Observation, palpation & auscultation Flashcards
Name the 9 objective assessment techniques
Observation Palpation Auscultation ABGs PFTs Pulse oximetry Chest X-rays Exercise tolerance tests Quality of life
Observation: what areas should you observe (7)
Eyes- colour indicating illness e.g jaundice
Hands - for any tremors e.g. flapping tremor is high CO2
Mouth- any cyanosis, are they hydrated?
Chest- shape, WOB, movements, symmetry
Position- fixing? Accessory muscles?
Skin- ruddy = inc CO2, cyanosed = lack of O2
Voice- full sentences? Pauses for breath? Any crackles?
What areas should be considered when palpating? (4)
Abdomen- is it soft and mobile? Can the diaphragm move?
Trachea- is there any deviation? Indicates pneumothorax
Skin- hydration levels, clammy, cold- indicate circulatory issues
Crackles- tactile Fremitus?
What 4 points should be observed when looking at the chest?
Shape- are they hyper inflated?
Movement- is it symmetrical, look at pump and bucket handle
Work of breathing- shortness of breath? Can they speak normally?
Pattern of breathing- deep? Shallow? Any indrawing?
What does nasal flaring achieve?
Decrease in airway resistance
Often seen in children
Auscultation: what are the 3 types of breath sounds
Normal
Increased
Decreased/ absent
Auscultation: explain what would be heard for increased breath sounds and possible causes (3)
Louder than normal on inspiration and expiration (darth Vader)
Caused by: consolidation, lung collapse, a large mass
Auscultation: explain a decreased breath sound and possible causes (4)
It’s just not there or v quiet
Caused by: shallow breathing, pain, drowsiness, emphysema
Auscultation: what would you expect to hear from normal breath sounds
Soft and muffled noises
Inspiration lasting twice as long as expiration and louder
Louder closer to trachea
Auscultation: what are the 3 added sounds
Wheeze
Crackle
Pleural rub
Auscultation: Explain what would be heard with a crackle and possible causes (3)
A short, non musical popping sound.
Caused by equalisation of pressure: can be sputum, collapsed airway, fibrosis
Auscultation: what would be heard from a wheeze and any possible causes(4)
A musical sound- can vary in pitch depending on where in the airway it is.
Whistling sound caused by narrowed airways, cause: sputum, tumour, bronchospasm
Auscultation: what is a pleural rub sound and possible cause
Creaky sound which is identical on inspiration and expiration
Caused by inflammation of pleura
How would you assess the 3 lobes with auscultations
Upper lobes- anteriorly
Middle lobe- anteriorly or laterally
Lower lobes- posteriorly
Which lung has no middle lobe
Left lung
