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D&T 3 test 2 > Physical exam: Alkhankan > Flashcards

Physical exam: Alkhankan Flashcards

1
Q

The posterior side of the lungs, are mostly what part of the lobes

A

lower

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2
Q

how many segments are on each side of the lob

A

10

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3
Q

what part of breathing is active and which is passive

A

inhalation/inspiration - active

expiration/exhalation - passive

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4
Q

what muscles relax during expiration

A

diaphragm and expiratory muscles

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5
Q

when does barometric air pressure equal alveolar pressure

A

no air movement

- end of expiration

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6
Q

what are pressures during inspiration

A

barometric pressure greater than alveolar pressure

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7
Q

what are pressures during expiration

A

alveolar pressure greater than barometric pressure

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8
Q

What shifts the curve to the right

A

low pH
increase CO2
increase temp

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9
Q

what does a shift to the right mean

A

better release oxygen

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10
Q

what does a shift to the left mean

A

greater affinity of oxygen for RBC

increase O2 uptake

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11
Q

what causes the graph to shift left

A

increase pH
decrease CO2
decrease temperature

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12
Q

what defines capacity

A

sum of 2 or more volumes

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13
Q

tidal volume

A

volume of air inspired and expired during normal quiet breathing

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14
Q

Inspiratory reserve volume

A

max. amount of air that can be inhaled after a normal tidal volume inspiration

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15
Q

expiratory reserve volume

A

max. amount of air that can be exhaled from the resting expiratory level

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16
Q

residual volume

A

volume of air remaining in lungs at the end of maximum expiration

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17
Q

vital capacity

A

volume of air that can be exhaled from the lungs after a max. inspiration

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18
Q

FVC

A

when vital capacity exhaled forcefully

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19
Q

SVC

A

when vital capacity is exhaled slowly

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20
Q

what adds up to vital capacity

A

IRV + TV + ERV

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21
Q

Inspiratory capacity

A

IC

max. amount of air that can be inhaled form the end of a tidal volume

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22
Q

formula for inspiratory capacity

A

= IRV + TV

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23
Q

Functional residual capacity

A

volume of air remaining in the lungs at the end of TV expiration

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24
Q

formula for FRC

A

ERV + RV

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25
Q

what are the forces at FRC

A
  • elastic force of chest wall = elastic force of lungs
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26
Q

total lung capacity

A

volume of air in the lungs after a max. inspiration

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27
Q

formula for TLC

A

IRV + TV + ERV + RV

28
Q

dysphonia

A

difficulty speaking

29
Q

epistaxis

A

hemorrhage from the nose

30
Q

tell me when the lungs develope

A
  • not fully grown at birth
  • rapid growth first 2 years
  • decline in growth by 8 years
31
Q

kussmals

A

rapid shallow breathing

32
Q

orthopnoea

A

short of breath in supine position, gets some relief by sitting or standing

33
Q

a drug overdose could do what to you lungs

A

bradypnea

34
Q

define clubbing

A

widening of AP and lateral diameter

angle between nail and skin is greater than 180 degress

35
Q

when can clubbing show up

A
  • intrathoracic malignancy
  • suppurative lung disease
  • diffuse interstitial fibrosis
36
Q

which way does the tracheal alignment shift: pneumothorax

A

shifts toward unaffected side

37
Q

which way does the tracheal alignment shift: pleural effusion

A

shifts toward unaffected side

38
Q

which way does the tracheal alignment shift: fibrosis or atelectasis

A

shifts toward affected side

39
Q

which way does the tracheal alignment shift: pulmonary consolidation

A

no shift

40
Q

what can cause asymmetry of chest expansion

A

unilateral or plueral disease

41
Q

in what disease state would you have bilateral comparison of vocal vibrations increased

A
  • alveolar consolidation
42
Q

in what disease state would you have bilateral comparison of vocal vibrations decreased

A

pneumothorax

pleural effusion

43
Q

when does hyperresonance occur during percussion

A

COPD

pneumothorax

44
Q

when does dullness occur during percussion

A

atelectasis
alveolar filling/consolidation
pleural effusion
fibrosis

45
Q

percuss pneumothorax and emphysema

A

increased percussion and hyperresonance

46
Q

percuss effusion and consolidated lung

A

reduced percussion

hyporesonance

47
Q

vesicular

A

soft low pitched with rustling quality during inspiration and even soften during expiration

48
Q

where is vesicular usually heard

A

over most of lung

49
Q

I:E ratio for vesicular

A

3:1

50
Q

Ronchi

A

low pitched wheezing

51
Q

what is rhonchi associated with

A 
rupture of fluid films 
abnormal airway collapsibility 
clear with coughing
asthma 
COPD
52
Q

fine crackles, when are they heard

A

heard at end of inspiration

53
Q

when are coarse crackles heard

A

early in inspiration

- secretions are in bronchi

54
Q

wheezes

A

high pitched

airway obstruction

55
Q

what are bronchial sounds

A

sounds are hollow tubular and lower pitched

56
Q

where are bronchial sounds normal

A

trachea

57
Q

what is I;E ratio

A

1:3

58
Q

What is stridor

A

musical high pitched,

59
Q

what does stridor indicate

A

upper airway obstruction

60
Q

stridor fixed lesions when biphasic indicates

A

coup

61
Q

forced vital capacity

A

total volume of air that can be exhaled forcefully from TLC

62
Q

FEV1

A

volume of air forcefully expired from full inflation TLC in first second

63
Q

obstructive disease FEV1/FEV

A

DDD/D–> DD

64
Q

restrictive disease FEV1/FEV

A

DD/DD–> normal

65
Q

what is PFT for obstructive, gold standard

A

FEV1/FEV less than 70

66
Q

what is PFT for restrictive, gold standard

A

FEV1/FEV less than 80

67
Q

what are DLCO levels in restrictie and obstructive

A

restrictive: decreased
obstructive: near normal except emphysema

D&T 3 test 2 (14 decks)

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