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IPA flash cards > IPA Cardiac and Pulm exam > Flashcards

IPA Cardiac and Pulm exam Flashcards

1
Q

Where is breathing controlled

A

In the brain in the medulla- complex

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2
Q

Function of respiration

A

provide O2 and remove CO2 from circulatory system

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3
Q

Is experation passive or active?

A

Expiration is passive

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4
Q

What factor helps during inspiration and alveolar compliance?

A

Elasticity

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5
Q

What is bradypenea

A

abnormal slowing of respiration

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6
Q

What is tachypenea

A

abnormal increased rate of respiration

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7
Q

What is Apnea

A

temporary cessation of breathing

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8
Q

What is hyperpenea

A

increased depth of breathing, usually associated with DKA

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9
Q

What are Cheynes-Stokes breathing

A

Abonormal pattern of breathing, progressively deeper and faster breathing, followed by gradual decrease resulting in apnea.

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10
Q

What is the abonormal pattern of breathing, progressively deeper and faster breathing, followed by gradual decrease resulting in apnea called

A

Cheynes-stokes breathing

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11
Q

Which breathing has a crescendo-decrescendo pattern with apnea between paterns?

A

Cheynes-stokes breathing

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12
Q

What is kussmaul breathing

A

Deep, rapid breathing, DKA or kidney failure, deep and rapid cycles of respirations

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13
Q

What is the breathing pattern that is deep, rapid breathing, DKA or kidney failure, deep and rapid cycles of respirations

A

Kussmaul breathing

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14
Q

What is the most common symptom of lung disease

A

cough

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15
Q

What is the earliest manifestation of bronchitis

A

increase in quanity of sputum production

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16
Q

How much sputum is secreted by bronchi every day

A

75-100 mL

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17
Q

What is coughing up of blood called

A

hemoptysis

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18
Q

What is the most common cause of hemoptysis

A

bronchitis

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19
Q

What are secondary causes of hemoptysis

A
  • Broncheictasis
  • Bronchiogenic carcinoma
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20
Q

Hemoptysis vs hematemesis

A

Coughing up blood vs vomitting blood

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21
Q

What is vommiting blood up called

A

Hematemesis

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22
Q

What is dyspena

A

shortness of breath

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23
Q

What are damaged airways called

A

bronchiectasis

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24
Q

What is the sudden onset of shortness of breath occurring at night during sleep

A

Paroxysmal-nocturnal dyspena

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25
Q

What is difficulty breathing while lying flat

A

orthopena

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26
Q

What is difficulty of breathing while sitting up and releved by a recumbent position

A

Platypenea

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27
Q

What is a condition where patients are more comfortable laying on one side

A

trepopnea

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28
Q

When does wheezing usually present in the cycle of breathing

A

during expiration when bronchoconstriction occurs

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29
Q

When does central cyonisis occur

A

When inadequate gas exchange occurs in the lungs that results in a significant reduction in arterial oxygenation ( mucous membranes, lips)

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30
Q

When does peripheral cyanosis occur

A

Results from an excessive extraction of oxygen at the periphery ( fingers, toes, nose)

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31
Q

Where does chest pain usually occur

A

usually chest wall or parietal pleura

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32
Q

What is a common symptom of inflammation of the parietal pleura

A

pleuritic pain ( Sharp, stabbing pain felt during inspiration. May be localized to one side).

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33
Q

What is snoring associated with

A

obstructive sleep apnea

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34
Q

What is noisy, harsh breathing produced by turbulent airflow through a partially obstructed airway at the level of the glottis or trachea?

A

Stridor

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35
Q

What is stridor considered

A

a medical emergency

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36
Q

What are voice changes caused by

A

inflammation of the vocal cords or laryngeal nerve issue

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37
Q

What is swelling of the ankles indicative of

A

right sided heart failure, renal disease, liver disease, obstruction of venous flow

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38
Q

What is COPD

A

umbrella term for Emphysema ( pink puffers- severe dyspena with little cough or sputum production) and chronic bronchitis (blue bloaters, cyanotic and have productive cough)

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39
Q

What is blue bloaters

A

chronic bronchitis

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40
Q

What is a pink puffer

A

emphysema (pathologic diagnosis, where alveoli lose their elastic)

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41
Q

What are the 4 things we look at for respiration

A

Rate (12-20
Rythym (regular, irregular)
Depth ( Shallow, normal, deep)
Effort ( normal, distressed, grasping)

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42
Q

What do you examine nails for in a thorax and lung exam

A

clubbing- sign of hypoxia

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43
Q

What are you looking for with thoracic expansion

A

symmetry and normal thoracic expansion

44
Q

What test are you doing using the ulnar side of your hand on the posterior thorax, checking for asymmetry moving down the chest while a patient says 99?

