Exam 3 Blueprint Deck Flashcards
Hear disease risk factors
Obesity Physical activity of less than 150min/week Nutrition High levels of LDL cholesterol Untreated high blood pressure Smoking Drugs Sex and gender differences - women have smaller coronary arteries - delay in seeking treatment
3 types of normal breath sounds
Vesicular
Bronchovesicular
Bronchial
VESICULAR: Pitch Amplitude Duration Quality Location
Low Soft Inspiration > expiration Rustling, like wind in trees Peripheral lung fields where air flows through smaller bronchioles and alveoli
BRONCHOVESICULAR Pitch Amplitude Duration Quality Location
Moderate
Moderate
Inspiration = expiration
Mixed
Over major bronchi where fewer alveoli are located
(Posterior, between scapulae esp on right;
Anterior, around upper sternum in 1st and 2nd ICS)
BRONCHIAL Pitch Amplitude Duration Quality Location
High Loud Inspiration < expiration Harsh, hollow tubular Trachea and larynx
What causes increased tactile fremitus?
Conditions that increase the density of lung tissue
Ex: pneumonia
What causes decreased tactile fremitus?
Anything is obstructing transmission of vibrations
Ex: obstructed bronchus, pleural effusion or thickening, pneumothorax, emphysema
What causes Rhonchal fremitus?
When inhaled air passes through thick secretions in larger bronchi.
May decrease somewhat by coughing
What causes pleural frictions fremitus?
Inflammation or decrease in lubricating fluid
Grating sound felt when palpating
What do fine crackles sound like?
Short crackling and popping sounds
What do coarse crackles sound like?
Low pitched bubbling and gurgling
What does Pleural friction rub sound like?
Low-pitched
Superficial
Grating quality
What does stridor sound like?
Dramatic crowning sound
What does a wheeze sound like?
High pitched
Sibilant
What does sonorous rhonchi sound like?
Low pitched
Moaning or snoring musical sound
Why does pleural friction rub occur
Inflammation
Why does stridor occur
Allergic reaction, airways closing
Why does a wheeze occur?
Constricted airways
Why does sonorous rhonchi occur
Gunk in lungs
When do fine crackles occur during breathing
At the top of inspiration
Discontinuous
When do coarse crackles occur during breathing
Start early in inspiration and my be present in expiration
Discontinuous
When does pleural friction rub occur during breathing
During inspiration and expiration
Discontinuous
When does stridor occur during breathing
Starts at beginning of inspiration and ends at beginning of expiration
Continuous
When does a wheeze occur during breathing
From end of inspiration to end of expiration
Continuous
When does sonorous rhonchi occur during breathing
End of inspiration to end of expiration
Continuous
Bronchophony test
99
Egophony test
Eeeee
Whispered pectoriloquy test
1234
Steps for normal lung assessment
Inspection Palpation Percussion Auscultation Adventitious sounds
What is normal during inspection of lung tissue
AP < transverse diameter Relaxed posture Normal musculature 10-20 breaths per minute Regular No cyanosis or pallor
What is normal during palpation of lung tissue
Symmetric chest expansion
Tactile fremitus present and equal bilaterally
Diminishing toward periphery
No lumps, masses or tenderness
Normal percussion over lung tissue
Resonant
Normal auscultation over lung tissue
Vesicular over peripheral fields Bronchovesicular parasternally (anterior) and between scapulae (posterior)
Where would you feel a thrill while palpating lung tissue
On left or right 2nd and 3rd ICS
What would a thrill in 2nd and 3rd right ICS mean?
Severe aortic stenosis and systemic hypertension
What would a thrill at 2nd and 3rd left ICS mean?
Pulmonic stenosis and pulmonic hypertension
When does a left sternal border lift (heave) occur
With right ventricular hypertrophy
If you feel cardiac enlargement at apex?
Volume overload
Heart failure, etc.
