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Physical Diagnosis > Midterm Practical: Lung Exam > Flashcards

Midterm Practical: Lung Exam Flashcards

1
Q

Patient Position & Gown

A

Seated
Gown open to the back

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2
Q

Respiration: What are you observing?

A

Rate, Rhythm & Amplitude

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3
Q

Example of an Abnormal Rate and Cause for the Abnormal Rate

A

Tachypnea
Pleuritic Chest Pain

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4
Q

Example of an Abnormal Rhythm and Cause for the Abnormal Rhythm

A

Cheyne Stokes
Stroke

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5
Q

Example of an Abnormal Amplitude and Cause for the Abnormal Amplitude

A

Hyperpnea
Increased Metabolic Demand

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6
Q

Anterior and Posterior Thorax: Steps for Inspection

A

Shape and Symmetry
Rashes, Masses, Lesions and Scars

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7
Q

2 Examples of Thorax Variations and what causes each Variation

A

Barrel Chest: Emphysema
Pectus Excavatum: Marfans Syndrome

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8
Q

Example of a Rash and it’s Cause

A

Poison Ivy: Contact Dermatitis

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9
Q

Example of a Mass and its Cause

A

Virchow’s Node: GI Cancer

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10
Q

Muscles: What are you observing?

A

Contraction of accessory Muscles of inspiration

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11
Q

What are the Accessory muscles of Inspiration and name a Cause for Recruitment of these muscles

A

SCM and Scalenes
Emphysema

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12
Q

Steps of Palpation

A

Anterior & Posterior Chest Palpation
Chest Expansion Test
Tactile Fremitus
Tracheal Deviation Test

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13
Q

A & P Chest Palpation

A

Ask if pt has any areas of TENDERNESS or HYPERSENSITIVITY
Explain procedure to patient
Shield Breasts
Palpate A & P Thorax

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14
Q

Reproduction of pain during chest Palpation points toward?

A

A Chest Wall Issue

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15
Q

Chest Expansion Test Steps

A

Explain procedure to patient
Proper hand positioning
Instruct patient to take a deep breath
Hands dont move independent of patients breath

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16
Q

What to state during Chest Expansion Test

A

“Unilateral Lag and Lack of Initiation are abnormal”
“Pathology is located on the side of lag”
Cause for abnormal chest expansion: Pneumothorax

17
Q

Tactile Fremitus Steps

A

“Can you please say 99 every time I move my hands?”
Use ulnar ridge of hands
Correct Locations
Sheild Breasts
No cupping of hands

18
Q

Tracheal Deviation Test Steps

A

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

19
Q

Tracheal Deviation Test Verbals

A

Pathology resulting in Ipsilateral tracheal deviation:
Atelectasis

Pathology resulting in Contralateral tracheal deviation:
Pneumothorax

20
Q

Percussion Steps

A

A & P Lung Fields
Diaphragmatic Excursion

21
Q

Percussion the A & P Lung Fields Details

A

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

22
Q

Percussion the A & P Lung Fields verbals

A

example of abnormal lung sound:
Hyperresonance
Cause of hyperresonance:
Pneumothorax

23
Q

Percussion Diaphragmatic Excursion Steps

A

1) explain procedure to patient
2)proper technique
3)location & Sound (mark 3 marks w. Wax pencil)

24
Q

Percussion Diaphragmatic Excursion Verbals

A

Normal diaphragmatic excursion range:
3-5.5cm

Cause of absent/Decreased decent of diaphragm:
Pleural Effusion

25
Q

Instructions for patient during Lung Auscultation

A

“Breathe in and out through your mouth each time the stethoscope moves to a new location”
“Let me know if I start going to fast”
“Clear your throat”

26
Q

Lung Auscultation Steps

A

1) Shield Breasts
2) Use Diaphragm of Scope on Skin
3) Correct locations
4) Utilize a Side-to-Side Pattern

27
Q

Lung Auscultation: State 2 Normal Breath Sounds and where they are found

A

Vesicular: Parenchyma/Alveoli
Tubular: Trachea/Major Bronchi

28
Q

Lung Auscultation: State 2 Adventitious Breath sounds and their Cause

A

Wheeze: Asthma
Crackles: Pneumonia

29
Q

Exam Sequence of the Lung Exam

A

Inspection
Palpation
Percussion
Auscultation

Physical Diagnosis (7 decks)

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