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PD 1 > Final Exam > Flashcards

Final Exam Flashcards

1
Q

There is no gold standard for

A

ROS

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2
Q

Red flags:

A

indicate symptoms that are worrisome for serious illness
ex. CP

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3
Q

LOC due to

A

-dysfunction of the heart, NS
-psychogenic attacks
-orthostatic hypotension
-seizures

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4
Q

CP due to

A

-M.I.
-GERD
-musculoskeletal injury/inflammation
-nerve related problems

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5
Q

SOB due to

A

-asthma
-COPD
-infection
-pneumothorax
-HF
-pericardial tamponade
-hypotension
-blood clots

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6
Q

Hematemesis causes

A

-peptic ulcers
-gastric cancer
-esophageal cancer
-upper GI bleed

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7
Q

Blood in stool causes

A

-rectal cancer
-colon cancer
-dysentery
-hemorrhoids
-anal fissure

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8
Q

Hematuria causes

A

kidney stones, infection, bladder cancer

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9
Q

Hemoptysis causes

A

-lung cancer
-pulmonary edema
-TB
-pneumonia
-lung trauma

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10
Q

Unintentional weight loss

A

-hyperthyroidism
-diabetes
-food intolerances
-malabsorption
-cancer
-HF
-infections
-dental problems
-medications

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11
Q

Thunderclap headache

A

**severe and sudden headache which peaks in one minute due to lifethreatening conditions **
-may be associated w/ nausea, vomiting or LOC
-brain bleed
-ruptured artery
-meningitis
blood clot
-HTN

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12
Q

Epidermis

A

outermost layer of the skin protecting you from outside environment
-provides warmth
-new skin cells
-contains melanin

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13
Q

Dermis

A

thick middle layer forming “true skin”
-capillaries + nerves
-sweat glands
-hair follicles

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14
Q

Hypodermis

A

bottom skinlayer composed of fat

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15
Q

Primary lesion

A

develop as a direct result of disease process /onset

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16
Q

Primary lesion types

A

-macule
-papule
-patch
-plaque
-nodule

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17
Q

Primary lesion types

A

-macule
-papule
-patch
-plaque
-nodule

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18
Q

Secondary lesion

A

irritated or exacerbated by patient

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19
Q

Secondary lesion examples

A

-erosion
-fissure
-ulceration

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20
Q

Distribution of skin lesions

A

-localized or generalized
-symmetric?
-discrete/ grouped
-confluent (small into large)
-cleavage plane (along skin tension lines)

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21
Q

Macule

A

non palpable w/ distinct borders less than 1cm

ex. freckle

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22
Q

Patch

A

nonpalpable w/ distinct borders >1cm

ex. vitiligo

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23
Q

Papule

A

palpable solid lesion less than 1cm/10mm

ex. wart

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24
Q

Plaque

A

palpable solid lesion >1cm/10mm

ex. psoriasis

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25
Q

Nodule

A

palpable solid lesion >1cm + taller than it is wide

ex. dermatofibroma

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26
Q

Tumor (mass)

A

solid firm lesion >2cm/20mm

ex. metastatic carcinoma

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27
Q

Wheal

A

edematous papules/plaques caused by swelling in dermis (allergic rxn)

ex. urticaria, PPD

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28
Q

Vesicle

A

small/superificial fluid filled blister less than 1cm

ex. blister

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29
Q

Pustule

A

pus filled vesicle

ex. acne

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30
Q

Bulla

A

large/raised fluid filled lesion >10mm

ex. large blister

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31
Q

Excoriation

A

superficial excavations of epidermis that result from scratching

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32
Q

Erosion

A

skin defect where there has been loss of epidermis only

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33
Q

Lichenification

A

skin thickening as a result of chronic rubbing
-accentuation of skin lines

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34
Q

General survey

A

-alert/awake/oriented
-no acute distress
-WNWD
-hygiene
-ambulation

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35
Q

Normal BP

JNC BP guidelines

A

<120/<80

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36
Q

Pre-HTN

JNC BP guidelines

A

120-139/80-89

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37
Q

Stage 1 HTN

JNC BP guidelines

A

140-159/90-99

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38
Q

Stage 2 HTN

JNC BP guidelines

A

160+ / >100

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39
Q

Normal HR

A

60-100

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40
Q

Diaphragm moves … during inhalation

A

down

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41
Q

Diaphragm moves … during exhalation

A

up

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42
Q

Normal RR

A

12-16

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43
Q

Fever =

A

100.4 +

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44
Q

CN 7/Facial nerve

A

facial expression (smiling and frowning)

