lower respiratory exam

Question 1

person who is in respiratory distress will start using what

Answer 1

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

-also hyperotrophy of traps, scalenes, SCM

Question 2

what is the main muscle of respiration?

Answer 2

diaphragm

Question 3

what is an acute cough and caused by what?

Answer 3

less than 3 weeks and caused by viral URI

Question 4

subacute cough and caused by what?

Answer 4

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

Question 5

chronic cough

Answer 5

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

Question 6

hemoptysis is what?

Answer 6

coughing up blood

Question 7

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

Answer 7

at night

Question 8

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

Answer 8

in the morning

Question 9

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

Answer 9

just saliva

Question 10

foul smelling sputum characteristic of what?

Answer 10

anerobic bacterial infection

Question 11

purulent sputum:

Answer 11

yellow/green thick sputum from pseudomonas

Question 12

how will patient be sitting in RSD

Answer 12

leaning over, hands on knees, shoulders raised

Question 13

breathing through pursed lips for what reason

Answer 13

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

Question 14

trachea deviated from midline can be caused by what?

Answer 14

collapsed lung, effusion, area of lung without air

Question 15

chest excursion is what and caused by what?

Answer 15

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

Question 16

nail clubbing think of what

Answer 16

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

Question 17

what diseases are associated with barrel chest

Answer 17

COPD and chronic bronchitis

Question 18

hair distribution decreasing indicates what?

Answer 18

less oxygenation so less hair

Question 19

inspecting respiration

Answer 19

rate, rhythm, depth, effort

Question 20

pectus excavatum can cause

Answer 20

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

Question 21

pectus carinatum can cause

Answer 21

dyspnea and exercise intolerance

Question 22

tactile fremitus: def, technique, and location

Answer 22

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

Question 23

increased tactile fremitus

Answer 23

pneumonia

Question 24

decreased tactile femitus

Answer 24

COPD, tumor, pleural effusion, pneumothorax

Question 25

ephogany

Answer 25

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

Question 26

bronchophagny

Answer 26

if words become clearer than consolidation

Question 27

whisper pectorilquouy

Answer 27

if pneumonia than louder

Question 28

flat tone heard over?

Answer 28

solid surface, bone, heavy muscles

Question 29

percussion over air sounds?

Answer 29

resonant,

Question 30

people with COPD are or pneumothorax

Answer 30

hyperresonant

Question 31

gatric air bubble and stomach sound

Answer 31

tympany

Question 32

dull sound heard over

Answer 32

liver and heart

Question 33

diaphragm should move ___ cm

Answer 33

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

Question 34

bronchial sounds

Answer 34

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

Question 35

broncho-vesicular sounds

Answer 35

over bifurcation of trachea, inspiration and expiration are equal

Question 36

vesicular sounds

Answer 36

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

Question 37

crackles

Answer 37

fine and coarse, high pitched

Question 38

wheezes

Answer 38

narrowing of airway, asthma, whitling, high pitched

Question 39

pleural friction rub

Answer 39

scratchy, leathery, harsh sound during expiration

Question 40

rhonchi

Answer 40

upper airway sound, secretions you can hear, low pitched

Question 41

strider

Answer 41

occlusion of larynx or trachea, emergency

Question 42

pneumonic for chest x ray interpretation

Answer 42

``` 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 ```

Question 43

what does a flat diaphragm indicate?

Answer 43

emphesema

Question 44

what is the normal respiration rate adult

Answer 44

14-20 times per minute

Question 45

thoracic expansion thumb placement

Answer 45

10th ribs

Question 46

dullness replaces resonance when fluid or solid tissue replaces air containing

Answer 46

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

Question 47

generalized hyperresonance

Answer 47

COPD, asthma

Question 48

unilateral hyperresonance

Answer 48

large pneumothorax, large air-filled bulla in lung

Question 49

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

Answer 49

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

Question 50

tracheal sound

Answer 50

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

Question 51

crackles: fine

Answer 51

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

Question 52

crackles: coarse

Answer 52

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

Question 53

crackles

Answer 53

discontinuous, intermittent, nonmusical and brief, | timing: inspiratory, expiratory, or mid-inspiratory/expiratory

Question 54

wheezes suggest

Answer 54

narrowed airways (asthma, copd, bronchitis)

Question 55

rhonchi suggest

Answer 55

secretions in large airways

Question 56

stridor

Answer 56

wheeze that is entriely predom inspiratory in nature | louder in neck vs chest wall