LUNG AND CHEST

Question 1

PALPATION OF POSTERIOR THORAX

Answer 1

POSITIVE: Pain, tenderness, masses, sensations and further assess for any abnormalities

Question 2

TACTILE FREMITUS (posterior thorax)

Answer 2

POSITIVE: 1. Increase Fremitus 2. Decreased or Absent Fremitus INDICATES: 1. Fluid or a solid mass within the lungs e.g. Lung Consolidation 2. Excess air in the lungs e.g. Emphysema

Question 3

RESPIRATORY EXCURSION

Answer 3

POSITIVE: Loss of symmetry in the movement of the thumbs INDICATES: Underlying lung problem on one or both sides

Question 4

PERCUSSION of POSTERIOR THORAX

Answer 4

Normal: Resonance Abnormal: Dullness indicates mass or fluid in the lung (Lung cancer or pneumonia) Hyper-resonance indicates trapped air in the lung (Emphysema, atelectasis or pneumothorax)

Question 5

DIAPHRAGMATIC EXCURSION

Answer 5

POSITIVE: Limited measurement INDICATES: Pathologies of pulmonary (eg result of emphysema (bilateral limited movement), abdominal (result of massive ascites, tumor), or superficial pain (fractured rib)

Question 6

NORMAL BREATH SOUNDS (both anterior and posterior are same verbals)

Answer 6

Listen for Characteristics: Pitch, Intensity, duration of the normal breath sounds of Bronchial (best heard over the trachea), and Broncho-vesicular (best heard over the main bronchus and upper right posterior lung field), Vesicular (best heard over the periphery of the lung)

Question 7

VOCAL RESONANCE POSTERIOR

Answer 7

SEATED ONLY Normal: The sounds transmitted are usually muffled and indistinct and are best heart medially

Question 8

VOCAL RESONANCE: WHISPERED PECTORILOQUY

Answer 8

POSITIVE: Increased clarity and loudness of spoken sounds INDICATES: Presence of consolidation in the lung

Question 9

VOCAL RESONANCE: EGOPHONY

Answer 9

POSITIVE: Increased clarity and nasal quality of “E” becoming “A” INDICATES: Presence of consolidation in the lung

Question 10

PALPATION of THE ANTERIOR THORAX

Answer 10

POSITIVE: Pain, tenderness, masses, sensations, and further assess for any abnormalities

Question 11

PALPATION of the LYMPH NODES of the THORAX and AXILLA

Answer 11

POSITIVE: 1. Enlarged, hard, immobile, non-tender 2. Enlarged, soft, mobile, tender INDICATES: 1. Cancer 2. Infection

Question 12

TRACHEAL POSITION

Answer 12

POSITIVE: Deviation of the trachea INDICATES: Underlying pathology

Question 13

PERCUSSION OF ANTERIOR THORAX

Answer 13

NORMAL: Resonance ABNORMAL: Dullness indicates mass or fluid in the lung (pneumonia or lung cancer) Hyper-resonance indicates trapped air in the lung (Emphysema, Atelectasis or Pneumothorax)

Question 14

COSTOCHONDRITIS

Answer 14

POSITIVE: Pain at the costochondral junction INDICATES: Inflammation at the costochondral junction

Question 15

POSSIBLE RIB FRACTURES

Answer 15

POSITIVE: Pain radiating from site of fracture INDICATES: Possible rib fracture