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45
Q

Weber and Rinne tests for

A

CN 8

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46
Q

Inspect skin for:

A

-color
-temp
-masses
-lesions
-turgor

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47
Q

Inspect nails for:

A

-capillary refill <2 seconds
-color (cyanosis, jaundice)
-shape (clubbing, koilonychia)
-lesions (Beau’s, splinters, terry’s, pitting)

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48
Q

Inspect hair for:

A

-scalp (bugs, lesions, seborrhea)
-texture
-quantity/distribution

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49
Q

Inspect neck for:

A

-symmetry
-masses/goiter
-lesions/scars
-tracheal deviation
-lymph nodes (size, shape, tenderness, mobility, delimitation)
-hyoid, cricoid, thyroid cartilage

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50
Q

Anterior triangle (neck)

A

-anterior SCM
-mandible
-midline neck

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51
Q

Posterior triangle (neck)

A

-posterior SCM
-trapezius
-mid clavicle

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52
Q

Inspect head for:

A

-trauma
-palpate bones
-Battle sign

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53
Q

Ear inspection:

A

-masses/lesions
-trauma/perf
-position
-mastoiditis
-discharge
-otoscopy
-Rinne/Weber test (CN 8)

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54
Q

Normal Weber test

A

no lateralization of sound
-tuning fork on forhead

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55
Q

Unilateral conductive hearing loss (Weber)

A

sound lateralizes towards affected ear
-not permanent
-cerumen impaction

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56
Q

Unilateral sensorineural loss (Weber)

A

sound lateralizes to normal/better hearing side
-inherited siorders
-drugs
-blow to the head
-noise exposure
-presbycusis

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57
Q

Rinne Test

A

tests for conductive hearing loss ONLY
-evaluates one ear at a time
-differentiates sound trasnmitted through air conduction from mastoid bone conduction

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58
Q

Positive Rinne Test

A

NORMAL = AC>BC
-no significant conductive hearing loss

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59
Q

Nose/sinus inspection

A

-masses/lesions
-symmetry
-perforation/trauma
-color
-rhinoscopy

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60
Q

CN 1

A

olfactory (smell)

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61
Q

Mouth/pharynx inspection:

A

-masses/lesions/color
-trauma
-discharge
-fissures
-hard/soft palate
-gingivae and teeth
-shape/number
-hygiene
-tongue
-uvula
-pharynx

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62
Q

Brachial artery

A

runs through antecubital fossa

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63
Q

Importance of estimating systolic BP by palpation

A

avoids lower systolic reading by auscultory method

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64
Q

RR =

A

one chest rise and fall

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65
Q

Battle sign =

A

basal skull fracture

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66
Q

Icterus

A

jaundice (high bilirubin)

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67
Q

Koilonychia

A

sign of iron deficiency anemia or hemochromatosis (liver conditions)

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68
Q

Beau’s lines

A

indentations running across nails due to:
-interruption of growth under cuticle via injury or illness
-zinc deficiency
-chemotherapy

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69
Q

Clubbing

A

indication of low O2 or respiratory disease

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70
Q

Terry’s nails

A

red or brown transverse band on fingernail bed due to :
-chronic condition (DM or liver failure)
-aging

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71
Q

Pitting of nails

A

indentations due to:
-psoriasis
-eczema
-joint inflammation

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72
Q

Eye exam:

A

-visual acuity
-pupils
-alignment + motility
-visual fields
-lids, conjunctiva, sclera, cornea
-optic nerve, vessels, macula

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73
Q

Visual acuity

A

measurement of eye ability to distinguish shapes and details of objects at a distance

