Physical Exam of the Chest and Lungs

Question 1

What are the topographic markers on the chest?

Answer 1

What are the topographical landmarks on the chest?

Question 1

What are the topographic markers on the chest?

Answer 1

• The nipples
• The angle of Louis
• The Suprasternal notch
• The costal angle (Usually no more than 90 degrees)
• The vertebra prominence (Upper Portion is C7 and the lower is T1)

Question 2

What type of mechanical and biological factors create changes in the respiratory function of pregnant women?

Answer 2

Enlarged uterus
Increased Progesterone
Estrogen causes the ligaments of the ribs to relax

Question 3

What is the condition caused by loss of muscle strength in the thorax and diaphragm, coupled with decreased lung resiliency in older adults?

Answer 3

Barrel Chest

Question 4

What happens to the structure of alveoli in older adults?

Answer 4

The alveoli become less elastic and more fibrous.

Question 5

What happens to the mucus membranes of older adults?

Answer 5

They become drier and bacterial growth may uccer from retained mucus

Question 6

What questions should be considered when a patient coughs or complains of coughing?

Answer 6

• The onset and nature of the cough
• Any characteristics of the sputum (Smell, consistency, color, presence of blood)
• The pattern and severity (How often is it happening? How bad it the cough?)
• Associated symptoms (Upper respiratory related?)
• Efforts to treat the cough (OTC / previously prescribed medications)

Question 7

What questions should be considered when a patient complains of shortness of breath?

Answer 7

• Onset of the problem (Sudden / Gradual)
• Pattern and factors facilitating or relieving it
• Any use of pillows to help with sleeping (Orthopnea / Platypnea)
• Associated symptoms
• Efforts to treat

Question 8

What pertinent data should be included in the patient’s past medial history?

Answer 8

• Past thoracic trauma or surgery
• Use of oxygen
• Chronic pulmonary diseases
• Any other system disorders
• Related respiratory tests
• Immunizations agains pneumonia and Influenza
• Prescription and non-prescription drugs

Question 9

What are important factors of family history?

Answer 9

History of:

• TB
• Cystic fibrosis
• Emphysema
• Allergies
• Malignancy
• Clotting disorders
• Bronchiectasis
• Bronchitis

Question 10

In young adults who describe severe, acute chest pain, what should you consider asking them?

Answer 10

If they use recreational drugs, particularly cocaine

Question 10

In young adults who describe severe, acute chest pain, what should you consider asking them?

Answer 10

If they use recreational drugs, particularly cocaine

Question 11

Absence of spontaneous respirations

1) Dyspnea
2) Orthopnea
3) Apnea

Answer 11

Apnea

Question 12

Feeling or sensation that one cannot breath well enough.

• 1) Platypnea
  2) Dyspnea
  3) Tachypnea

Answer 12

Dyspnea

Question 13

Grave condition in which breathing stops and will not spontaneously start again unless resuscitative measures are immediately instituted.

• Cheyne Strokes
• Biot Respirations
• Secondary Apnea
• Tachypnea

Answer 13

Secondary Apnea

Question 14

Shortness of breath that begins or increases when the patient lies down

• Paroxysmal nocturnal dyspnea
• Platypnea
• Orthopnea

Answer 14

Orthopnea

Question 15

Sudden onset of shortness of breath after a period of sleep; sitting upright is helpful.

• Bradypnea
• Tachypnea
• Paroxysmal nocturnal dyspnea

Answer 15

Paroxysmal nocturnal dyspnea

Question 16

Dyspnea increase in the upright posture.

1) Tachypnea
2) Kussmaul breathing
3) Platypnea
4) Hyperpnea

Answer 16

Platypnea

Question 17

How many respirations a minute would be considered? tachypea

Answer 17

faster than 20 and approaching 25

Question 18

Somewhat irregular respirations varying in depth and interrupted by intervals of apnea but lacking the repetitive pattern of periodic respirations of cheyne stokes.

1) Kussmaul Respirations
2) Biot Respirations
3) Cheyne Stokes Respirations