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Patient Evaluation > Exam 3 - Chest Exam > Flashcards

Exam 3 - Chest Exam Flashcards

1
Q

ribs 1-7 articulate with _______.

A

sternum

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2
Q

ribs 8, 9, 10 articulate with ________________.

A

costal cartilages

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3
Q

11th rib is

A

floating, feel tip laterally

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4
Q

12th rib is

A

floating, feel tip posteriorly

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5
Q

2nd rib articulates with

A

sternal angle

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6
Q

Inferior angle of scapula is at level of the ___ rib posteriorly.

A

7th

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7
Q

you can only access middle lobe sounds __________.

A

anteriorly

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8
Q

apex of lung is ______ above clavicle

A

2-4 cms

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9
Q

Lower border of lung at 6th rib at ___________________.

A

mid clavicular line

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10
Q

lower border of lung at 8th rib at ________________.

A

midaxillary line

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11
Q

Lower border for lung at 10th thoracic spinous process

A

posteriorly

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12
Q

The sternal angle bifurcates into the main stem bronchi at _____________ anteriorly and at __ posteriorly .

A

sternal angle, T4

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13
Q

_________ space is between the visceral pleura (on the organ) and parietal pleura

A

potential

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14
Q

inspection of chest

A 
masses/lesions
position of trachea
shape/symmetry
chest deformities
AP/lateral diameter
inspiratory retractions
local lag
Rate (14-20)
Rhythm, death, effort
use of accessory muscles
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15
Q

Palpation

A

ID areas of tenderness or suspicious
ID masses
Respiratory expansion - this can confirm local lag

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16
Q

Tactile Fremitus

A

palpable vibrations with speech

decreased over the heart, scapulae

scouting technique , compare B/l

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17
Q

Indications in which TF will be dampened

A 
soft voice
thick chest wall
obese
COPD
plural effusion
fibrosis
penumothorax
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18
Q

percussion

A

helps detect air-filled vs. fluid filled or solid

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19
Q

vesicular

A

soft, low pitched

inspir > expir = normal

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20
Q

Bronchial

A

louder, high pitched (sternal notch)

expir > inspir = normal

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21
Q

Bronchovesicular

A

intermediate sound and pitch

inspir = expir

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22
Q

tracheal

A

very loud, high pitch

inspir = expir

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23
Q

adventitious sounds

A 
crackles
wheezes
rhonchi
stridor
pleural friction rub
24
Q

crackles (rales)

A

intermittent, non musical, brief - fine or coarse

small airways popping open with inspiration
air bubbles moving through secretions

25
Q

crackles are normally heard at ______________.

A

anterior bases, after prolonged bed rest, w/ HF

heard throughout the respiratory cycle

26
Q

wheezes

A

longer than crackles, musical, may clear with a cough ( so check again)
high pitch, hiss or shrill quality
suggests a narrowed pathway

NOT heard throughout the respiratory cycle

27
Q

Rhonchi

A

low pitch, snoring quality
longer than a crackle
suggests larger airways
may clear with cough

NOT heard throughout the respiratory cycle

28
Q

Stridor

A

inspiratory wheeze, especially in neck

indicates partial obstruction of larynx or trachea

immediate TX required

29
Q

Pleural Friction Rub

A

inflamed, roughened pleural surfaces grating against each other, creaking leathery sound
Usually confined to a small area

If effusion develops into the potential space, then the rub may disappear

30
Q

Bronchophony (spoken word)

A

if fluid in lung then word is louder and clearer

31
Q

Egophony

A

eeeeeeeww, fluid will make it sound more like ayyyyyyyyy

32
Q

Whispered pectoriloquy (whispered word)

A

fluid will enhance it, normally it is really hard to hear

33
Q

tachypnea

A

rapid / shallow breathing - acidosis, restrictive lung disease, pain, pregnant

34
Q

Hyperpnea

A

rapid and deep, exercise, anxiety and hypoxic people

35
Q

Bradypnea

A

slow breathing, diabetic coma, drug induced increased ICP

36
Q

Kussmaul

A

deep breathing but a fast normal or slow rate

METABOLIC ACIDOSIS

37
Q

Cheyne- Stokes

A

alternating periods of hyperpnea and apnea

can be normal in children and older adults when sleeping

CHF, drugs or brain damage

38
Q

Ataxic Breathing (Biot’s)

A

unpredictable, irregular
shallow, deep, apnea
brain damage

39
Q

Obstructive Breathing

A

prolonged expiration, increased resistance in narrowed airway, asthma,, FB,

40
Q

Pectus excavatum - funnel chest

A

depressed sternum
compressed heart and great vessels

reconstructive surgery if severe

41
Q

Pectus carinatum - pigeon chest

A

sternum is anterior , increased AP diameter

depresses costal cartilages laterally

42
Q

Thoracic Kyphoscoliosis

A

hunch back with vertebral rotation

43
Q

Forced Vital Capacity (FVC)

A

measure the amount of air you can force out after you inhale as deep as you can.

44
Q

Forced expiratory Volume (FEV)

A

measures the amount of air one can exhale with force in one breathe.

1 sec. FEV1
2 sec FEV2
3 sec FEV3

FEV1/FVC

45
Q

Forced Expiratory flow 25%-75%

A

this measures the air flow halfway through an exhale

46
Q

Peak Expiratory Flow (PEF)

A

measures how much air you can exhale when you try your hardest.

measured at the same time as FVC

47
Q

Maximum voluntary ventilation (MVV)

A

measures the greatest amount of air you can breathe in and out during 1 minute

48
Q

Slow vital capacity (SVC)

A

measures how much air you can breathe out slowly after you inhale as deep as you can

49
Q

Total Lung Capacity (TLC)

A

measures the amount of air in your lungs after you inhale as deep as possible

50
Q

Functional Residual Capacity (FRC)

A

measures the amount of air in your lungs at the end of a normal exhaled breath

51
Q

Residual Volume (RV)

A

measures the amount of air in your lungs after you have exhaled completely. It can be done by breathing in helium or nitrogen gas and seeing how much is exhaled

52
Q

Expiratory reserve volume (ERV)

A

measures the difference between the amount of air in your lungs after a normal exhale (FRC) and the amount after you exhale with force (RV)

53
Q

medication for loss of consciousness

A

etomidate, ketamine, propofol, versed

54
Q

paralyzing agent

A

succinylchloride

55
Q

what is better for patient who have not faster

A

RSI

Patient Evaluation (29 decks)

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