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74
Q

Snellen chart

A

20 feet away

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75
Q

Jaeger chart

A

handheld 12-14 inches away

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76
Q

20/40 vision

A

pt can only read at 20 ft the same ltters that a “normal” person can read at 40 ft away

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77
Q

legally blind =

A

20/200

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78
Q

Eyelashes function

A

protect eyes from small particles
-danger warning
-highly sensitive to touch

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79
Q

Eyelids function

A

protects the eye and keeps cornea from drying out
-automatic reflexes

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80
Q

Sclera

A

maintains eyeball shape and protects from injury
-covered by conjunctiva (moisturizes eye)

whites of eyeball

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81
Q

Iris

A

colored part of eye that regulates amount of light entering the eye
-helps to refract light and focus to retina
-constricts pupil in bright light
-dilates pupil in darkness to let in light

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82
Q

Pupil

A

changes in size (controlled by iris)
-constricts in bright light
-dilates in darkness

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83
Q

Anterior chamber

A

front part between cornea and iris
-filled w/ aqueous humor
-nourishment to eye
-keeps eyeball inflated

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84
Q

Mydriasis

A

dilated pupil

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85
Q

Mitotic pupil

A

constricted

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86
Q

Caruncle

A

small pink globular portion in inner corner (medial canthus)
-oil and sweat glands
-moisturizes
-protects from bacteria

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87
Q

Lacrimal apparatus

A

-lacrimal glands (secrete tears)
-lacrimal sac + duct (convey tears into nasal cavity)

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88
Q

Lacrimal gland

A

secretes tears within orbit above lateral eye
-cleanses and protects eyes
-drains to puncta (inside upper/lower eyelids)

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89
Q

pathway of tears

A

lacrimal gland -> puncta -> canaliculi

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90
Q

Lacrimal sac

A

connects canaliculi to nasolacrimal duct

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91
Q

Conjunctiva

A

mucous membrane covering front of eye (sclera) and lines inner eyelids
-protection
-lubrication by prod. mucous and tears
-does not cover cornea

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92
Q

Lens

A

clear part behind iris that focuses light and images on the retina
-in front of vitreous body
-works w/ cornea to focus light on retina

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93
Q

Cataract

A

clouding of eye’s lens

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94
Q

Retina

A

thin layer of tissue lining back of the eye near optic nerve
-receives light from lens
-converts light into neural signals
-sends signals to brain for visual recognition

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95
Q

Macula

A

part of retina that processes what you see directly in front of you
-contains fovea

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96
Q

Fovea

A

depression within retina where visual acuity is the highest
-repsonsible for central vision

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97
Q

Vitreous humor

A

allows light to reach the retina and maintains eyeball shape

98
Q

Cranial nerves innervating motor, sensory, and autonomic structures in the eye

A

CN 2 - optic
CN 3 - oculomotor
CN 4 - trochlear
CN 5 - trigeminal
CN 6 - abducens

99
Q

CN 2

A

optic nerve
-critical to vision
-extension of CNS
-sends light signals to brain

100
Q

CN controlling lateral rectus muscle

A

CN 6

101
Q

CN controlling superior oblique

A

CN 4

102
Q

CN controlling majority of extraocular muscles

A

CN 3

103
Q

Optic cup

A

in the center of optic disc where optic nerve connects to retina

104
Q

Disc to Cup to disc ratio

A

2:1
-normal = less than 0.5

105
Q

CN 3 - oculomotor

A

-allows movement of eye muscles (superior/medial/inferior rectus, inferior oblique)
-constriction of pupil
-focusing eyes + position of upper eyelid
-works w/ other CN to control eye movements
-responsible for downgaze

106
Q

Orbit

A

bony cavity in the skull housing the eye, the muscles moving the eye, lacrimal gland, BV + nerves

107
Q

Visual fields

A

how wide of an area your eye can see when you focus on a central point

108
Q

Rods

(retina)

A

dim light vision (size, shape, brightness)
-found in periphery of eye
-no color vision

109
Q

Cones

(retina)

A

responsible for color vision (photoreceptors)
-found near fovea (front)

110
Q

Optic disc

A

where optic nerve exits eye into brain
-no light sensitive cells

blind spot

111
Q

Age -related Macular degeneration (AMD)

