Lower Respiratory

Question 1

Spirometry

Answer 1

measures lung function with amount and speed of air inhaled/exhaled

Question 2

Dull

1. Intensity
2. Pitch
3. Duration
4. Example

Answer 2

1. Medium
2. Medium
3. Medium
4. Liver

*Fluid or solid tissue replaces air-containing lung or occupies space

Question 3

Incentive Spirometer

Answer 3

used in hospitals to gauge lung performance (often used after surgery)

Question 4

Order to LR exam

Answer 4

1. Inspect
2. Palpate
3. Percuss
4. Auscultate

Question 5

% Saturation =

Answer 5

red / red+ blue

Question 6

Tympanitic

1. Intensity
2. Pitch
3. Duration
4. Example

Answer 6

1. Loud
2. High (musical timbre)
3. Longer
4. Gastric air bubble or puffed out cheek

Question 7

Pectus Excavatum

Answer 7

Depression in lower portion of the sternum: can compress heart and great vessels, cause murmurs

*funnel chest

Question 8

Atelactisis may cause..

Answer 8

diaphragmatic excursion

Question 9

What should you consider as a cause of post surgical fever?

Answer 9

atelectasis

Question 10

Pulse Oximetry: how does it work? what is it used for?

Answer 10

1. Capillary pulse brings arterial blood to fingers
   - HbO2 absorbs infrared>red light. Hb absorbs red>infrared light
   - amount of light received by the detector indicates the amount of oxygen bound to the hemoglobin in the blood.
2. the instrument can calculate the SpO2

Question 11

Resonant

1. Intensity
2. Pitch
3. Duration
4. Example

Answer 11

1. Loud
2. Low
3. Long
4. Healthy lung

Question 12

Pulmonary Function Test

Answer 12

• non invasive way to show how well the lungs are working

- can be a diagnostic tool (obstructive vs. restrictive)

Question 13

Barrel Chest

Answer 13

increased AP diameter (seen in COPD)

-some can come with aging, and can be normal in infancy

Question 14

Hyperresonant

1. Intensity
2. Pitch
3. Duration
4. Example

Answer 14

1. Very loud
2. Lower
3. Longer
4. heard over hyperinflated lungs

Question 15

Tracheal deviation may be involved in…

Answer 15

1. Pnuemothorax (tension and non tension)
2. Pleural effusion
3. Atelactasis
4. Mass

Question 16

Traumatic flair chest

Answer 16

Multiple rib fractures may result in paradoxical movements of the thorax. On Inspiration the injured area caves inward, and on expiration it moves outward

Question 17

Pectus carinatum

Answer 17

Sternum displaced anteriorly (↑AP diameter), adjacent costal cartilages are depressed

*pigeon chest

Question 18

Clubbing may be caused by…

Answer 18

• Congenital heart disease
• Interstitial lung disease
• Bronchiectasis
• Pulmonary fibrosis
• Cystic fibrosis
• Lung abscess
• Malignancy (Lung cancer) -IBD

**NOT COPD

Question 19

CTAB

Answer 19

clear to auscultation bilaterally

Question 20

Where do we insert a chest tube?

Answer 20

1. 4th and 5th intercostal space (just anterior to the axillary line)
2. 5th intercostal space (jus inferior to the nipple in a male, inframammary fold in a female)

Question 21

Flat

1. Intensity
2. Pitch
3. Duration
4. Example

Answer 21

1. Soft
2. High
3. Short
4. Thigh

Question 22

Chest x ray interpretation: A-I

Answer 22

• Adequate/assessment of quality/Airway
• Bones and soft tissues
• Cardiac size, valves
• Diaphragm
• Effusion/endotracheal tube/EKG leads
• Fields and fissures/Foreign body
• Great vessels/gastric bubble
• Hilar masses
• Impression

Question 23

Why do chest tubes need to be placed on the superior margin of the rib?

Answer 23

to avoid the neuromuscular bundle

Question 24

Causes of a bad waveform in pulse oximetry reading? misinformation?

Answer 24

1. Improper placement, hypo perfusion, hypothermia, motion artifact
2. WORSE than no information