Landmarking/IPPA

Question 1

semi- folwers

Answer 1

sitting at 45

Question 2

fowlers

Answer 2

sitting at 60

Question 3

high fowlers

Answer 3

sitting at 90

Question 4

feet higher than head to increased BP

Answer 4

trendelenburg

Question 5

When inspecting head/neck what do we look for? Hint: inc WOB

Answer 5

nasal flaring, pursed lip breathing, grunting, diaphoresis

JVD, tracheal disposititon, accessory muscles, supraclavicular/ suprasternal indrawing, tracheostomy scars

Question 6

PERRLA

Answer 6

Pupils should be Equal, Round, reactive to Light, and Accomodation

Question 7

Drooping eyelid- neuromascular diseases

Answer 7

ptosis

Question 8

Clubbing of fingers is indicative of what?

Answer 8

peripheral cyanosis, lung disease, chronic low O2, cardiac disease, carcinoma

Question 9

Pectus carinatum

Answer 9

protruding chest

Question 10

Pectus Excavatum

Answer 10

chest caves in

Question 11

Observed Anterior-posterior and lateral symmetry. Often seen in COPD pt.

Answer 11

Barrel Chest

Question 12

Gradual increase and decrease in respiration with periods of apnea- increased intracranial pressure

Answer 12

Cheyne- Stokes

Question 13

rapid and deep breaths can be due to CNS problems

Answer 13

Biot’s

Question 14

tachypnea and hyperpnea due to renal failure or DKA or metabolic acidosis

Answer 14

Kussamaul

Question 15

Prolonged inspiratory phase with short expiratory phase

caused by lesions on brain stem

Answer 15

Apneustic

Question 16

Types of paradoxial movement

Answer 16

Obstructive sleep apnea, Flail chest

Question 17

Use of tactile techniques to assess the patient for clinical findings

Answer 17

palpation

Question 18

palpation procedures

Answer 18

chest excursion, tracheal shift, tactile fermitus, vocal fermitus, capillary refill, pedal edema

Question 19

chest excursion normal

Answer 19

bilateral expansion of about 3-5cm of the chest

Question 20

Tracheal shift towards

Answer 20

Atelectasis, consolidation, pneumoectomy, lobectomy

Question 21

Tracheal shift away

Answer 21

tension pneumothorax, pleural effusion, herniated abdominal contents

Question 22

how do we tell if someone has increased/ decreased lung density based on virabrations?

Answer 22

increased vibration= increased lung density

decreased vibration= decreased

Question 23

Edema

Answer 23

leaking of fluid from the capilaries to the surrounding tissues

Question 24

causes of edema

Answer 24

• mild: xs salt, pregnancy

- serious: CHF, kidney disease, venous insufficiency in the legs, poor lymphatic drainage

Question 25

Capillary refill

Answer 25

normal: < 3s
abnormal: >5 s

Question 26

percussion

Answer 26

“tapping” the chest wall to asess density of underlying tissue to assess resonance

Question 27

Abnormal percussion sounds. Increase/ decrease resonance

Answer 27

• Decrease resonance–>increase lung density tissue

- inceased resonance–> more air and less dense

Question 28

Process in which pt’s are asked to inhale whille we percuss the lowr lung field until percussion note changes

Answer 28

Diaphragmatic excursion; 5-7cm

Question 29

Continous- heard most often on exhalation

Answer 29

wheezes

Question 30

discontinuous- heard most often on inspiration

Answer 30

crackles

Question 31

monophonic, high- pitched wheeze heard over the upper airway in patients with croup and epiglottitis

Answer 31

stridor

Question 32

creaky or grating type; sounds like leather rubbing

Answer 32

pleurisy

Question 33

voice sounds

Answer 33

egophony: pt says “eeee” and hear “aaaaa”

whispering pectoriloquy: pt says “1,2,3” and we expect not to hear distinct speech

Question 34

Systematic auscaltation

Answer 34

During inspiration and expiration, side to side, apices to bases, deep breaths through the mouth