A

blurs central vision
-damage to macula

112
Q

Retinal detachment

A

emergency situation where retina pulls away from normal position
-separates retinal cells from BV/O2
-can result in permanent vision loss

113
Q

Signs of retinal detachment

A

-reduced vision
-sudden onset of floaters
-flashes of light
-curtain like shadow over vision
-gradual reduced peripheral vision
-blurred vision

114
Q

Diabetic retinopathy

A

damage to BV at retina
-may be asymptomatic or mild at first
-retinal exudates

115
Q

Large cup to disc ratio

A

glaucoma

116
Q

Central retina artery occulsion (CRAO)

A

emergency when one of the vessels attached to retina is blocked usually due to embolus
-sudden loss of vision in one eye
-causes: blood clot, cholesterol deposit
-high risk: age, HTN, glaucoma, diabetes
-treatment: fluid release, hyperbaric O2, anticoags
-cherry red spots on exam

117
Q

AV nicking

A

arteriole corssing venule resulting in compression of vein with bulging on either side
-hourglass shape
-eye disease caused by HTN

118
Q

Cotton wool spots

A

opaque fluffy white patches on retina
-DM
-HTN

119
Q

Retinal hemorrhage

A

abnromal bleeding within BV of retina
-vision problems often temporary
-causes: diabetic retinopathy, retinal vein occlusion, ocular ischemic syndrome, sickle cell retinopathy

120
Q

Roth spots

A

white centered retinal hemorrhage associated w bacterial endocarditis

121
Q

External ear inspection:

A

-asymmetry
-deformities (cauliflower ear)
-piercings
-erythema/edema (otitis externa)
-scars
-lesions
-mastoid erythema/swelling (mastoiditis)

122
Q

Cone of light R ear

A

5 o clock

123
Q

Cone of light L ear

A

7 o clock

124
Q

Parts of TM

A

-malleus/umbo
-pars tensa
-pars flaccida
-cone of light

125
Q

Lateral process of malleus

A

transmits sound vibrations from eardrum to incus

126
Q

Pars tensa

A

main portion of TM

127
Q

Pars tensa

A

main portion of TM

128
Q

Pars flaccida

A

small flaccid portion of TM

129
Q

Cardiac inpsection:

A

-size/shape/symmetry (AP diameter)
-deformities (excavatum, carinatum)
-scars/lesions
-lip/skin color
-heaves
-apical impulse

130
Q

Scoliosis

A

side to side spine curvature

131
Q

Lordosis

A

exaggerated lumbar curvature

132
Q

Kyphosis

A

exaggerated cervical/thoracic curvature of the spine

133
Q

Normal heart of chest Xray

A

should be 1/2 of diaphragm length

134
Q

Thrills

A

vibratory sensation overlying area of turbulence, indicating loud heart murmur caused by incompetent valve
-felt with metacarpal heads at aortic, pulmonic, mitral and tricuspid valves
-palpable murmur

135
Q

Heaves/lifts

A

precordial impulse (visible chest wall pulsations) palpated in pts w/ cardiac or respiratory disease
-felt with base of palm
-RV hypertrophy
-valvular regurgitation
-pressure overload
-cardiac aneurysms

136
Q

Heart PMI

A

apex at L MCL 5th ICS

137
Q

Aortic valve

A

RSB, 2nd ICS
-listen/feel for thills or AAA

semilunar valve

138
Q

Pulmonic valve

A

LSB, 2nd ICS
-listen/feel for thrills + palpable P2

semilunar valve

139
Q

Tricuspid Valve

A

LSB 5th ICS
-listen/feel for thrills, RV heave, L atrial enlargement

AV valve

140
Q

Mitral Valve

A

L MCL 5th ICS
-listen/feel for thrills/ PMI

AV valve

141
Q

Normal heart sounds

A

-expiration S2 = single
-inspiration S2 = 1st AV closure (A2), 2nd pulmonic closure (P2)
-A2 heard widely all over chest
-P2 is soft and only heard at pulmonic region (A2 still louder here)

