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PT Exam - 3 > Physical Exam (1) - Pulmonary > Flashcards

Physical Exam (1) - Pulmonary Flashcards

1
Q

parts of a physical examination

A

observation and inspection

palpation

auscultation

cough assessment

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2
Q

observation and inspection

A

general appearance

inspection of face, head and neck

inspection of unmoving chest

inspection of moving chest

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3
Q

general appearance includes

A

level of consciousness

body type and proportions

posture

extremities

equipment

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4
Q

level of consiousness

A

are they AxO

if there is a lack of O2 –> could have affect on A&O

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5
Q

body type and proportions

A

are they obese or cachectic

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6
Q

abnormal postures may indicate

A

MS anomalies

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7
Q

MS anomalies may contribute to

A

pulmonary dysfxn or result from pulmonary problems

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8
Q

what could anomalies of the spine and rib cage interfere with

A

normal excursion

result in restrictive patterns

commonly include scoliosis, kyphosis and ankylosing spondylitis

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9
Q

extremities

A

inspect for signs of local cyanosis or digital clubbing

look for painful, swollen joints

edema

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10
Q

equipment

A

take note of any equipment used in managing the pt

cardiac monitor, vent, oxygen, etc.

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11
Q

where is a good area to detect color changes

A

face

head

neck

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12
Q

color changes

A

cyanosis

pallor

redness

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13
Q

what should we observe about breathing

A

pursed lip breathing

nasal flaring

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14
Q

what should we look for on the neck

A

jugular vein distension

hypertrophy of the SCM

use of other neck muscular hypertrophy

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15
Q

what does the use of other neck muscles indicate

A

use of accessory muscles

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16
Q

what should we look for in the face

A

signs of distress

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17
Q

inspection of the unmoving chest

A

static components

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18
Q

what should we look for on the unmoving chest

A

conditions of the skin

shape and symmetry of the chest

rib angles

intercostal spaces

musculature around the chest

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19
Q

conditions of the skin

A

incisions

scars

trauma

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20
Q

inspection of the moving chest

A

moving components

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21
Q

what should we determine –> moving chest

A

rate of respiration

inspiration and expiration ratio, in time

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22
Q

normal rate of respiration

A

12-20 breaths per min

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23
Q

inspiration and expiration ratio normal

A

1:2

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24
Q

is there any… –> moving chest

A

noise w/ breathing

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25
Q

what should we look for –> moving chest

A

symmetry of ventilation

muscles of breathing

breathing pattern

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26
Q

symmetry of ventilation

A

are the left and right sides expanding the same amount

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27
Q

muscles of breathing

A

primary v. secondary muscles being used

28
Q

breathing patterns

A

should be diaphragmatic

29
Q

eupnea

A

normal breathing

30
Q

dyspnea

A

SOB

31
Q

orthopnea

A

SOB when laying down

characterized by the # of pillows a pt needs to not have SOB

32
Q

tachypnea

A

persistent rate of >20 breaths/min

33
Q

bradypnea

A

rate < 12 breaths/min

34
Q

palpation is used to

A

either confirm or rule out a suspected abnormality

35
Q

what do we palpate

A

thoracic musculature

skeleton

36
Q

what are we feeling for

A

pulsations

tenderness

bulges

depressions

unusual movements

37
Q

what should we locate

A

landmarks

38
Q

thoracic excursion

A

specific lung segments

more objective measures

diaphragm motion

chest wall pain

39
Q

specific lung segments

A

utilizing your hands to compare the extent of expansion and timing of movement in the upper, middle and lower lobes

40
Q

upper segments

A

stand in front of pt

place you hands on their upper traps

41
Q

middle segments

A

stand in front of pt

place hands around side of the pt

have thumbs line up right below the nipple line

42
Q

lower segments

A

stand behind the pt

fingers facing down

43
Q

more objective measures

A

tape measure

measure of sternal angle with goniometer

44
Q

tape measure

A

placed at level of xiphoid process

measure at full inspiration and full expiration

45
Q

what is a normal differentiation b/w full inspiration and expiration

A

2-4”

wide range

46
Q

measure of sternal angle w/ goni

A

axis is at the xipho-sternal jxn

arms of the goni aligned w/ lower margin of the ribs

47
Q

when do we measure of sternal angle w/ goni

A

full inspiration and expiration

48
Q

diaphragm motion

A

place thumbs at sternal angle with fingers over lower margins or ribs

inspiration should cause ribs to separate

49
Q

what should we have the pt do –> chest wall pain

A

describe the
-location
-type
-characteristics of pain
-point of painful area

50
Q

how can we palpate chest wall pain

A

with firm pressure

51
Q

what should we have the pt do –> chest wall pain

A

cough

take deep breaths

to see if these reproduce of exacerbate the sxs

52
Q

what must we differentiate b/w –> chest wall pain

A

cardiogenic pain

nerve root pain

costal cartilages or ribs

musculature

53
Q

cardiogenic pain –> chest wall pain

A

located substernally

w/ or w/o radiation to UE

described as pressure or a weight on the chest

54
Q

how does nerve root pain happen

A

if inflamed or irritated

55
Q

what will pain follow –> nerve root pain –> chest wall pain

A

dermatomal distribution

56
Q

nerve root levels that involved the chest, back and abdoment

A

C2 (lower neck, shoulders and clavicular areas)

T2-T12

57
Q

what are causes of nerve root pain

A

degenerative arthritis

neoplasms

OA

disc lesions

58
Q

costal cartilages or ribs is d/t –> CWP

A

fx

subluxation

inflammation

infection

59
Q

costal cartilages or ribs sxs –> CWP

A

well localized

tender to palpation
–> palpate ON the rib will cause pain

60
Q

muscular CWP is d/t

A

spasm

strain

delayed muscle soreness following activity

61
Q

how do we differentiate muscular CWP

A

history

deep palpation of muscle bellies

giving resistance to the action of suspect muscle in an attempt to reproduce the pain

62
Q

where will palpation cause pain –> muscular CWP

A

intercostal space

63
Q

when we use the area/stretch the area –> CWP

A

it will hurt

64
Q

if needed our physical exam must be

A

expanded to rule out other MS problems

65
Q

MS problems

A

thoracic outlet syndrome

cervical disc problems

shoulder girdle pathologies

PT Exam - 3 (20 decks)

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