Lung

Question 1

Flail Chest

Answer 1

Multiple rib fracture, causing paradoxical chest movement with inspiration

Question 2

Barrel Chest

Answer 2

AP diameter = lateral diameter

Question 3

Kussmaul breathing

Answer 3

Hyperpnea- increased depth (acidosis)

Question 4

Biot Breathing what is it? And why is it so problematic?

Answer 4

Irregular with long periods of apnea and it leads to an increase in intracranial pressure which leads to brain damage

Question 5

Cheyne- Stokes Breathing

Answer 5

Irregular with increases and decreases in rates/ depths and apnea

Question 6

Tactile Fremitus what is it?

Answer 6

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

Question 7

Tactile fremitus explain how to check on a patient

Answer 7

Place ulnar hand side on patient’s back and ask them to say 99

Question 8

Similarly, __________ is increased transmission of “99” on auscultation if there is lung consolidation

Answer 8

Bronchophony

Question 9

Normal breath sounds (4)

Answer 9

1. Tracheal
2. Bronchial
3. Vesicular
4. Bronchovesicular

Question 10

Harsh, loud, high pitched over trachea, equal length on E/I

Answer 10

Tracheal

Question 11

Loud, high-pitched over manubrium E longer than I with pause between

Answer 11

Bronchial

Question 12

Soft, low-pitched over lung fields; I longer/louder than E

Answer 12

Vesicular

Question 13

Mix of sounds heard over carina; I=E, heard in 1st/2nd interspaces anteriorly and between scapulae posteriorly

Answer 13

Bronchovesicular

Question 14

Abnormal breath sounds (5)

Answer 14

1. Rales
2. Wheezes
3. Bronchi
4. Strider
5. Pleural Rub

Question 15

Crackles heard on inspiration due to opening of collapsed alveoli

Answer 15

Rales

Question 16

High-pitched, continuous sound on expiration due to bronchial narrowing (swelling, secretion, tumor, asthma)

Answer 16

Wheezes

Question 17

Low-pitched associated with mucous plugging (bronchitis)

Answer 17

Bronchial

Question 18

High-pitched, upper airway sound due to turbulent flow from obstruction

Answer 18

Strider

Question 19

Grating inspirations sound made by roughened pleura (inflammation, neoplasm, fibrin deposition, pneumonia, pulmonary infarct)

Answer 19

Pleural Rub

Question 20

Abnormal sound transmission (2)

Answer 20

1. Egophany

2. Whispered pectoriloquy

Question 21

E to A sound change in auscultation in area of consolidation (fluid-filling)

Answer 21

Egophany

Question 22

Intensification of whispered words with lung consolidation (normally little to no sound heard on auscultation)

Answer 22

Whispered Pectoriloquy

Question 23

Superior lung border

Answer 23

3-4cm above medial end of clavicle

Question 24

Inferior lung border

Answer 24

6th rib at midclavicular line/ to 8th rib at mid Axilla Ray line

Question 25

Posterior lung border

Answer 25

T9 (expiration) and T12 ( inspiration)

Question 26

Marks 2nd rib, carina and T4

Answer 26

Stern all angle of Louis

Question 27

Diaphragm at rib 5 anteriorly, t9 posteriorly

Answer 27

End of expiration

Question 28

I:E Ration and what happens in obstructive states?

Answer 28

1:2

Prolonged expiration