142
Q

Split S2 auscultation

A

LSB 2nd ICS using diaphragm
-semi-recumbent position in quiet insp
-intensity elevated in P2 louder than A2

143
Q

S1

A

closure of AV valves as ventricular pressures exceed atrial pressures + beginning of systole
-louder at apex

“lub”

144
Q

S2

A

closure of semilunar valves + beginning of diastole
-louder at base

145
Q

Splitting of S2

A

A2 and P2 are not synchronized during inspiration
-vibration of valve leaftlets and structures
-decreased intrathoracic pressure
-LSB 2nd ICS

146
Q

Gallop

A

rapid HR of ventricular filling characterized by ventricular bulge and low frequency sound
-extra heart sound before S1
-likely LV failure
-heard RSB or LSB or epigastrium
-insp. increase in intensity = RV gallop

147
Q

Snaps/clicks

A

short high pitched sounds in pts w/ heart disease indicating structural changes within valve
-systolic ejection murmurs
-abrupt opening of semilunar
-rapid distension of proximal aorta/pulmonary artery at onsent of ejection

148
Q

Pericardial friction rub

A

diagnosis for pericarditis
-extra heart sound w/ 2 systolic components + one diastolic component
-sandpaper on wood
-variable intensity with cardiac cycle phase

149
Q

Murmurs

A

sounds by turbulent blood flow through heart heard with stethoscope

150
Q

S3

A

normal in young/healthy adults
-impaired LV function
-raised end diastolic pressure
-low pitches at apex (use bell)
-(gallop) when tachy

151
Q

S4

A

accompanies and is due to atrial systole
-only heard in sinus rhythm
-loud in atrial hypertrophy (IHD, HTN)
-low pitched at apex (bell)

152
Q

Grade 1 Murmur

A

soft urmur only heard under quiet conditions

153
Q

Grade 2 murmur

A

soft murmur heard under noisy conditions

154
Q

Grade 3 murmur

A

easily heard prominent murmur

155
Q

Grade 4 murmur

A

louder murmur with associated thrill

156
Q

Grade 5 murmur

A

even louder with stehtoscope tilted against chest

157
Q

Grade. 6murmur

A

can be heard 5-10mm away from chest

158
Q

Estimate max HR

A

200–age

159
Q

Heart rhythms generated by

A

SA node sends electrical signal from atria to AV node, to ventricles

160
Q

SA node

A

pacemaker of the heart
-generates electrical signal causes atria. tocontract

161
Q

Erb’s Point

A

LSB 3rd ICS
-aortic regurgitation
-pt sits up and leans forward

162
Q

Aortic Regurg

A

-soft/high pitched
-early diastolic
-decrescendo
-pt sits up and leans forward

163
Q

Aortic murmurs positioning

A

sit erect and lean forward

164
Q

Mitral stenosis positioning

A

left lateral decubitus

165
Q

Near vision / myopia

A

able to read newsprint
-deviation: unable to read small print occurs w/ aging

166
Q

Distant vision / hyperopia

A

snellen or LogMAR charts
-deviation: denominator of 40 or more on snellen with corrective lenses

167
Q

Strabismus

A

abnromal aligment of eyes

cross eyed

168
Q

Nystagmus

A

rapid involuntary movement of eyes

169
Q

Hirschberg corneal light reflex test

A

assess for strabismus by shining light and observing for reflection off of cornea
-normal = slightly nasal reflection from cneter of cornea

170
Q

Esotropia

A

one eye turned inwards

171
Q

Exotropia

A

eye turned outwards

172
Q

Turbinates

A

cleanse and humidify air passing from nostrils to lungs

173
Q

Absent transillumination

A

sinus filled with pus

174
Q

Caries

A

dental cavity

175
Q

Teeth numbers

A

32 teeth counting starts from R wisdom tooth and ends bottom R wisdom tooth

176
Q

Yellow tongue coating indicates

A

digestive system disorders

177
Q

Thick white tongue coating indicates

A

intox or infection

178
Q

Leukoplakia

A

does not result due to cancer but accelerates risk of developing cancer
-tobacco use
-HPV
-abrasive oral products
-braces, dentures, retainers
-jagged teeth
-poor oral hygiene
-tongue/cheek biting
-excessive ETOH use

