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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
what should we look for --> moving chest
symmetry of ventilation muscles of breathing breathing pattern
26
symmetry of ventilation
are the left and right sides expanding the same amount
27
muscles of breathing
primary v. secondary muscles being used
28
breathing patterns
should be diaphragmatic
29
eupnea
normal breathing
30
dyspnea
SOB
31
orthopnea
SOB when laying down characterized by the # of pillows a pt needs to not have SOB
32
tachypnea
persistent rate of >20 breaths/min
33
bradypnea
rate < 12 breaths/min
34
palpation is used to
either confirm or rule out a suspected abnormality
35
what do we palpate
thoracic musculature skeleton
36
what are we feeling for
pulsations tenderness bulges depressions unusual movements
37
what should we locate
landmarks
38
thoracic excursion
specific lung segments more objective measures diaphragm motion chest wall pain
39
specific lung segments
utilizing your hands to compare the extent of expansion and timing of movement in the upper, middle and lower lobes
40
upper segments
stand in front of pt place you hands on their upper traps
41
middle segments
stand in front of pt place hands around side of the pt have thumbs line up right below the nipple line
42
lower segments
stand behind the pt fingers facing down
43
more objective measures
tape measure measure of sternal angle with goniometer
44
tape measure
placed at level of xiphoid process measure at full inspiration and full expiration
45
what is a normal differentiation b/w full inspiration and expiration
2-4" wide range
46
measure of sternal angle w/ goni
axis is at the xipho-sternal jxn arms of the goni aligned w/ lower margin of the ribs
47
when do we measure of sternal angle w/ goni
full inspiration and expiration
48
diaphragm motion
place thumbs at sternal angle with fingers over lower margins or ribs inspiration should cause ribs to separate
49
what should we have the pt do --> chest wall pain
describe the -location -type -characteristics of pain -point of painful area
50
how can we palpate chest wall pain
with firm pressure
51
what should we have the pt do --> chest wall pain
cough take deep breaths to see if these reproduce of exacerbate the sxs
52
what must we differentiate b/w --> chest wall pain
cardiogenic pain nerve root pain costal cartilages or ribs musculature
53
cardiogenic pain --> chest wall pain
located substernally w/ or w/o radiation to UE described as pressure or a weight on the chest
54
how does nerve root pain happen
if inflamed or irritated
55
what will pain follow --> nerve root pain --> chest wall pain
dermatomal distribution
56
nerve root levels that involved the chest, back and abdoment
C2 (lower neck, shoulders and clavicular areas) T2-T12
57
what are causes of nerve root pain
degenerative arthritis neoplasms OA disc lesions
58
costal cartilages or ribs is d/t --> CWP
fx subluxation inflammation infection
59
costal cartilages or ribs sxs --> CWP
well localized tender to palpation --> palpate ON the rib will cause pain
60
muscular CWP is d/t
spasm strain delayed muscle soreness following activity
61
how do we differentiate muscular CWP
history deep palpation of muscle bellies giving resistance to the action of suspect muscle in an attempt to reproduce the pain
62
where will palpation cause pain --> muscular CWP
intercostal space
63
when we use the area/stretch the area --> CWP
it will hurt
64
if needed our physical exam must be
expanded to rule out other MS problems
65
MS problems
thoracic outlet syndrome cervical disc problems shoulder girdle pathologies

PT Exam - 3 (20 decks)

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