Module 6: Respiratory System

Question 1

Identify signs of respiratory distress in adults

Answer 1

• Accessory muscle use
• Intercostal retractions
• Forward leaning
• Deep, exaggerated, or labored breathing

Question 2

Identify signs of respiratory distress in children

Answer 2

• Infants – nasal flaring

- Toddlers/older children – tripod position

Question 3

A trachea that deviates toward the side of pathology can be caused by

Answer 3

• Atelectasis
• Pneumothorax
• Agenesis of lung
• Pneumonectomy
• Pleural fibrosis

Question 4

A deviated trachea that is away from the pathologic side can be caused by

Answer 4

• Tension pneumothorax
• Pleural effusion
• Large chest wall mass
• A tracheal mass

Question 5

AP: Lateral Ratio

Answer 5

• Comparison of depth to width of the chest wall

- Normal AP:lateral ratio = 2:3

Question 6

Basic breathing sounds

Answer 6

Lung sounds created by movement of air through the respiratory tract

Question 7

Adventitious lung sounds

Answer 7

Added sounds superimposed on the basic breath sounds

Question 8

Adventitious Breath Sounds – Crackles

Answer 8

• Short, high-pitched, discontinuous breath sounds
• Can be described as popping/explosive
• Thought to be the opening of small airways and alveoli during inspiration

Question 9

Adventitious Breath Sounds - Rhonchi

Answer 9

• Coarse, low-pitched, continuous sounds
• Snoring-like sound made when exhaling
• Due to secretions in the bronchial airways
• Often found in COPD, bronchitis, inflammation, etc.

Question 10

Adventitious Breath Sounds – Wheezes

Answer 10

• High-pitched, musical sound
• Mostly heard when airways are constricted/partially obstructed
• Could be from bronchospasm, asthma, COPD, & bronchitis

Question 11

Pleural Friction Rubs

Answer 11

• Sound that occurs when inflamed visceral & parietal pleura rub together
• Harsh scratching/crinkling sound
• Often found in pleurisy, neoplasm, & pulmonary infarction

Question 12

Stridor

Answer 12

• High-pitched sound
• Generally only heard in inspiration
• Possible obstruction or stenosis
• Should be considered a medical emergency

Question 13

3 Types of Rib Motion

Answer 13

• Bucket handle
• Pump handle
• Caliber motion

Question 14

Bucket Handle Rib Motion

Answer 14

• Lateral
• Occurs during inspiration
• Can be visualized as the handle of a bucket lifted w/ attachments

Question 15

Pump Handle Rib Motion

Answer 15

• Can be visualized as the spine representing a pump w/ sternum acting as the handle
• As inspiration occurs, the handle is lifted
• Results in an increase in the AP diameter

Question 16

Caliber Rib Motion

Answer 16

• Ribs 11 & 12
• Inspiration results in increase angle
• Similar to motion of calibers

Question 17

Tactile Fremitus

Answer 17

• The transmission of sound from the bronchial tree to the chest wall as the patient speaks
• It can be assessed by the provider through palpation of the vibratory sensation
• Increased w/ consolidation found in pneumonia

Question 18

Special Testing for Tactile Fremitus Includes These Tests

Answer 18

• Bronchophony
• Whispered Pectoriloquy
• Egophony

Question 19

Bronchophony

Answer 19

A technique of assessment for consolidation where vocal resonance is heard louder and clearer over areas of consolidation

Question 20

Whispered Pectoriloquy

Answer 20

A technique of assessment where the patient whispers a word that is perceived to have an increase in volume or clarity as the provider auscultates

Question 21

Egophony

Answer 21

• A test for consolidation where the patient is asked to say “E” while the provider auscultates the lungs
• An area of consolidation is encountered when the “E” is perceived as an “A”