A

Tactile fremitus
- Air or fluid outside the lung can make this not symmetrical

45
Q

When are tactile fremitus vibrations increased

A

pnumonia

46
Q

When are tactile fremitus vibrations decreased

A

unilateral: pneumothorax, pleural effusion, bronchial obstruction, atelectasis
bilateral: COPD, obesity

47
Q

Effusion vs consolidation

A

Effusion- pleural fluid in pleural cavity
consolidation- fluid in alveoli/lung

48
Q

If you are ascultating and hear loud, harsh, and high pitched sounds that sound like air going through a tube, where are you likely ascultating

A

You are hearing stridor from the upper respiratory tract

49
Q

If you are listening to a low pitched noise, caused by fluid in the large and medium sized airways, what are you listening to?

A

Ronchi
Sound like snoring/gurgling

49
Q

If you’re hearing scratchy sounds associated with fluid in the alveoli and airways, what are you listening to?

A

Crackles, rales

50
Q

What are you hearing if you hear a wisteling, high-pitched noise that is loud on expiration, caused by air forced through a narrow airway?

A

Wheezing

51
Q

If you have an absense of sound in the lungs what is it?

A

Little air movement, clinical emergency, chronic emphysema, severe asthma, effusions, pneumothorax

52
Q

What is egophony

A

have patient say letter e while auscultating (if abnormal, will hear like aaaaah. Positive egophany, or e to a change.)
- Accompanies pneumonia

53
Q

What do you perform if bronchophony is present

A

a whispered pectoriloquy
whisper 99
abnormal if you can hear

54
Q

What causes barrel chest

A

COPD, aging

55
Q

What causes flail chest

A

3 or more adjacent rib fractures

56
Q

When your injured ribs cave in with inspiration and outward with expiration what is this called

A

flail rib

57
Q

What is kyphoscoliosis

A

scoliosis and forward curving spine

58
Q

What are decreased or absent breath sounds, fine crackles called

A

Atelectasis- complete or partial collapse of lung or lobe

59
Q

What is the PMI and where is it

A

right at left niple line, mid-clavicular, 5th intercostal space. Apex of tip of heart

60
Q

What is S1 produced by

A

closure of tricuspid and mitral valves

61
Q

What is S2 produced by

A

closure of aoritc andpulmonic semilunar valves

62
Q

What are the 2 components of S2

A

A2 (aortic valve closure which happens 1st)
P2 (Pulmonic valve closure which happens 2nd)

63
Q

What part of the heart do extra heart sounds usually arise from

A

usually Left ventricle, rarely R

64
Q

What is S3 usually associated with

A

heart failure- too much volume, fill L ventricle too quickly.

65
Q

Most common cause of left ventricular hypertophy? How does this sound on auscultation?

A

long standing hypertension ( atrial kick, gallop because of stiff heart)

66
Q

Which part of the stethescope do you use to listen for S3 and S4

A

Bell

67
Q

Most murmors are ?/6 ?

A

2-3/6

68
Q

What part of the stethescope for high pitched sounds vs low pitched sounds

A

High pitched- diaphragm
Low pitched- Bell

69
Q

What is Homan’s sign

A

Extend pt’s knee, check for calf tenderness after sudden dorsiflexion of foot- pain could be associated w DVT

70
Q

What is the Allen Test

A

determine patency of radial and ulnar arteries- check for arterial insufficiency

71
Q

What are vibratory sensations you feel when palpating the heart

A

Thrills
Associated with murmors

72
Q

what are impules that rythymically lift your fingers when you palpate the heart

A

Heaves

73
Q

Which side of the stethescope do you use to listen for murmors

A

Bell

74
Q

When do you hear ventricular septal defect

A

during all of systole

75
Q

What sound do you hear if you have pericardial disease

A

rubs usually

76
Q

Thick and stiff arteries are called what

A

Arteriosclerosis

77
Q

Plaque buildup in the arteries, causing narrowing, (a type of arteriosclerosis) is called what

