Overview of Heart/Lung/Abdomen Exam Flashcards
sputum
substance expelled by lung (coughed up)
color, consistency, quantity, frequency, presence or absence of blood
hemoptysis
coughing up blood from lungs
-could be sign of serious condition
clot - cancer, cavitary lesion, cardiac disease, PE
tinged - smoking, infections
dyspnea
shortness of breath (subjective)
-objective finding - tachypnea
paroxysmal nocturnal dyspnea
SOB that occurs during sleeping
orthopnea
difficulty breathing while lying flat
wheezing
high pitched sound resulting from partially obstructed airway
-bronchospasm, mucosal edema, foreign body aspiration, tumor, CHF
all that wheezes is not asthma
cyanosis
bluish discoloration of skin
-decreased oxygen
central cyanosis
inadequate gas exchange at level of lungs
peripheral cyanosis
excessive extraction of inadequate supply of oxygen at periphery
pleuritic pain
chest wall pain associated with breathing
-inflammation of pleuras
skills for respiratory exam?
inspection, palpation, percussion, auscultation
inspection of chest
shape of chest and how it moves when breathing
- deformity and asymmetry
- abnormal retraction of muscles
- impaired respiratory movements
anterior, posterior, and lateral aspects
tactile fremitus
say 99
symmetry of chest excursion
anterior and posterior
hands on back at 10th rib
dull
percussion of solid organ
resonant
percussion over structure containing air (lung)
tympanic
over hollow or air containing structure or organ (stomach)
flat
percussion over large muscle mass
auscultation
NEVER listen through clothes
types of normal breath sounds
tracheal, bronchial, bronchovesicular, vesicular
tracheal breath sounds
very loud/high pitched
-harsh sounding
-heard over trachea and neck
I:E ratio 1:1
brachial breath sounds
-loud and high pitched
I:E ratio 1:3
tubular sounding
heard over manubrium
bronchovesicular breath sounds
moderate to intermediate
I:E ratio 1:1
tubular rustling sound
over mainstem bronchi between scapula
vesicular breath sounds
soft, low pitch
I:E ration 3:1
gentle rustling
heard over most of lung fields
abnormal lung sounds
rales/crackles
wheezes
rhonchi
rales/crackles
result from opening and closing of alveoli and small airways during respiration
wheezes
high itched sound from partial obstruction of smaller airway
rhonchi
low pitched sound from larger airways partially obstructed
p wave
atrial contraction
QRS complex
ventricular contraction
T wave
ventricular polarization
PMI
point of maximal impulse
5th intercostal space
mid-clavicular line
thrill
palpable vibration felt over precordium
heave
palpable impulse or displacement of sternum
aortic area?
right sternal borde 2nd ICS
tricuspid area?
left sternal border 4th ICS
pulmonic area?
left sternal border 2nd ICS
Erb’s Point?
left sternal border 3rd ICS
mitral area?
apex of heart 5th ICS
normal heart sounds?
S1 and S2
S1
first heat sound (lub)
closure of tricuspid and mitral valves
-at tricuspid and mitral valves
S2
second heart sound (dub)
closure of aortic and pulmonic valves
-at aortic and pulmonic valves
physiologic splitting
of second heart sound
-best over pulmonic valve
exam of abdomen?
inspect, auscultate, percuss, palpate, rectal, special technique
best place to listen to abdomen
RLQ
normal bowel sounds
high pitched tinkle 3-5 seconds
borborygmi
increased hyperactive bowel sounds
lower pitched rumbling
hyperperistalsis
abdominal bruits
soft sound made by disrupted arterial flow through a narrowed artery
best way to percuss abdomen?
patient supine
tympany in abdomen?
presence of gas in stomach and small bowel
dull sound?
liver
resonant sound?
lung
hepatomegaly?
greater than 10cm
palpation of abdomen?
light, deep, liver, spleen, kidney
rebound tenderness
slowly, gently, deeply palpate
-quick release
inferior approach
liver palpation
-11th 12th rib in RUQ
hooking technique
also for liver palpation
spleen palpation
11th 12th rib LUQ
sandwich method
palpate kidneys
5 listening posts
aortic, pulmonic, Erbs, tricuspid, mitral
