PE skills: Respiratory Flashcards
What is chronic bronchitis?
Bronchi are chronically INFLAMED.
PRODUCTIVE COUGH
AIRWAY OBSTRUCTION may develop
What adventitious sounds are heard in a pt w/ chronic bronchitis?
None
Crackles in early inspirations
Wheezes or ronchi
What is left sided heart failure?
Increased pressure in the pulmonary veins causes congestion and interstitial edema around the alveoli.
Bronchial mucosa can become eddematous
What adventitious sounds are associated with left sided heart failure?
LATE INSPIRATORY CRACKLES in the dependent portions of the lungs
possibly wheezes
In what three conditions are the lungs resonant when you percuss them?
Normal
Chronic bronchitis
Left sided EARLY heart failure
What is consolidation?
Alveoli are filled with fluid or blood cells, as in pneumonia, pulmonary edema, or pulmonary hemorrhage.
What breath sounds would you hear with consolidation?
BRONCHIAL over the involved area
If you listen to a pt with pneumonia, what adventitious sounds would you hear?
Late inspiratory CRACKLES
In a pt w/ pneumonia (consolidation) would tactile fremitus be increased, decreased or the same?
Increased
with:
Broncophony (99> sound stays loud at periphery)
egophony (Eā> A transition)
whispered pectoriloquy (increased resonance)
What is atelectasis (lobar obstruction)?
When a plug ina mainstem bronchus (as from mucus or a foreign object) obsturcts air flow, affected lunt tissue collapses into an airless state?
What is seen on exam in a pt w/ atelectasis?
DULL over airless area
Trachea SHIFTS towards the INVOLVED side.
ABSENT breath sounds.
ABSENT tactile fremitus.
What is a pleural effusion?
Fluid accumulates in the pleural space, separates the air-filled lung from the chest wall, blocking the transmission of sound.
What is seen on exam in a pt w/ pleural effusion?
DULL over the fluid.
Large effusion SHIFTS trachea towards OPPOSITE side.
DECREASED TO ABSENT breath sounds.
Pleural rub.
Tactile fremitus may be INCREASED at the TOP of a pleural effusion but usually DECREASED to ABSENT.
What conditions are dull upon percussion?
Consolidation
Atelectasis
Pleural effusion
What is a pneumothorax?
When air leaks into the pleural space, usually unilaterally, the lung recoils from the chest wall.
Pleural air BLOCKS transmission of sound.
What conditions are hyperesonant upon percussion?
Pneumothorax
COPD
Asthma
What is seen on exam in a pt w/ a pneumothorax?
Trachea SHIFTED toward OPPOSITE side if there is a lot of air.
DECREASED to ABSENT breath sounds, adventitious sounds and tactile fremitus over pleural air.
What is COPD?
Slowly progressive disorder in which the DISTAL AIR SPACES ENLARGE and the lungs become superinflated.
What is seen on exam in a pt w/ COPD?
HYPERRESONANT
Decreased/absent breath sounds
Crackles, wheezes, and rhonchi of associated bronchitis
What is asthma?
Widespread NARROWING of the trachebronchial tree diminishes air flow to a fluctuating degree. During attacks, air flow decreases further and the lungs hyperinflate.
What is seen/heard on exam in a pt w/ asthma?
Wheezes
