Exam 2 Questions Flashcards
Which of the following is the normal percussion note over the peripheral lung fields?
Resonance
A 70 year old male presents to the clinic for an annual with a history of smoking 1 pack of cigarettes a day for 50 years. How many pack years is that? (50). When examining his chest you note an increase in his AP diameter. What is the name for a patient with an increased AP diameter?
Barrel chest
Expected assessment findings in the normal lung are
muffled voice sounds and symmetrical tactile fremitus
The trachea bifurcates anteriorly at
the manubrial sternal angle or the angle of Louis - this is also the top of the heart and where the 2nd rib is
Unequal chest expansion will occur when
part of the lung is obstructed or collapsed
When auscultating the lungs of an adult patient, you note that over the posterior lower lobes you hear low-pitched soft breath sounds with inspiration being longer than expiration. Those are
normal and vesicular
Broncophony on auscultation is associated with
pulmonary consolidation as in pneumonia
Percussion over an area of atelecisis in the lungs would reveal
dullness
When auscultating a patient’s lungs you ask them to say “EEE” and you hear a clear “AAA”, you note this as E to A changes and know that it is consistent with
pulmonary consolidation like lobular pneumonia
A physical finding consistent with emphysema is
hyper-resonance
Name the following condition: an allergic hypersensitivity to certain inhaled allergens, irritants, microorganisms stress or and exercise that’s characterized by bronchopasm
Asthma
The following condition is an inflammatory condition of the lung, affecting primarily the alveoli, caused by infection with either a virus, a bacteria or other microorganism, and the alveoli become consolidated
pneumonia
We don’t see retraction phenomenon in
a benign condition
Exam of the male breast includes
inspection and palpation
The 4 lymph nodes in the axilla:
central, pectoral, sub scapular and lateral. Epitrochlear is not part of the axilla
Mrs. R reports a recent breast inflammation and you would expect ____ axillary node enlargement
ipsilateral
Which 2 heart chambers are most anterior in the chest?
Right atrium and ventricle. Remember that the heart is twisted in the body, and there’s very little of the left ventricle anterior and there’s no left atrium.
In the inspection of a normal adult, where would you expect to palpate the apical impulse?
At the 5th ICS at the mid-clavicular line
Systole coincides with the
carotid artery pulse (S1)
What is heard louder at the base of the heart?
S2
What is closure of the mitral and tricuspid valves?
S1
Closure of the pulmonic and aortic valves?
S2
In cardiovascular assessment, a thrill is
A murmur that is palpable. (level 4,5,6) - turbulent blood flow which is palpable feeling through the chest wall
Afterload is
the resistance against which the ventricle must pump blood. (or the opposing pressure the ventricle must generate to open the aortic valve against the pressure in the aorta)
Preload
the volume of blood in the ventricle at the end of diastole
the findings from your assessment of a 70 y/o male include swelling in his ankles and jugular venous pulsations 7cm above the sternal angle. Is this normal? No. What’s wrong with him?
When you have increased pressure in the right side of the heart, you’re going to have visible pulsations and edema in the feet.
When the left side of the heart has too much pressure, there will be
buildup of fluid in the lungs
An S4 heart sound is
a rumbling sound heard because the ventricle is resistant to blood filling from the atrial contraction or atrial kick.
S3 and S4 are both
ventricular filling sounds
S3 is at beginning of
rapid filling during diastole
S4 is at the end of
diastole with atrial contraction/atrial kick
S4 is called an ___ gallop
atrial
S3 is called a ____ gallop
ventricular
S3 and S4 combined are called a ____ gallop
summation
John doe has a murmur heard after S1 but before S2. This murmur is classified as
Mitral regurgitation, systolic (it could also be aortic stenosis)
Which of the following would cause a person to be at the highest risk for peripheral vascular disease of the venous system:
Prolonged standing without moving the muscles of your legs
When does peripheral vascular pressure fall to the lowest point?
During diastole
Posterior tibial pulse can be found behind the
medial malleolus
To assess the dorsalis pedis artery, it’s lateral to the
extensor tendon of the great toe
WP is a 35 year old with infection in left foot. Which of the following would you expect to find:
Enlarged and tender inguinal nodes.
Heard louder at the apex of the heart?
S1
What sound heard over the abdominal aorta would suggest either an aneurism, stenosis, or other problem in the main vessels of the abdomen?
Bruit
Which of the following is not normally palpable in the adult?
Gallbladder
main reason we do auscultation before percussion and palpation is to
prevent the distortion of bowel sounds.
More than 95% of aortic aneurisms are located
ABOVE the umbilicus
The normal liver span at the mid-clavicular line is
6-12
Mrs. T is complaining of tenderness along the posterior costovertebral angels, this is most indicative of a
kidney inflammation
Your patient complains of an inability to void. What finding on exam makes you think his bladder is full?
Subprapubic dullness to percussion.
You suspect that Mrs. W has appendicitis. Which of the following procedures would not be an expected finding?
The Murphy’s sign
While hooking your fingers under the ribs on the right side, you ask the patient to take a deep breath and they are unable to complete the breath?
Cholecystitis which is inflammation of the gallbladder
Jane Doe has a diastolic murmur, which are possible?
Aortic regurgitation and mitral stenosis
Patient complains of sore on lower leg that doesn’t seem to be getting better. You suspect venous insufficiency. Which of the findings below reflects venous insufficiency?
All of them (soreness in legs, hyper pigmentation, ulcerations present usually on medial side, leg will be warm to the touch)
Patient complains of severe pain in right foot and you suspect arterial insufficiency. Findings include:
Pallor of the foot on elevation
If you note the presence of a large right epitrochlear lymph node, you want to
examine the areas that feed into that. Hand
