Midterm Practical: Lung Exam Flashcards
Patient Position & Gown
Seated
Gown open to the back
Respiration: What are you observing?
Rate, Rhythm & Amplitude
Example of an Abnormal Rate and Cause for the Abnormal Rate
Tachypnea
Pleuritic Chest Pain
Example of an Abnormal Rhythm and Cause for the Abnormal Rhythm
Cheyne Stokes
Stroke
Example of an Abnormal Amplitude and Cause for the Abnormal Amplitude
Hyperpnea
Increased Metabolic Demand
Anterior and Posterior Thorax: Steps for Inspection
Shape and Symmetry
Rashes, Masses, Lesions and Scars
2 Examples of Thorax Variations and what causes each Variation
Barrel Chest: Emphysema
Pectus Excavatum: Marfans Syndrome
Example of a Rash and it’s Cause
Poison Ivy: Contact Dermatitis
Example of a Mass and its Cause
Virchow’s Node: GI Cancer
Muscles: What are you observing?
Contraction of accessory Muscles of inspiration
What are the Accessory muscles of Inspiration and name a Cause for Recruitment of these muscles
SCM and Scalenes
Emphysema
Steps of Palpation
Anterior & Posterior Chest Palpation
Chest Expansion Test
Tactile Fremitus
Tracheal Deviation Test
A & P Chest Palpation
Ask if pt has any areas of TENDERNESS or HYPERSENSITIVITY
Explain procedure to patient
Shield Breasts
Palpate A & P Thorax
Reproduction of pain during chest Palpation points toward?
A Chest Wall Issue
Chest Expansion Test Steps
Explain procedure to patient
Proper hand positioning
Instruct patient to take a deep breath
Hands dont move independent of patients breath
What to state during Chest Expansion Test
“Unilateral Lag and Lack of Initiation are abnormal”
“Pathology is located on the side of lag”
Cause for abnormal chest expansion: Pneumothorax
Tactile Fremitus Steps
“Can you please say 99 every time I move my hands?”
Use ulnar ridge of hands
Correct Locations
Sheild Breasts
No cupping of hands
Tracheal Deviation Test Steps
1)Explain procedure to patient
2) Place index finger on one side of trachea just below cricoid cartilage.
3) not space between finger & SCM muscle
4) Repeat steps 2-3 on other side of trachea
Tracheal Deviation Test Verbals
Pathology resulting in Ipsilateral tracheal deviation:
Atelectasis
Pathology resulting in Contralateral tracheal deviation:
Pneumothorax
Percussion Steps
A & P Lung Fields
Diaphragmatic Excursion
Percussion the A & P Lung Fields Details
1) explain procedure to patient
2) correct locations & proper technique
3) made good resonant sound
4)shield breasts
5) use a side-to-side pattern
Percussion the A & P Lung Fields verbals
example of abnormal lung sound:
Hyperresonance
Cause of hyperresonance:
Pneumothorax
Percussion Diaphragmatic Excursion Steps
1) explain procedure to patient
2)proper technique
3)location & Sound (mark 3 marks w. Wax pencil)
Percussion Diaphragmatic Excursion Verbals
Normal diaphragmatic excursion range:
3-5.5cm
Cause of absent/Decreased decent of diaphragm:
Pleural Effusion