179
Q

Tongue thrush

A

yeast infection by Candida

180
Q

Tongue deviation

A

due to damage of hypoglossal nerve (12th CN)

181
Q

Uvula function

A

prevents food and liquid from going up your nose while swallowing

182
Q

Tonsils

A

contain WBCs to kill germs entering through nose/mouth

183
Q

Tympany

A

heard over air filled structures
-small/large intestine
-gas in GI tract
-lungs

184
Q

Dullness

A

heard over fluid or solid organs and can be used to determine margins
-liver
-spleen
-splenomegaly. inTraube’s space
-enlarged organ
-distended uterus/bladder
-ascites

185
Q

Percussion of liver span

A

-4-8cm midsternal line
-6-12cm R MCL

186
Q

Upper border of liver dullness

A

between R MCL 5th ICS, midaxillary 7th ICS
-scapular line 9th ICS (inferior)
-hyperresonance below = hyperinflation (emphysema)

187
Q

Splenic dullness

A

9th-11th L ICS posterior to midaxillary line
-7cm wide

188
Q

Traube’s space

A

L midaxillary line 6th ICS + L MCL

189
Q

Tests for ascites

A

-shifting dullness
-fluid wave

190
Q

Appendicitis

A

-Mcburney’s point
-low grade fever
-constipation or diarrhea
-nasuea/vomiting

191
Q

Appendicitis PE

A

-rebound tenderness
-Rovsing’s sign
-Psoas sign
-Obturator sign
-WBC count and CRP
-CT scan
-ultrasound

192
Q

Guarding

A

abdominal muscles tense when palpating
-indicates peritonitis or ruptured appendix

193
Q

Abdominal exam order

A
  1. inspect
  2. auscultate
  3. percuss
  4. palpate
194
Q

Pulmonary exam order

A
  1. inspect
  2. palpate
  3. percuss
  4. auscultate
195
Q

Why auscultate before palpate during abdominal exam?

A

ensures that examiner is listening to undisturbed bowel sounds

196
Q

Aortic bruits

A

heard in epigastrim; may indicate AAA

197
Q

Renal artery bruits

A

upper quadrants; sign of renal artery stenosis causes by HTN

198
Q

Iliac/femoral bruits

A

lower quadrants; may be sign of periperal atherosclerosis

199
Q

2nd ICS MCL = landmark for

A

pneumonia

200
Q

4th-5th ICS = landmark for

A

chest tube placement

201
Q

Contraction of diaphragm

A

-increase thoracic cavity volume (expansion)
-decrease intrathoracic pressure causes air to rush into lungs

202
Q

Relaxation of diaphragm

A

-decrease thoracic cavity volume (recoil)
-intrathoracic pressure increases forcing air out of lungs

203
Q

Pneumothorax

A

abnormal collection of air in pleural space

collapsed lung

204
Q

Tension pneumo

A

air leaks outside of the lung into pleural cavity
-air trapped between pleura and lung
-tracheal deviation (move to unaffected side)

205
Q

Dyspnea ROS

A

-awareness of SOB
-at rest or exertion
-new. orold
-decreased exercise tolerance
-difficulty taking deep breath

206
Q

Lung sounds over trachea and bronchi

A

louder, high pitched and harsh sounding than lung tissue (vesicular sounds)

207
Q

Inspiration

A

-contraction of diaphragm (moves down)
-scalenes elevate upper ribs
-SCM elevates sternum
-pec major/minor pull ribs outwards
-serratus anterior elevates ribs
-lat dorsi elevates lower ribs

208
Q

Expiration

A

-recoil
-abd muscles push diaphragm up
-internal intercostals depress ribs
-increased work of breathing recruits accessory muscles (retractions)

209
Q

Retractions

A

inward movement of the chest wall caused by obstructive airway disease
-intercostal and supraclavicular
-nasal flaring
-increased expiratory phase + RR

210
Q

Tactile fremitus

A

air poor conductor of low frequency sound that is more prominent in upper portion of back

211
Q

Tactile fremitus increased

A

-inflammation
-pneumonia
-atelectasis
-fibrosis
-tumor
-increased density of lung tissue

