Macleod's II Flashcards
Irritation of the parietal pleura of the top few ribs causes localised pain. How many ribs does this refer to?
Irritation of the parietal pleura of the upper six ribs causes localised pain.
What type of pain is felt from irritation of the parietal pleura overlying the central diaphragm?
Pain that is referred to the neck or shoulder tip
Describe mediastinal pain.
Mediastinal pain is central, retrosternal and unrelated to respiration or cough.
What is Cheyne-Stokes respiration?
Periodic breathing that is cyclical with increasing rate and depth of breathing, followed by diminishing respiratory effort and rate, ending in a period of apnoea or hypopnoea.
Define Tachypnoea and Bradypnoea
Tachypnoea is >25 breaths/min.
Bradypnoea is <10 breaths/min.
What are the lung conditions that coal miners are at risk of?
COPD and pulmonary fibrosis
What is the cause of Farmer’s lungs?
Fungal spores of thermophilic actinomycetes or Micropolyspora faeni
What is the cause of Malt worker’s lungs?
Aspergillus clavatus
What is the cause of Bird Fancier’s lungs?
Bloom on birds’ feathers or excreta
What are the accessory muscles of respiration?
Sternocleidomastoid, platysma and trapezius muscles.
How to examine for stridor?
Ask patient to cough and then breathe deeply in and out with the mouth wide open. Listen for high pitch breathing sounds resulting from turbulent airflow in the larynx or lower in the bronchial tree.
What does central cyanosis reflects?
What does peripheral cyanosis reflects?
Central cyanosis reflects arterial hypoxaemia.
Peripheral cyanosis is usually due to circulatory disorders or cold, but can arise with severe central cyanosis.
What does clubbing suggest?
Thoracic disease such as lung cancer, bronchiectasis, interstitial lung disease.
It can also suggest gastrointestinal disorders.
What is asterixis?
Asterixis is flapping tremor of the hands, seen in CO2 retention and severe ventilatory failure.
What does unilateral asterixis indicative of?
A structural abnormality in the contralateral cerebral hemisphere.
What are the findings in superior vena cava obstruction?
JVP is raised and non-pulsatile. Abdominjugular reflex is also absent.
Who will have a barrel-shaped chest? How do you define a barrel shaped chest?
Patients with severe COPD.
When the anteroposterior diameter is greater than the lateral diameter.
How do you determine the position of the mediastinum?
Shift of the upper mediastinum causes tracheal deviation.
Displacement of the apex beat indicates lower mediastinum shift.
What is a common cause of displacement of the cardiac impulse without tracheal deviation?
Left ventricular hypertrophy.
In tension pneumothorax, does the trachea deviate away or towards the side of the lung lesion?
Away from side of lung lesion.
What does paradoxical inward movement of the chest during normal tidal breathing indicate?
Bilateral reduction of expansion on side indicates diaphragmatic paralysis, or more commonly, severe COPD.
What are the possible diagnosis of dullness in percussion of chest?
Pulmonary consolidation, pulmonary collapse, severe pulmonary fibrosis
What are the possible diagnosis of stony dull percussion note from the chest?
Pleural effusion, haemothorax
Resonance below which rib indicates hyperinflation?
Below the 5th rib
Describe the sound of bronchial breathing.
High-pitched breath sounds with a hollow or blowing quality. Breath sounds are of similar length and intensity in inspiration and expiration, with a characteristic pause between the 2 phases.
