Lungs Flashcards
- What are some common or concerning symptoms of the pulmonary system?
a. chest pain, shortness of breath (dyspnea), wheezing, cough, blood streaked sputum/hemoptysis, retraction, cyanosis, audible stridor
- What are some causes of chest pain?
angina… MI, pericarditis, AAA, bronchitis, costochondritis, musculoskeletal pain, herpes zost., esophagus problems, extrathoracic structures like neck, gallbladder, stomach
What causes the percussive note of healthy lung tissue? What causes hyperresonance? Dullness?
Resonance is due to air filled cavities. Hyperresonance from overinflated lungs from COPD, asthma, pneumothorax and emphysema. Air replaced by fluid or solid tissue replaces air or solid matter may occupy the pleural space beneath your percussing fingers.
- What is the purpose of auscultating the lungs in a ladder-like pattern?
Compare both sides
- What are vesicular sounds? What are adventitious sounds?
Vesicular sounds are soft and low pitched. They are heard through inspiration continue without pause through expiration and then fade away about one third of the way through expiration.
Adventitious sounds are added sounds that you normally do not hear; they are superimposed on the usual breath sounds (i.e. crackles, wheezes and rhonchi)
Crackles may be from abnormalities of the lungs (pneumonia, fibrosis, early heart failure) or of the airways (bronchitis, bronchiectasis).
- Compare / contrast the following terms: bronchophony, egophony, and whispered pectoriloquy. How are they typically described/characterized? What do they indicate about pulmonary function?
a. Ask the patient to say “ninety-nine” - normally the sounds transmitted through the chest are muffled and indistinct… Louder voice sounds = bronchophony
b. Ask the patient to say “ee” - normally hear a muffled long E sound… If ‘ee’ sounds like ‘A” egophony is present - seen in lobar consolidation from pneumonia
c. Ask the patient to whisper “ninety-nine” or “one-two-three” - the whispered voice is normally heard faintly and indistinctly, if at all… louder, clearer whispered sounds are called whispered pectoriloquy
- Compare / contrast the following terms: rhonchi, rales (crackles), wheezes, and stridor. How are they typically described/characterized? What are they caused by?
. Rhonchi - relatively low-pitched with snoring quality; suggest secretions in large airways
a. Fine crackles: soft, high-pitched, very brief; may be from abnormalities of lungs (pneumonia, fibrosis, early heart failure) or of the airways (bronchitis)
b. Wheezes - relatively high-pitched with hissing or shrill quality; suggest narrow airways, as in asthma, COPD or bronchitis
c. Stridor - high pitched noisy respiration coming from trachea or larynx - indicates upper airway obstruction
- What produces fremitus? Is the presence of fremitus characterized as a normal or abnormal finding?
a. Bates - 307 - Fremitus refers to the palpable vibrations transmitted through the bronchopulmnary tree to the chest wall as the pt. is speaking. The presence of fremitus is a NORMAL finding. Absence or decreased fremitus is a concern and indicates obstructed bronchus, COPD, pleural changes or an infiltrating tumor. Asymmetric increased fremitus can indicate pneumonia.