A

Atherosclerosis

78
Q

What is a common vasospastic disorder

A

Raynaud disease (Turn white–>cyanotic(blue) –>rubor (red)

79
Q

What disease is categorized by the 5 P’s and what are the 5 P’s

A

Arterial occlusion

5P’s
-Pain
-Pallor
-Paresthesia
-Paralysis
-Pulselessness

80
Q

What is the high-pressure delivery system of the body

A

the left side of the heart and arteries

81
Q

What is the area of exchange in the body

A

capillaries

82
Q

What is the low-pressure return system in the body

A

the Right side of the heart and veins

83
Q

What are the 2 layers of the pericardial sac

A
  1. Visceral pericardium- the cells of the heart
  2. The parietal pericardium- outer layer/sac
84
Q

Blood flow through the heart

A

IVC/SVC–> Right atrium–>Tricuspid valve–>Right ventricle –>Pulmonic semilunar valve–>Pulmonic artery–> Lungs–>Pulmonic veins–> Left atrium–>Bicuspid valve–>Left ventricle–> Aortic semilunar valve–> Aorta

85
Q

What is S1 produced by

A

Closing of mitral valve(Bicuspid valve, between L atrium and ventrical), and tricuspid valve; occurs at the same time as a pulse does

86
Q

Where is S2 heard

A

As the pulmonic and aortic valves shut

87
Q

What is the QRS complex demonstrating

A

ventricular contraction

88
Q

If you hear a sound between S1 and S2, what is this?

A

Systolic murmor

89
Q

When is S3 heard

A

At the end of filling with the opening of the tricuspid and mitral valves
Right after S2 (when these close)
Very beginning of diastole

90
Q

When is S4 heard

A

end of diastole, also called an atrial kick or gallop.

91
Q

Ejection click vs opening snap

A

Ejection click occurs during systole (opening of aortic valve between S1 and S2)
Opening snap is opening of the AV valves because of stenosis, occurs during diastole

92
Q

What are the systolic murmors

A
  • Aortic or pulmonary stenosis
  • Mitral or tricuspid regurgitation
    Between S1-S2
93
Q

What are the diastolic murmors

A

-Aortic or pulmonary regurgitation
- Mitral or tricuspid stenosis
Between S2–>S1

94
Q

What are palpable cords

A

thrombosed veins

95
Q

What are thrills associated with

A

murmors

96
Q

pectus excavatum vs pectus carinatum

A

excavatum- funnel chest (think “cave”)
Carinatum- pigeon chest

97
Q

Effusion vs consolidation in terms of where fluid is

A

Effusion–>Fluid in pleural cavity
Consolidation–> Fluid in lung

98
Q

Signs of Effusion vs consolidation with auscultation, percussion, fremitus, and egophony

A

Effusion: Decreased auscultation, no breath signs. Dull percussion. Decreased Fremitus. Absent egophony
Consolidation: Bronchial breath sounds. Dull percussion. Increased Fremitus. Present egophony
Key differences: Same for percussion (dull), opposite for everything else.

99
Q

When do effusion and consolidation give the same sign

A

percussion- both are dull

100
Q

Do you hear ronchi on inspiration or expiration

A

Inspiration- air moving through lungs on inspiration- sounds like snoring/gurgling

101
Q

What are crackles (rales) due to

A

Scratchy sounds associated with fluid in alveoli and airways. Rales occur at the end of the lung in the alveoli.

102
Q

Where are rales vs ronchi

A

Rales in tales (end of lung) and ronchi in the bronchi

103
Q

Wheezing vs stridor, insperation vs expiration?

A

Wheezing is in expiration, stridor is inspratory

104
Q

How is chronic bronchitis classified

A

three consecutive months of bronchitis, 2 years in a row

105
Q

What do a pnumothorax, hemothorax, pleural effusion, atelectisis, and emphysema have in common

A

They can have absent breath sounds
- Pleural effusion, Hemothorax, and Atelectasis can all have decreased or absent breath sounds
-Atelectasis is accompanied by fine crackles

106
Q
A

IPA flash cards (8 decks)

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