Lung Flashcards
Flail Chest
Multiple rib fracture, causing paradoxical chest movement with inspiration
Barrel Chest
AP diameter = lateral diameter
Kussmaul breathing
Hyperpnea- increased depth (acidosis)
Biot Breathing what is it? And why is it so problematic?
Irregular with long periods of apnea and it leads to an increase in intracranial pressure which leads to brain damage
Cheyne- Stokes Breathing
Irregular with increases and decreases in rates/ depths and apnea
Tactile Fremitus what is it?
Vibration felt in chest wall on speaking; increase in density of lung will increase sound vibration while a decrease due to fat, air, or fluid on chest cavity will decrease sound vibration
Tactile fremitus explain how to check on a patient
Place ulnar hand side on patient’s back and ask them to say 99
Similarly, __________ is increased transmission of “99” on auscultation if there is lung consolidation
Bronchophony
Normal breath sounds (4)
- Tracheal
- Bronchial
- Vesicular
- Bronchovesicular
Harsh, loud, high pitched over trachea, equal length on E/I
Tracheal
Loud, high-pitched over manubrium E longer than I with pause between
Bronchial
Soft, low-pitched over lung fields; I longer/louder than E
Vesicular
Mix of sounds heard over carina; I=E, heard in 1st/2nd interspaces anteriorly and between scapulae posteriorly
Bronchovesicular
Abnormal breath sounds (5)
- Rales
- Wheezes
- Bronchi
- Strider
- Pleural Rub
Crackles heard on inspiration due to opening of collapsed alveoli
Rales
High-pitched, continuous sound on expiration due to bronchial narrowing (swelling, secretion, tumor, asthma)
Wheezes
Low-pitched associated with mucous plugging (bronchitis)
Bronchial
High-pitched, upper airway sound due to turbulent flow from obstruction
Strider
Grating inspirations sound made by roughened pleura (inflammation, neoplasm, fibrin deposition, pneumonia, pulmonary infarct)
Pleural Rub
Abnormal sound transmission (2)
- Egophany
2. Whispered pectoriloquy
E to A sound change in auscultation in area of consolidation (fluid-filling)
Egophany
Intensification of whispered words with lung consolidation (normally little to no sound heard on auscultation)
Whispered Pectoriloquy
Superior lung border
3-4cm above medial end of clavicle
Inferior lung border
6th rib at midclavicular line/ to 8th rib at mid Axilla Ray line
Posterior lung border
T9 (expiration) and T12 ( inspiration)
Marks 2nd rib, carina and T4
Stern all angle of Louis
Diaphragm at rib 5 anteriorly, t9 posteriorly
End of expiration
I:E Ration and what happens in obstructive states?
1:2
Prolonged expiration
