Lung Assessments Flashcards
Which of the 5 cardiac ausculatory sites can most murmurs be heard (APETM)?
Erb’s Point
Describe the difference between the bell and the diaphragm of a stethoscope.
1) Bell - Used to hear low pitched sounds (most breath sounds)
2) Diaphragm - Used to hear high pitched sounds (most heart sounds)
What is the implication of left ventricular hypertrophy on the Point of Maximal Intensity (PMI)?
PMI (apex of the heart) is displaced laterally or distally when the left ventricular muscle is hypertrophied.
What are the “Lubb” and “Dubb” heart sounds?
1) Lubb (S1) - First heart sound which is the beginning of ventricular systole, caused by closure of the tricuspid and mitral valves.
2) Dubb (S2) - The second heart sound which is the beginning of ventricular diastole, caused by the closure of the aortic and pulmonic valves.
Which heart sound does your radial pulse correspond to?
Lubb or S1
Where do the 2 heart sounds (S1 and S2) fall on the cardiac cycle of the EKG?
1) S1 - R-wave
2) S2 - At the end of the T-wave
How do you perform the following lung auscultation examinations:
1) Egophony
2) Whispered Pectoriloquoy
3) Broncophony
1) Egophony - “E” for “A” change
2) Whispered Pectoriloquoy - Whispered sounds, which usually would not be heard through the stethoscope, can now be heard if the patient has consolidation.
3) Broncophony - The patient says “99” and it remains louder than usual over areas of consolidation.
What is the clinical significance (when are they found) for the following:
1) Fluid Crackles
2) Atelectic Crackles
3) Rhonchi
4) Wheezes
5) Stridor
1) Fluid Crackles - Pneumonia, pulmonary edema, CHF
2) Atelectic Crackles - Pneumonia, pulmonary edema, ⬇ mobility
3) Rhonchi - Asthma
4) Wheezes - Asthma, tumors, build up of secretions, COPD, and anaphylaxis.
5) Infants with croup
5) Stridor
What is the clinical significance (when are they found) for the following:
1) Pleural Friction Rub
2) Pericardial Friction Rub
3) Absence of Breath Sounds
4) Inequality of Breath Sounds
5) Bronchial Breath Sounds
1) Pleural Friction Rub - Pleural effusion, TB, lung cancer, pleurisy
2) Pericardial Friction Rub - Rheumatic fever
3) Absence of Breath Sounds - Apnea, emphysema, bronchitis, pulmonary edema, asthma, pneumonia, pneumothorax, hemothorax.
4) Inequality of Breath Sounds - Tumor in one lobe, thoracotamy, partial collapse, pneumonia with consolidation.
5) Bronchial Breath Sounds - Normal
What is the clinical significance of the Angle of Louis?
The Carina is located under the Angle of Louis
What common complications occurs in the right middle lobe?
Because of the downward slope of the right mainstream bronchus, aspiration into the middle lobe is more common.
Before and after auctioning a patient, the nurse auscultated which anatomic sites and why?
Auscultated the trachea, carina, and mainstream bronchi in order to identify the presence of secretions and measure effectiveness.
Describe the location of the following anatomical structures:
1) Trachea
2) Carina
3) Right and Left Mainstem Bronchi
4) Right and Left Upper Lobe
5) Right middle lobe
6) Lingula of alert Upper Lobe
7) Right and Left Lower Lobe
1) Trachea - Neck, above suprasternal notch
2) Carina - Angle of Louis
3) Right and Left Mainstem Bronchi - Right and left 2nd intercostal space.
4) Right and Left Upper Lobe - Right and left 2nd intercostal space at the midclavicular line.
5) Right middle lobe - Right 5th intercostal space at the midclavicular line.
6) Lingula of alert Upper Lobe - Left 5th intercostal space at the midclavicular line.
7) Right and Left Lower Lobe - Right and left mid axillary line at armpit.
