Lower Respiratory Complaint Flashcards
What does a pulse oximeter do; what does each light measure?
Direct beams of red and infrared light through a measurement site.
Red light: oxyhemoglobin
Blue light: deoxyhemoglobin
% saturation = red / red + blue
What is an incentive spirometer used for?
Device used to help you keep your lungs healthy after surgery or when you have a lung illness. Teaches you how to take slow deep breaths. Important to breath in SLOWLY
What is a pulmonary function test used for?
- Non-invasive
- Diagnosis of certain lung disorders (obstructive vs restrictive)
When is accessory muscle use seen in breathing?
Asthma, COPD, airway obstruction, viral illness
What can a tracheal deviation be seen in?
Pneumothorax (tension and non-tension), pleural effusion, atelectasis, and a mass
Describe nail clubbing and the pathologies that can lead to it?
- Loss of normal angle between nail and proximal nail fold (>180 degrees)
- CHD, Interstitial lung disease, pulmonary fibrosis, cystic fibrosis, lung abscess, and lung cancer
Discuss tactile fremitus technique and what abnormal findings mean (decreased and increased when)?
- Palpable vibrations transmitted through the bronchopulmonary tree to the chest wall as person speaks
- Pt says “99” or “1-1-1”
- Decreased or absent = COPD, Pleural changes (effusions, fibrosis), pneumothorax
- Increased = Pneumonia (consolidation)
What is the normal percussion tone for the lungs?
Resonance
What is the normal percussion tone for the heart?
Flat
When percussing what is each finger referred to as based on its placement?
- Dominant = Plexor finger = strike using middle finger
- Non-dominant = Pleximeter = finger that is struck by dominant hand, at the distal interphalangeal joint of the middle finger
What type of sound would be heard when percussing over an area of pneumonia, effusion/empyema (fluids in lungs)?
Dullness
What type of sound would be heard when percussing over an area affected by pneumothorax (air in lungs)?
Unilateral Hyper-resonance
What is done in a diaphragmatic excursion; normal measurement, what does higher than normal dullness indicate?
- You determine the distance between the levels of dullness during expiration and inspiration.
- Normal is 3-5.5
- If dullness is higher than normal, suspect atelectasis or phrenic nerve paralysis
What does asymmetry found during diaphragmatic excursion indicate?
- Pleural effusion
- High diaphragm secondary to: atelectasis or phrenic nerve paralysis
When listening to lung sounds, what part of stethoscope is used, and what is the direction of listening posts, how many?
- Diaphragm
- Move in a ladder like fashion
- At minimum should listen to each lobe (5 spots)
What are the 4 normal breath sounds and what do you hear/where are they best heard?
1) Vesicular - soft, low pitched, heard over most of lungs
2) Bronchovesicular - slightly higher pitch and heard best at 1st/2nd intercostal space
3) bronchial - loud and high pitched, heard over the bronchi/manubrium
4) Tracheal - Super loud and high pitched. Best over trachea… duh
What is Bronchophony ( abnormal vocal resonance)?
Spoken words get louder and clearer (indicates consolidation)
What is whispered pectoriloquy ( abnormal vocal resonance)?
Whispered words are louder and clearer during auscultation
What is Egophony? (abnormal vocal resonance)?
When patient says “ee” it sounds like “A”