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Physical Diagnosis > Exam 3 Review > Flashcards

Exam 3 Review Flashcards

1
Q

sternal angle is at rib __

A

rib 2

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2
Q

inferior wing of scapula is at rib __

A

rib 7

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3
Q

lung boundaries

A

superiorly: 3-4 cm above medial end of clavicle
inferiorly:
- midclavicular line: rib 6
- midaxillary line: rib 8
- posterior: T9 and T12

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4
Q

important things at the sternal angle of Louis

A
  1. rib 2
  2. bifurcation of trachea
  3. carina
  4. T4
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5
Q

Diaphragm boundaries at end of expiration

A

anteriorly - rib 5

posteriorly - T9

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6
Q

Barrel chest definition and associated disease(s)

A

AP diameter >/= lateral diameter

COPD

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7
Q

Flail chest definition

A

multiple broken ribs –> moves opposite to rest of chest wall with inspiration

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8
Q

Pectus carinatum definition

A

anterior protrusion of sternum

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9
Q

Pectus excavatum definition and associated disease(s)

A

depression of sternum

mitral valve prolapse

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10
Q

Kyphoscoliosis definition

A

abnormal AP diameter and lateral curvature of spine

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11
Q

Normal inspiratory:expiratory ratio

A

1:2

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12
Q

I:E ratio in asthma or COPD

A

1:3 or 1:4

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13
Q

Normal adult respiratory rate

A

10-14/minute

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14
Q

bradypnea

A

abnormally slow breathing

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15
Q

tachypnea

A

abnormally fast breathing

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16
Q

apnea

A

absent breathing

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17
Q

Hypernea/Kussmaul’s breathing definition and associated cause(s)

A

increased depth

Metabolic acidosis

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18
Q

Biot breathing definition and cause(s)

A

irregular breathing + periods of apnea

increased intracranial pressure, drug-induced, brain damage

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19
Q

Cheyne-Stokes breathing definition and causes(s)

A

irregular breathing + periods of increased and decreased rates + apnea

drug-induced, brain damage

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20
Q

Tactile fremitus definition, test, indications

A

vibration felt on chest wall when patient is speaking

place edge of hand on patient’s chest while they say 99

increased fremitus = increased lung density
decreased fremitus = decreased lung density (fat, air, fluid in chest cavity)

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21
Q

Flat sound description + associated organs

A

high pitched sound from thick, dense mass

bone or muscle

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22
Q

Dull sound description + associated organs

A

low amplitude, short duration from solid organ

liver or heart

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23
Q

Resonant sound description + associated organs

A

high amplitude, low pitched from air-filled tissue

lung

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24
Q

Tympanic sound description + associated organs

A

high pitched, hollow sound from hollow, air-filled structure

stomach

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25
Hyperresonant sound description + associated organs
low pitched, hollow sound emphysematous lung
26
The stethoscope bell is best used for [low/high] pitched sounds
low
27
The stethoscope diaphragm is best used for [low/high] pitched sounds
high
28
tracheal breath sounds
harsh, loud, high pitched over trachea inspiratory = expiratory in length
29
bronchial breath sounds
loud, high pitched over manubrium inspiratory < expiratory in length with pause in between
30
vesicular breath sounds
soft, low pitched over most lung fields inspiratory > expiratory in length and volume
31
bronchovesicular breath sounds
mixture of bronchial and vesicular over carina and mainstem bronchi inspiratory = expiratory in length
32
Rales/Crackles/Crepitation description, cause, associated disease(s)
short, continuous, nonmusical sound on inspiration (similar to velcro) caused by opening of collapsed distal airways and alveoli pulmonary edema, CHF, pulmonary fibrosis, pneumonia, atelectasis
33
Wheezes description, cause, associated disease(s)
continuous, musical, high pitched sounds during expiration narrowing of bronchi (swelling, secretion, foreign body, tumor) asthma, COPD, pulmonary edema, CH ("cardiac asthma")
34
Rhonchi description, cause, associated disease(s)
low pitched sound mucus plugging and poor movement of secretions bronchitis
35
Stridor description, cause, associated disease(s)
high pitched, inspiratory, upper airway sound turbulent airflow in upper airway (airway obstruction from mass or swelling) tumor, croup, foreign body
36
Pleural rub description, cause, associated disease(s)
grating sound on inspiration and beginning of expiration (like creaking leather) roughened or thickened pleura (inflammation, neoplasm, fibrin deposits) pneumonia, pulmonary infarction
37
Egophany test and indication
"eee" will be heard as "aaa" through stethoscope lung consolidation (fluid filled)
38
Whispered pectoriloquy test and indication
intensification of whispered "one-two-three" can be heard lung consolidation (fluid filled)
39
Bronchophony test and indication
"ninety nine" will be transmitted louder lung consolidation (fluid filled)
40
proper positions for a breast exam
1. arms at sides 2. arms overhead 3. hands pressed against hips 4. torso leaning forward
41
Cremasteric reflex is absent in patients with ___
testicular torsion
42
testicular pain causes
renal colic, appendicitis, disease of testis or epididymis (torsion, infection, tumor)
43
Flank pain causes
kidney hydronephrosis, bladder/ureter distension, referred pain from testicle or labia
44
low pelvic pain causes
salpingo-oophoritis, cystitis, pregnancy complication, hernia, ovarian torsion, tubo-ovarian abscess
45
Epigastrium contents
- stomach - pancreas - part of liver - aorta
46
Suprapubic area contents
- bladder | - uterus
47
right shoulder pain
- acute cholecystitis | - anything irritating the right hemidiaphragm
48
testicular pain
- renal colic | - appendicitis
49
periodic epigastric pain 1 hour after eating
gastric peptic ulcer
50
periodic epigastric pain 2-3 hours after eating
duodenal peptic ulcer
51
back pain
- perforated duodenal ulcer | - pancreatic pain
52
nocturnal pain
duodenal peptic ulcer
53
pain after eating
abdominal angina triad
54
tenesmus
a feeling of needing to void the bowel, but unable to defecate
55
hematochezia
bright red blood per rectum from colonic tumor, diverticular disease, ulcerative colitis
56
melena
black, tarry stool from bleeding in first section of duodenum or upper GI tract
57
caput medusae
abnormal, dilated periumbilical veins
58
spider telangiectasias
small patches of prominent, thin veins
59
Normal bowel sounds occur every ___
5-10 seconds
60
absence of bowel sounds
no sounds within 2 minutes
61
borborygmi
low pitched rumbling caused by hyperperistalsis
62
the normal span of the liver is ___
10 cm or less
63
percussing for shifting dullness helps detect ___
ascites
64
rebound tenderness indicates ___
peritoneal irritation (appendicitis, perforated bowel, etc.)
65
McBurney's point
area of the abdomen that is 2/3 of the distance between the umbilicus and the right anterior superior iliac spine
66
Fluid waves test tests for ___
ascites
67
Rovsing's sign
test for appendicitis pushing on patient's LLQ --> pain at RLQ will be positive
68
Obturator sign
tests for inflammation, appendicitis, peritoneal irritation flex and internally rotate hip
69
Psoas sign
tests for intraabdominal inflammation, appendicitis, or psoas abscess
70
Murphy's sign
tests for acute cholecystitis palpate liver on deep inspiration, feeling for gall bladder; if patient stops inspiration because of pain, test is positive

Physical Diagnosis (2 decks)

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