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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
What is the exception to the rule that abnormal fremitus always indicates a lung pathology?
Right paraspinal fremitus vibrations are often more pronounced than the left from T3-T6 due to the presence of the heart
26
What is the normal range of diaphragmatic excursion?
1-2 inches or from T10-T12
27
What kinds of things can limit the movement of the diaphragm and therefore diaphragmatic excursion?
Emphysema, ascites, pregnancy, or pain
28
What are the five clinically useful percussion sounds?
``` 1 resonant 2 flat 3 dull 4 tympanic 5 hyper-resonant ```
29
Which percussion sound is that which is normally heard over the lung fields?
Resonant
30
Which percussion sound is normally heard over larger bones like the sternum and scapulae?
Flat
31
Which percussion sound is only heard over hyper inflated alveoli as in advanced emphysema?
Hyper-resonant
32
Which percussion sound is normally heard over the heart, liver, and diaphragm?
Dull
33
Which percussion sound is normally heard over the abdomen over the gastric air bubble and intestines?
Tympanic
34
Is auscultation louder upon inspiration or expiration?
Inspiration
35
What the 3 forms of breath sounds?
1 bronchial (main airways) 2 bronchovesicular 3 vesicular
36
What are the three types of added sounds?
1 crackles 2 wheezing 3 friction rubs
37
What are the 3 voice sounds?
1 spoken ABC 2 EEE 3 whispered ABC
38
Which is associated with a loud and long expiratory phase: large or small airways?
Large (bronchi and bronchioles)
39
Which is associated with a short and soft expiratory phase: large or small airways?
Small (terminal airways and alveoli)
40
What is the intercostal space location of the bronchial/main bronchi?
2nd parasternal/paraspinal ICS
41
What is the intercostal space location of the bronchovesicular/large bronchials?
3rd-4th parasternal/paraspinal ICS
42
What kinds of airways should encompass the majority of the lung field?
Vesicular/terminal and alveolar
43
What is another name for the crackles heard upon abnormal lung pathology?
Rales
44
What causes the crackling sound in some lung pathologies?
Excess production and secretion of mucus or the inflation of multiple collapsed alveoli
45
When are crackles usually heard during the breathing pattern?
Early, mid, or late inspiration
46
What action can often clear coarse crackles?
Coughing
47
What are the locations for coarse, medium, and fine crackles?
``` Coarse = large airways (bronchi) Medium = medium size airways (bronchioles) Fine = small airways (terminal airways) ```
48
What kind of crackles are unable to be cleared by coughing?
Fine
49
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?
Sonorous rhonchi
50
How much fine crackles be cleared?
Mucus escalator
51
What is another term for wheezes?
Sibilant rhonchi
52
What causes wheezing?
Narrowed airways (due to bronchospasm or excess mucus/compression)
53
What is the phenomenon for increased intensity and clarity of the whispered word, "ABC"?
Whispered pectoriloquy
54
What is the phenomenon for increased intensity and clarity of the spoken word, "ABC"?
Bronchophony
55
What is the phenomenon for increased intensity and clarity of the spoken word, "EEE"?
Egophony
56
What can be implied with loud than expected whispered pectoriloquy, bronchophony, and egophony?
Consolidating pneumonia
57
Sound vibrations are better conduction through what medium?
Continuous fluid/solids
58
Do fremitus, breath sounds, and spoken/whispered words transmit louder or softer through consolidation?
Louder

Physical Diagnosis II Exam One (3 decks)

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