Lung exam

Question 1

Barrel Chest

Answer 1

Increased AP diameter; normal in infancy and sometimes in aging or COPD

Question 2

Funnel Chest

Answer 2

Pectus Excavatum; chest is depressed

Question 3

Pigeon Chest

Answer 3

Pectus Carinatum; sternum is displaced anteriorly

Question 4

Flail chest

Answer 4

paradoxical movement of a portion of the chest wall; due to multiple rib fractures

Question 5

Fremitus

Answer 5

Palpable vibrations transmitted through the bronchopulmonary tree to the chest wall when the patient speaks; increases from air, fluid to solid

Question 6

Fremitus Technique

Answer 6

Use ball of hand on pt chest and ask them to say 99 or 111

Question 7

Percussion

Answer 7

Used to determine resonance; hollow sound may indicate pneomothorax

Question 8

Percussion technique

Answer 8

Place non-dominant hand on pt chest, spread fingers out and place middle finger withing intercostal, tap using dominant hand, compare right and left

Question 9

Auscultation

Answer 9

Used to hear breath sounds and abnormal sounds

Question 10

Auscultation technique

Answer 10

Ask pt to breathe through open mouth, listen over same areas as percussed, alternate between left and right sides

Question 11

Crackles

Answer 11

Crepitations; unique crackling sound of the lung, heard during inspiration, caused by snapping open of airways that have been collapsed by fluid or exudate

Question 12

Bibasal crackles

Answer 12

Due to fibrosis or mild pulmonary edema

Question 13

Localized crackles

Answer 13

Due to pneomonia

Question 14

Widespread crackles

Answer 14

Sever pulmonary edema

Question 15

Pleural rub

Answer 15

Leathery sound which occurs on chest movement when two pleural layers rub together, heard with inspiration and expiration

Question 16

Fibrosis auscultation

Answer 16

Chest expansion: decreased bilaterally; trachea: shifted to affected; Fremitus: increased; percussion: dull; bronchial breath sounds; Coarse crepitations

Question 17

Pleural Effusion auscultation

Answer 17

Chest Expansion: decreased on affected; trachea: shifted to opposite; Fremitus: absent; Percussion: stony, dull; Breath sounds: absent but bronchial above fluid

Question 18

COPD/ Asthma auscultation

Answer 18

Chest: decreased bilaterally; Trachea: center; Fremitus: normal/decreased; percussion: increased; Breath sounds: decreased; polyphonic wheeze

Question 19

Lung collapse auscultation

Answer 19

Chest: decreased on affected; Trachea: shifted to affected; Fremitus: absent; percussion: dull; Breath sounds: decreased

Question 20

Consolidation auscultation

Answer 20

Chest: decreased on affected; Trachea: central; Fremitus: increased; Percussion: dull; Breath sounds: bronchial; crepitations