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Clinical Assessment 2 > Lungs and Thorax Lecture > Flashcards

Lungs and Thorax Lecture Flashcards

1
Q

What are the ROS for thorax/ lungs?

A

Chest pain SOB/ dyspnea Wheezing Cough Hemoptysis

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2
Q

2 conditions to be concerned with for health maintenance

A

Smoking

Influenza

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3
Q

Where does the trachea bifurcate into main bronchi?

A

Sternal angle/ T4

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4
Q

What is the order to the pulmonary exam?

A

Inspection Palpation Percussion Auscultation

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5
Q

What four things are we looking for on inspection?

A

Color

Breathing/ wheezing

Neck

Shape of chest

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6
Q

What is an acceptable AP to lateral ratio of the chest?

A

2:1

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7
Q

What is a barrel chest associated with?

A

COPD can be with normal aging

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8
Q

What is this a picture of?

A

Barrel Chest

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9
Q

What is a traumatic flail chest?

A

2 or more ribs broken in 3 or more places

Paradoxical movement

Moves in on inspiration, out on expiration

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10
Q

What is this?

A

Pectus Excavatum (funnel chest)

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11
Q

What is this?

A

Pectus Carinatum (pigeon chest)

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12
Q

What are the spots for tactile fremitus?

A

3 B/L anterior

4 B/L posterior

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13
Q

What causes a absent or decrease in tactile fremitus?

A

Bronchial dilation

COPD

Pneumothorax

Atelectasis

Tumor

Pleural effusion

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14
Q

What can cause an increase in tractile fremitus?

A

Consolidation (lobar pneumonia)

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15
Q

What four things can cause abnormal chest excursions?

A

Splinting

Bronchial obstruction

Pleural effusion

Lobar pneumonia

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16
Q

How many sites do you perform percussion?

A

Posteriorly- 7 sites

Anteriorly 6 sites

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17
Q

What type fashion should you move in when doing percussion?

A

Ladder fashion

18
Q

What is the normal sound with percussion of the lung?

A

Resonant

19
Q

What is hyper-resonance associated with?

A

Emphysema, pneumothorax

20
Q

What is tympany associated with?

A

Large pneumonia

21
Q

What are three specials for lung auscultation?

A

Bronchophony

Whispered petrolioquy

Egophony

22
Q

What are vesicular breath sounds?

A

Normal sound heard over healthy tissue

23
Q

What are bronchovesicular lung sounds?

A

Sounds heard over a large bronchi

24
Q

What does a pleural rub sounds like?

A

Stepping on snow

25
Q

What is mediastinal crunch (Hamman’s Sign)?

A

Series of precordial crackles syncronous with the heart beat, not with respiration

26
Q

What is atelectasis?

A

Main bronchus is plugged with fluid or blood

27
Q

What is consolidation?

A

Alveoli filled with fluid or blood cells, as in pneumonia, pulmonary edema or pulmonary hemorrhage

28
Q

What is a pleural effusion?

A

Fluid in pleural spaces separates air-filled lung from pluera

29
Q

What is a pneumothorax?

A

When air leaks into pleural space causing lung to recoil from chest wall, pleural air blocks transmission of sound

30
Q

What age is pnemococcal vaccine given to?

A

Adults >65

31
Q

What other populations in pneumococcal vaccine given to?

A

Routine vaccine for all children and infants

adults with chronic illness

smokers age 19-64

anyone about to get a cochelar implant

adults and children older than 2 who are immunocomprimised

32
Q

What are the 5 A’s

A

Ask

Advise

Assess

Assist

Arrange

33
Q

What are the steps of the stages of change model?

A

Precontemplation

Contemplation

Preparation

Action

Maintenance

34
Q

What causes a unilateral decreases in chest expansion?

A

Chronic fibrosis of the underlying lung or pleura

Pleural effusion

Lobal pneumonia

Pleural pain w/ splinting

Unilateral bronchial obstruction

35
Q

What does unilateral hyperresonance suggest?

A

Large pneumothorax or a large air filled bulla in the lung

36
Q

What’s a sound that is soft and low pitched, heard through inspiration, continue without pause through expiration then fade away about 1/3 through expiration

A

Vesicular

37
Q

What are louder, harsher, sounds higher in pitch.

Short silence between inspiratory and expiratory sounds

Expiratory sound lasts longer

A

Bronchial

38
Q

What is a Discontinuous, intermittent, nonmusical, brief sound that is like a dot in time?

A

Crackle (rales)

39
Q

Where might bronchial breath sounds replace normal vesicular breath sounds?

A

Over airless areas of the lung

40
Q

What is it called when a spoken “ee” is heard as an “ay”?

A

Egophony

41
Q

What is it called when spoken words are heard louder on auscultation?

A

Bronchophony

42
Q

Will tactile fremitus be increased or decreased in the airless state of the lung?

A

Increased

Clinical Assessment 2 (17 decks)

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