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PCM Final Exam > DSA | Lower Respiratory Tract Exam (Arnce/Mcgowan) > Flashcards

DSA | Lower Respiratory Tract Exam (Arnce/Mcgowan) Flashcards

1
Q

Normal adult breathing rate?

A

14-20/min

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2
Q

Define the following terms:

Hypopnea=

Bradypnea=

Hyperpnea=

Tachypnea=

A

Hypopnea= decreased depth (shallow) and rate (slow) of respiration

Bradypnea= RR< 14

Hyperpnea= Increased depth of breathing and fast rate of respiration (normal in exercise)

Tachypnea= RR > 20

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3
Q

Define the following terms:

Dyspnea=

Hypoxia =

Hypoxemia =

Apnea=

A

Dyspnea= feeling short of breath

Hypoxia = deficiency in the amt of O2 reaching the tissues

Hypoxemia = oxygen deficiency in arterial blood

Apnea= no breathing

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4
Q

Define the following terms:

Atelectasis =

Pleximeter finger =

Plexor finger =

A

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

Pleximeter finger = hyperextended middle finger of non-dominant hand in percussion

Plexor finger = “tapping” finer, dominant hand, for percussion

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5
Q

Label

A
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6
Q

Label

A
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7
Q

Angle of Louis

AKA?

A

Sternal Angle

2nd rib joins sternum here

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8
Q

Where would you perform a needle thoracentesis (decompression)?

How about Chest tube insertion?

A

Needle thoracentesis : 2nd intercostal space, midclavicular line

Chest tube insertion: 4th and 5th intercostal space

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9
Q

Where does the neurovascular bundle run with ribs?

A

Runs along the inferior margin of each rib

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10
Q

What are the vital signs you should obtain when examining the lower respiratory track?

A

RR

HR

BP

Temp

*O2 Sat

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11
Q

What are the 4 major steps of performing an exam of the lower respiratory track?

A

Inspection

Palpation

Percussion

Auscultation

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12
Q

Pulse Oximetry:

Oxygenated hemoglobin absorbs ______ light, and allows _____ light to pass through

Deoxygenated blood absorbs ______ light and allows _____ light to pass through

A

Oxygenated hemoglobin absorbs ___infared___ light, and allows ___red__ light to pass through

Deoxygenated blood absorbs ___red___ light and allows __infared___ light to pass through

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13
Q

What does a pulse ox measure?

A

Peripheral arterial oxygen saturation (SpO2)

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14
Q

What is end tidal CO2?

A

The concentration of CO2 in exhaled air at the end of respiration

Expressed as partial pressure in mm of mercury (PETCO2)

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15
Q

What device is used to help with atelectasis, treatment and prevention?

A

Incentive spirometer (IS)

*atelectasis= loss of lung volume due to the collapse of lung tissue (alveoli)

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16
Q

How do we determine lung function?

A

Use:

Pulmonary function test (PFT)

Spirometry

17
Q

When inspecting for respiratory distress, what are you looking for?

A

Posture/positioning –> (e.g. tripoding)

Accessory muscle use –> (e.g. trapezius, scalenes, sternomastoid)

Cyanosis

Clubbing of finers

Chest shape (funnel/pigeon chest)

18
Q

What is pectus excavatum?

A

“funnel chest”

Depression in lower portion of the sternum: can compress heart and great vessels, cause murmurs

19
Q

What is pectus carinatum?

A

“Pigeon chest”

Sternum displaced anteriorly, adjacent costal cartilages are depressed

20
Q

What is a barrel chest?

What pathology is typically associated with barrel chest?

A

Increased AP diameter resembling a barrel

COPD

21
Q

What do

“Pink Puffer”

and

“Blue Bloater”

Refer to?

A

Pink puffer = Emphysema

Blue Bloater = Chronic bronchitis

22
Q

What is a flail chest?

A

Multiple rib fractures can result in

paradoxical movemnts of the thorax

23
Q

What is tactile fremitus?

A

Palpable vibrations

24
Q

What is the proper way to percuss?

A
25
Q

What are the 5 percussion sounds?

A

Flat

Dull

Resonant

Hyperresonant

Tympanitic

26
Q

What type of sound would you hear on percussion?

A

Dull

27
Q

What type of sound would you hear on percussion?

A

Hyper-resonant

28
Q

How do you test for diaphragmatic excursion?

A
29
Q

Auscultating for lung sounds:

What do you ask pt. to do?

How do you auscultate?

A

Breathe deeply through open mouth

Compare sides in ladder like fashion

Auscultate 2 sides anterior, 4 spots posterior

Use diaphragm of stethoscope

30
Q

Describe where you would hear:

Bronchiovesicular

Vesicular

Bonchial

Breath sounds

A
31
Q

Abnormal/Adventitious Sounds

Stridor

What is it?

What causes?

A

What is it= inspiratory sound, from narrowing in upper airway

What causes= croup, epiglottitis, upper airway foreign body, anaphylaxis

32
Q

Abnormal/Adventitious Sounds

Wheezing

What is it?

What causes?

A

What is it= Expiratory sound, musical quality

What causes = Asthma, COPD

33
Q

Abnormal/Adventitious Sounds

Crackles

What is it?

What causes?

A

What is it= inspiratory sound, “popping”

What causes = pneumonia, pulm fibrosis, COPD, asthma

34
Q

Vocal resonance

Normal sounds?

Abnormal?

A

Normal sounds - words are muffled and indistinct to auscultation, whispered words are faint and indistinct (if heard at all), when pt. says “ee”, you hear a muffled long E on auscultation

Abnormal - “bronchophony”-spoken words get louder, “whispered pectoriloquy“-whispered words are lounder and clearer during auscultation, “egophony”- pt. says “ee” it sounds like “A”

35
Q

How do you document a normal lung exam?

A

“Lungs clear to auscultation bilaterally (CTAB)”

36
Q

What are the ABC’s (A-I) Mneumonic for chest X-ray interpretation?

A
37
Q
A

PCM Final Exam (7 decks)

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