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PD > Lung/Thorax > Flashcards

Lung/Thorax Flashcards

1
Q

Cyanosis, accessory muscle use during breathing and pursed lips are all signs of _____

A

respiratory distress

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2
Q

pectus excavatum and pectus carinatum are types of ______

A

chest wall deformities

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3
Q

What are signs to look for somewhere other than your thorax during inspection of thoracic functions?

A
  • cyanosis and/or clubbing of the fingernails
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4
Q

When you palpate during respiration you are looking for ____ (2)

A
  • respiratory expansion

- fremitus (vibration which usually means friction between the pleura)

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5
Q

When you percuss you’re looking for (2)

A
  • diaphragmatic excursion

- resonance of the lungs (dull, resonant, hyperresonant)

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6
Q

I:E ratio

A

-Inspiration:expiration ratio–normal is 1:2

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7
Q

Egophony:

A

E –> A changes

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8
Q

Whispered pectoriloquy is a form of ______

A

auscultation

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9
Q

____ is vibrations perceived in a tactile, non-acoustic manner when the person says “ninety nine”. This signifies______

A
  • fremitus

- an area of consolidation–i.e., a mass like a tumor or pneumonia

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10
Q

Decreased fremitus suggests

A
  • obstruction of the bronchial system or

- the lung being displaced away from the chest wall by air, fluid or solid

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11
Q

Dullness replaces resonance during percussion when ______

A

there is fluid or solid replacing air-containing lung or pleural space

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12
Q

Inspiratory sounds of any pitch caused by popping open of airways is called _____

A

crackles

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13
Q

Early inspiratory crackles suggests (2)

A
  • COPD

- asthma

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14
Q

Mid-inspiratory crackles suggests

A
  • bronchiectasis
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15
Q

Late inspiratory crackles suggests (2)

A
  • CHF

- pulmonary fibrosis

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16
Q

How does whispered pectoriliquy work?

A
  • when one auscultates the chest and hears identifiable words, they need to identify the vowels. Normal lungs filter out the formants of the vowels, solids such as tumor and pneumonia don’t filter out the vowels
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17
Q

Where does egophany (e –> a sounds) work on the lungs?

A
  • above consolidation

- above pleural effusion

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18
Q

These are cavernous breath sounds, like blowing over a bottle

A

amphoric breath sounds

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19
Q

_____ is at the air fluid border in cases such as hydropneumothorax and is splashing sounds when the patient moves

A

succession splash

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20
Q 
The following indicates: \_\_\_\_\_\_
•	Inspection
•	Palpation: increased fremitus 
•	Percussion: dull (due to consolidation)
•	Whispered pectoriloquy: present 
•	Egophony: present 
•	Late inspiratory crackles
A

pneumonia

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21
Q 
The following indicates: \_\_\_\_\_\_
•	Inspection: trachea shifted to the opposite side (by fluid)
•	Palpation: decreased fremitus 
•	Percussion: dull 
•	Whispered pectoriloquy: present 
•	Egophony: present
A

pleural effusion

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22
Q 
The following indicates: \_\_\_\_\_\_
•	Inspection: trachea shifted to the opposite side
•	Palpation: decreased fremitus 
•	Percussion: hyperresonant
•	Whispered pectoriloquy: present 
•	Egophony: present
A

pneumothorax

23
Q 
The following indicates: \_\_\_\_\_\_
•	Inspection
•	Palpation/fremitus: normal 
•	Percussion: resonant
•	Whispered pectoriloquy: present 
•	Egophony: present 
•	Late inspiratory crackles
A

CHF

24
Q

In the case of asthma, when do you hear wheezing?

A
  • either only on expiration or in both phases
25
Q

(T/F) Asthmatics have difficulty breathing but no issues with fluid or mucus

A
  • F: they have a cough with thick sputum
26
Q

pleuritic pain, cough with sputum, fever, dyspnea and bronchial breath sounds suggests

A

pneumonia

27
Q

dyspnea, cough, orthopnea (inability to breath when not standing), sometimes wheezing, vesicular breath sounds (quiet inspiratory sounds, non-existant expiratory sounds) suggests ______

A

CHF

28
Q

S1 sound indicates

A
  • closure of the mitral and tricuspid valves (mitral first, then tricuspid)
29
Q

S2 sound indicates

A
  • closure of the aortic and pulmonic valves and varies with respiration
30
Q

Systolic murmurs can indicate ______(2)

A
  • aortic or pulmonic stenosis

- mitral/tricupsid regurge

31
Q

when do systolic murmurs occur?

A
  • between S1 and S2
32
Q

Diastolic murmurs can indicate _____(2)

A
  • mitral/tricuspid stenosis

- aortic/pulmonic regurge

33
Q

When do diastolic murmurs occur?

A
  • between S2 and S1
34
Q

L lateral decubitis position

  • benefits
  • where to auscultate and with what
  • what does it accentuate
A
  • brings L ventricle close to the chest wall
  • auscultate at the PMI (point of maximum impulse) with bell
  • accentuates S3 and S4 and mitral murmurs
35
Q

Leaning forward, complete exhalation and pausing in expiration

  • where to auscultate and with what
  • what does it accentuate
A
  • apex and along the L sternal border with the bell

- soft decrescendo murmurs of aortic insufficiency/regurge

36
Q

Patient stands and/or strains with valsalva

  • what happens within the heart at this point?
  • what does it accentuate?
A
  • decreased L ventricular volume from decreased VR to the heart
  • systolic hypertrophic cardiomyopathy murmur and prolapse of the mitral valve increases, murmur lengthens
37
Q

Patient squats and/or releases valsalva

  • what happens within the heart at this point?
  • what does it accentuate?
A
  • increased LV volume from increased VR to the heart

- systolic aortic stenosis murmur

38
Q

The protodiastolic gallop is also referred to as ____

A

S3 heart sound

39
Q

When is S3 heard?

A
  • after the aortic valve closes
40
Q

Where is the S3 best heard?

A
  • LV apex (with bell)
41
Q

What position of the patient is best for hearing this?

A
  • L lateral decubitus
42
Q

a pathologic change in ventricular compliance which is a sign of a failing heart is indicated by _____

A
  • S3 sound
43
Q

a presystolic gallop is also referred to as ____

A

S4 sound

44
Q

when is the S4 physiological?

A
  • in young children with a very thin chest wall
45
Q

What does an S4 indicate in adults?

A
  • thinning of the myocardium in CHF and therefore a failing heart
46
Q

When does the S4 occur?

A
  • during atrial contraction, just before systole, immediately preceding S1 of the next beat
47
Q

If the S4 disappears suspect _______

A

atrial fibrillation (atrium not contracting due to an electrical problem)

48
Q

Summation of S1, S2, S3 and S4 sounds in quick succession is called ______

A
  • quadruple/summation gallop
49
Q

Grade 1 murmur

A
  • faint, heard after listener has tuned in and may not be heard in all positions
50
Q

Grade 2 murmur

A
  • quiet, but heard immediately with stethoscope
51
Q

Grade 3 murmur

A
  • moderately loud murmur
52
Q

Grade 4 murmur

A

loud with a palpable thrill

53
Q

Grade 5 murmur

A
  • very loud with palpable thrill, may be heard with the stethoscope partly off the chest
54
Q

Grade 6 murmur

A
  • very loud with palpable thrill, may be heard with the stethoscope entirely off the chest

PD (8 decks)

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