212
Q

Tactile fremitus decreased

A

-air trapping and decreased density of lung tissue
-asthma
-COPD
-bronchial obstruction
-pneumothorax

213
Q

Normal diaphragmatic excursion

A

3-5cm

214
Q

Tracheal sounds

A

-insp and exp timing equal
-heard over trachea and neck
-loud

215
Q

Bronchial sounds

A

-heard over manubrium and large airways
-exp longer than insp
-loud

216
Q

Bronchivesicular sounds

A

-insp and exp almost equal
-1st + 2nd ICS between scapula

217
Q

Vesicular sounds

A

-insp greater than exp
-heard over lung tissue
-soft

218
Q

Crackles (rales)

in the tails

A

-short, popping, discontinuous
-fine: wood burning in fireplace
-coarse: lower pitch + longer
-cause: air being forced through narrow airways w/ mucus, pus, fluid; opening of deflated alveoli
-conditions: infection, inflammation, CHF

nonmusical

219
Q

Wheezes

A

high pitched musical sounds through both insp and exp
-cause: airway constriction
-conditions: asthma, COPD, bronchitis

rapid airflow; “silent chest” after wheeze = bad

220
Q

Rhonchi

in the bronchi

A

lower pitched than wheezes + loudest during expiration
-“snoring” quality
-cause: secretions in large airways that clears with cough
-conditions: bronchitis, pneumonia

variant of wheeze

221
Q

Friction rub

A

deep harsh grating primarily during insp
-cause: friction of inflamed pleural surfaces rubbing together
-conditions: pleuritis or pneumonia

222
Q

Fine crackles

A

-soft
-high pitched
-mid. tolate insp
-sudden inspiratory opening of lungs
-fibrosis (velcro) interstitial lung disease

223
Q

Coarse crackles

A

-popping sounds
-early insp lasting throughout exp
-long duration
-disappear w/ cough
-COPD, asthma, bronchiectasis, pneumonia, HF

224
Q

Crackles (rales) in HF

A

opening of airways narrowed by peribronchial edema
-coarse

225
Q

Expriatory crackles

A

most often insp but can hear in exp in COPD and bronchiectasis

226
Q

Stridor

A

-loud pitched
-musical
-upper respiratory
-louder over neck
-mostly inspiratory
-croup in children

227
Q

Hamman’s sign

A

crunching or crackling sound best heard over 3-5th ICS during heartbeat
-pneumomediastinum (air leaked into mediastinum)
-pneumothorax

228
Q

Hamman’s sign

A

crunching or crackling sound best heard over 3-5th ICS during heartbeat
-pneumomediastinum (air leaked into mediastinum)
-pneumothorax

229
Q

Loud bronchophony indicates

A

pneumonia or other consolidation

230
Q

Whispered pectoriloquy

A

-muffled/absent = normal
-clear/loud = abnormal

231
Q

Biot’s respiration

A

ataxic respiration
-periodic breathing
-hyperpnea + apnea
-poor prognosis
-neural damage

232
Q

Kussmaul breathing

A

metabolic acidosis (DKA) + hyperpnea
-K = ketones
-U = uremia
-S = sepsis
-S = salicylates
-M = methanol
-A = aldehydes
U [null]
-L = lactic acid/lactic acidosis

233
Q

Cheyne-Stokes respiration

A

periodic breathing w/ graudal hyperpnea + apnea
-sleep/hypoxemia, drugs
-hypoperfusion of brain in resp center

234
Q

Tactile fremitus

A

wall vibrations when speaking

235
Q

Anterior chamber

A

between cornea and iris

236
Q

Subconjunctival hemorrhage

A

bleeding in sclera due to strain

237
Q

Hyphema

A

bleeding into anterior chamber

238
Q

Exotropia

A

eye deviates outwards

239
Q

Esotropia

A

eye deviates inwards towards nose

240
Q

Hypotropia

A

eye turns downward

241
Q

Hypertropia

A

eye turns upwards

242
Q

Papilledema

A

disc swelling secondary to increased intracranial pressure

PD 1 (1 decks)

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