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PCM 1 final > lower respiratory exam > Flashcards

lower respiratory exam Flashcards

1
Q

person who is in respiratory distress will start using what

A

lower respiratory muscles so if you see retraction inward of intercostal muscles this is a sign

-also hyperotrophy of traps, scalenes, SCM

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2
Q

what is the main muscle of respiration?

A

diaphragm

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3
Q

what is an acute cough and caused by what?

A

less than 3 weeks and caused by viral URI

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4
Q

subacute cough and caused by what?

A

6-8 weeks, post infectious setting, bacterial chronic sinusitis, ongiong asthma

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5
Q

chronic cough

A

over 8 weeks, chronic bronchitis, GERD, post nasal drainage, asthma

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6
Q

hemoptysis is what?

A

coughing up blood

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7
Q

if you have an acute cough when is it occuring most?

A

at night

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8
Q

if you have chronic lunger when are you most likely coughing?

A

in the morning

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9
Q

if you have lots of epithelial cells then sputum test is revealing what?

A

just saliva

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10
Q

foul smelling sputum characteristic of what?

A

anerobic bacterial infection

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11
Q

purulent sputum:

A

yellow/green thick sputum from pseudomonas

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12
Q

how will patient be sitting in RSD

A

leaning over, hands on knees, shoulders raised

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13
Q

breathing through pursed lips for what reason

A

keeps pressure in airways up to prevent collapsing of airways. breath out twice as long as breathing in

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14
Q

trachea deviated from midline can be caused by what?

A

collapsed lung, effusion, area of lung without air

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15
Q

chest excursion is what and caused by what?

A

just one side of chest is moving, fluid in the pluera, damage to phrenic nerve

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16
Q

nail clubbing think of what

A

hypoxia: IBS, PF, CF, Interstitial lung disease, bonchiesctasis, lung cancer, Congenital heart disease

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17
Q

what diseases are associated with barrel chest

A

COPD and chronic bronchitis

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18
Q

hair distribution decreasing indicates what?

A

less oxygenation so less hair

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19
Q

inspecting respiration

A

rate, rhythm, depth, effort

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20
Q

pectus excavatum can cause

A

dyspnea, exercise intolerance, reduced CO and SV, restircion to lung flow

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21
Q

pectus carinatum can cause

A

dyspnea and exercise intolerance

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22
Q

tactile fremitus: def, technique, and location

A

feeling vibration when speaking
have patient say 99 with doctor’s hands on posterior lateral thorax
can also do it with hands on chest

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23
Q

increased tactile fremitus

A

pneumonia

24
Q

decreased tactile femitus

A

COPD, tumor, pleural effusion, pneumothorax

25
Q

ephogany

A

have patient say E with stethoscope listening, if sounds like A something wrong

26
Q

bronchophagny

A

if words become clearer than consolidation

27
Q

whisper pectorilquouy

A

if pneumonia than louder

28
Q

flat tone heard over?

A

solid surface, bone, heavy muscles

29
Q

percussion over air sounds?

A

resonant,

30
Q

people with COPD are or pneumothorax

A

hyperresonant

31
Q

gatric air bubble and stomach sound

A

tympany

32
Q

dull sound heard over

A

liver and heart

33
Q

diaphragm should move ___ cm

A

3-5 cm
inhale and hold = inferior spot
exhale and hold = superior mark

34
Q

bronchial sounds

A

over trachea, loud and harsh, expiration is a little longer than inspiration

35
Q

broncho-vesicular sounds

A

over bifurcation of trachea, inspiration and expiration are equal

36
Q

vesicular sounds

A

over the parenchyma, long inspiration, short expiration, quiet sound low pitched

37
Q

crackles

A

fine and coarse, high pitched

38
Q

wheezes

A

narrowing of airway, asthma, whitling, high pitched

39
Q

pleural friction rub

A

scratchy, leathery, harsh sound during expiration

40
Q

rhonchi

A

upper airway sound, secretions you can hear, low pitched

41
Q

strider

A

occlusion of larynx or trachea, emergency

42
Q

pneumonic for chest x ray interpretation

A 
Adequate: position, inspirtation, exposure, rotation PIER
Bones and soft tissues
Cardiac size, valves
Diaphragms round, flat, free air
Effusions
Fields and fissures
Great vessels
Hilar masses
Impression
43
Q

what does a flat diaphragm indicate?

A

emphesema

44
Q

what is the normal respiration rate adult

A

14-20 times per minute

45
Q

thoracic expansion thumb placement

A

10th ribs

46
Q

dullness replaces resonance when fluid or solid tissue replaces air containing

A
  • lobar pneumonia (alveoli filled with fluid and blood cells)
  • pleural accumulations: Hemothorax, empyema, effusion, fibrous tumor
47
Q

generalized hyperresonance

A

COPD, asthma

48
Q

unilateral hyperresonance

A

large pneumothorax, large air-filled bulla in lung

49
Q

if bronchovesicular or bronchial breath sounds are heard more distal to expected locations then:

A

suspect air-filled lung had been replaced by fluid-filled or solid lung tissue

50
Q

tracheal sound

A

very loud and high pitched
heard equally in inspiration and expiration
heard best over trachea in neck

51
Q

crackles: fine

A

soft, high pithed, very brief (5-10 msec)

52
Q

crackles: coarse

A

louder, lower in pitch, brief (20-30 msec)

53
Q

crackles

A

discontinuous, intermittent, nonmusical and brief,

timing: inspiratory, expiratory, or mid-inspiratory/expiratory

54
Q

wheezes suggest

A

narrowed airways (asthma, copd, bronchitis)

55
Q

rhonchi suggest

A

secretions in large airways

56
Q

stridor

A

wheeze that is entriely predom inspiratory in nature

louder in neck vs chest wall

PCM 1 final (3 decks)

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