac size

A

normal= <50% of chest diameter on PA or < 60% on AP films

- heart shape, calcifications and prosthetic valves

46
Q

Diaphragm

A

round/flat/free air

47
Q

Fields and Fissures

A

infiltrates (interstitial or alveolar), masses, consolidation, air bronchogram, pneumothorax, vascular markings

48
Q

Foreign body

A

piercing, bullet fragments, lines

49
Q

Great Vessels

A

aortic size and shape

50
Q

Hilar Masses

A

lymphadenopathy, widening (aortic dissection), mass

PCM 1 Final (6 decks)

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