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Physical Diagnosis II Exam One > Lung Exam > Flashcards

Lung Exam Flashcards

1
Q

At which intercostal space level and spinal level does the trachea bifurcate?

A

2nd ICS anteriorly

T3 spinous posteriorly

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2
Q

Is the base of the lung higher in the front or back?

A

Front (6th rib)

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3
Q

The angle of the base of the lungs is approximately at which spinal level posteriorly?

A

T10

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4
Q

What are the 5 traditional lung physical exam procedures?

A 
1 inspection
2 palpation
3 fremitus
4 percussion
5 auscultation
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5
Q

What is the most effective and efficient functional lung assessment?

A

Auscultation

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6
Q

What is another name for each rapid, deep breath seen in hyperventilation?

A

Kussmaul (hyperpnea)

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7
Q

What is the term for abnormally slow breathing? Fast breathing?

A 
Slow = bradypnea
Fast = tachypnea
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8
Q

What is hypopnea?

A

Shallow breaths

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9
Q

What is the term for dyspnea initiated or aggravated when lying down?

A

Orthopnea

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10
Q

What is platypnea?

A

Dyspnea initiated or aggravated in the upright position

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11
Q

What kind of dyspnea is provoked by minimal effort such as climbing a few stairs?

A

Exertional dyspnea

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12
Q

What is Cheyne-Stokes breathing?

A

Alternating crescendo-decrescendo breathing and apnea

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13
Q

What type of respiration involved a few deep breaths followed by a period of apnea?

A

Biot respiration

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14
Q

Which part of the chest is 2X wider in an adult: width or depth?

A

Width

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15
Q

What kind of condition would result in the presentation of flail chest?

A

Multiple, unilateral rib fractures

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16
Q

How is the movement of the rib cage different with flair chest?

A

Fractured rib cage moves downward with inspiration instead of upward like the other side

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17
Q

What is respiratory splinting?

A

When the patient holds their chest in an attempt to limit movement

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18
Q

In which conditions could we observe respiratory splinting?

A

Pleurisy, bruised or cracked rib

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19
Q

What is the term for a lateral curvature of the spine?

A

Scoliosis

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20
Q

What is the term for a humped back?

A

Hyperkyphosis

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21
Q

What is the term for a congentially depressed sternum?

A

Pectus excavatum

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22
Q

What is the term for an abnormal prominence of the sternum?

A

Pectus carinatum

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23
Q

What is the term for anincreased anteroposterior chest diameter and with what condition is it prevalent?

A

Barrel chest; COPD

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24
Q

What kind of obstruction is associated with ICS retraction? With ICS bulging?

A 
Retraction = Large airway/inspiratory obstruction
Bulging = expiratory obstruction
25
Q

What is the exception to the rule that abnormal fremitus always indicates a lung pathology?

A

Right paraspinal fremitus vibrations are often more pronounced than the left from T3-T6 due to the presence of the heart

26
Q

What is the normal range of diaphragmatic excursion?

A

1-2 inches or from T10-T12

27
Q

What kinds of things can limit the movement of the diaphragm and therefore diaphragmatic excursion?

A

Emphysema, ascites, pregnancy, or pain

28
Q

What are the five clinically useful percussion sounds?

A 
1 resonant
2 flat
3 dull
4 tympanic
5 hyper-resonant
29
Q

Which percussion sound is that which is normally heard over the lung fields?

A

Resonant

30
Q

Which percussion sound is normally heard over larger bones like the sternum and scapulae?

A

Flat

31
Q

Which percussion sound is only heard over hyper inflated alveoli as in advanced emphysema?

A

Hyper-resonant

32
Q

Which percussion sound is normally heard over the heart, liver, and diaphragm?

A

Dull

33
Q

Which percussion sound is normally heard over the abdomen over the gastric air bubble and intestines?

A

Tympanic

34
Q

Is auscultation louder upon inspiration or expiration?

A

Inspiration

35
Q

What the 3 forms of breath sounds?

A

1 bronchial (main airways)
2 bronchovesicular
3 vesicular

36
Q

What are the three types of added sounds?

A

1 crackles
2 wheezing
3 friction rubs

37
Q

What are the 3 voice sounds?

A

1 spoken ABC
2 EEE
3 whispered ABC

38
Q

Which is associated with a loud and long expiratory phase: large or small airways?

A

Large (bronchi and bronchioles)

39
Q

Which is associated with a short and soft expiratory phase: large or small airways?

A

Small (terminal airways and alveoli)

40
Q

What is the intercostal space location of the bronchial/main bronchi?

A

2nd parasternal/paraspinal ICS

41
Q

What is the intercostal space location of the bronchovesicular/large bronchials?

A

3rd-4th parasternal/paraspinal ICS

42
Q

What kinds of airways should encompass the majority of the lung field?

A

Vesicular/terminal and alveolar

43
Q

What is another name for the crackles heard upon abnormal lung pathology?

A

Rales

44
Q

What causes the crackling sound in some lung pathologies?

A

Excess production and secretion of mucus or the inflation of multiple collapsed alveoli

45
Q

When are crackles usually heard during the breathing pattern?

A

Early, mid, or late inspiration

46
Q

What action can often clear coarse crackles?

A

Coughing

47
Q

What are the locations for coarse, medium, and fine crackles?

A 
Coarse = large airways (bronchi)
Medium = medium size airways (bronchioles)
Fine = small airways (terminal airways)
48
Q

What kind of crackles are unable to be cleared by coughing?

A

Fine

49
Q

What is the term for loud crackles heard through all of inspiration and/or expiration due to air passing over thick mucus in large airways in a patient too debilitated to clear it with coughing?

A

Sonorous rhonchi

50
Q

How much fine crackles be cleared?

A

Mucus escalator

51
Q

What is another term for wheezes?

A

Sibilant rhonchi

52
Q

What causes wheezing?

A

Narrowed airways (due to bronchospasm or excess mucus/compression)

53
Q

What is the phenomenon for increased intensity and clarity of the whispered word, “ABC”?

A

Whispered pectoriloquy

54
Q

What is the phenomenon for increased intensity and clarity of the spoken word, “ABC”?

A

Bronchophony

55
Q

What is the phenomenon for increased intensity and clarity of the spoken word, “EEE”?

A

Egophony

56
Q

What can be implied with loud than expected whispered pectoriloquy, bronchophony, and egophony?

A

Consolidating pneumonia

57
Q

Sound vibrations are better conduction through what medium?

A

Continuous fluid/solids

58
Q

Do fremitus, breath sounds, and spoken/whispered words transmit louder or softer through consolidation?

A

Louder

Physical Diagnosis II Exam One (3 decks)

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