H&P Flashcards
Immunizations that protect against respiratory diseases
ADULT (3)
pneumococcal
influenza
Tdap (pertussis)
Immunizations that protect against respiratory diseases
CHILD (8)
DTaP rotavirus HIB PCV IPV influenza MMR varicella
Barrel chest (5)
ribs are more horizontal
spine kyphotic
sternal angle prominent
trachea posteriorly displaced
AP diameter is increased
normal AP diameter to transverse diameter is
1:2
Kyphosis
the spine is deviated posteriorly
Scoliosis
the spine is deviated laterally
Pectus carinatum
prominent sternal protrusion
aka “Pigeon chest”
Pectus excavatum
indentation of the lower sternum above the xiphoid
aka “funnel chest”
pursed lips might indicate
increased expiration
flared nares indicate
air hunger
clubbing of finger nails indicates
chronic hypoxemia
Orthopnea
SOB that begins or increases while supine
– if only at night = paroxysmal nocturnal
Platypnea
SOB increases in the upright position
Hypopnea
abnormally shallow respirations
Cheyne-stokes
varying periods of increasing depth interspersed with apnea
may occur during sleep, especially infants, but typically in seriously ill patients – brain damage at the cerebral level or with drug-caused respiratory compromise
Kussmaul respiration
rapid, deep, labored breathing
severe metabolic acidosis, particularly diabetic ketoacidosis (DKA) but also kidney failure. It is a form of hyperventilation
causes of Rate increases
metabolic acidosis, CNS lesions of the pons, Anxiety, ASA poisoning, hypoxemia, pain, exercise
causes of Rate decreases
metabolic alkalosis, CNS lesions of the cerebrum, Myasthenia gravis, narcotic overdoses, extreme obesity, excellent fitness
chest wall expansion is obstructed to inspiration
Retractions
can be superior or inferior
superior retraction
in upper respiratory
stridor, chest wall caves at sternum and supra sternal notch
retraction on one of bronchi
commonly in right
unilateral retraction
no involvement of suprasternal notch
Crepitus
PALPATE
“rice krispies”
indicates air in the subcutaneous tissue (from a rupture somewhere in the respiratory system or infection with gas-producing organism)
Pleural friction rub
PALPATE
coarse, grating vibration associated with inspiration (inflammation of the pleural surfaces)
tactile fremitus
vibration of the chest wall
due to speech
tactile fremitus decreased when
Excess air in the lungs, emphysema, pleural thickening or effusion, bronchial obstruction
tactile fremitus
Lung consolidation, heavy bronchial secretions, compressed lung, tumor
tracheal deviation may be caused by
atelectasis, thyroid enlargement, pleural fibrosis, pleural infusion, tension pneumothorax, tumor
