PHYSICAL EXAMINATION OF RESPIRATORY SYSTEM

Question 1

Peripheral cyanosis:

Answer 1

C:cold
O:obstruction
L:Lvf and shock
D:dec cardiac output

Question 2

Central cyanosis:

Answer 2

P:polycythemia
A:altitude
L:lung disease
M:met-sulfhemogloinemia
S:shunt

Question 3

Edema:

Answer 3

Right ventricular failure—
cor pulmonale

Question 4

Chronic bronchitis:

Answer 4

Clinical diagnosis:daily productive cough for 3 months or more,in at least 2 consecutive years
-overweight and cyanotic
-elevated hemoglobin
-peripheral edema
-rhonchi and wheezing

Question 5

Emphysema:

Answer 5

Permanent enlargement and destruction of airspaces distal to the terminal bronchiole
-older and thin
-severe dyspnea
-quiet chest
-x-ray:hyperinflation with flattened diaphragm

Question 6

Horner syndrome:

Answer 6

Pancoast tumor

Question 7

Chemosis:

Answer 7

-SVC obstruction
-COPD –Hyperthroidism

Question 8

Neck lymph nodes:

Answer 8

-TB
-lymphoma
-sarcoidosis
-malignancy

Question 9

Dilated veins

Answer 9

SVC obstruction

Question 10

Clubbing nails:

Answer 10

— lung cancer
—TB
—empyema
—abscess
—fibrosing alveolitis
—bronchiectasis

Question 11

Wasting of small muscles of hand

Answer 11

pancoast
tumour

Question 12

Causes of clubbing:

Answer 12

C:cyanotic heart disease/cystic fibrosis
L:lung cancer -lung abscess
U:ulcerative colitis
B:bronchiectasis
B:benign mesothelioma
I:infective endocarditis/idiopathic pulmonary fibrosis
N:neurogenic tumors
G:gastrointestinal disease

Question 13

Barrel chest:

Answer 13

emphysema

Question 14

Pectus excavatum

Answer 14

funnel chest

Question 15

Pectus carinatum

Answer 15

pigeon chest

Question 16

Eupnea:

Answer 16

Normal breathing patterns and rate
Causes :balance diet and healthy life

Question 17

Tachypnea:

Answer 17

Fast and shallow braath
Causes:fever,anxiety,exercise,shock

Question 18

Biot:deep breath with periods of apnea

Answer 18

Causes:Spinal meningitis ,head injury

Question 19

Kussmaul

Answer 19

Fast and deep breath
Causes:renal failure,diabetic keto acidosis

Question 20

Bradypnea:

Answer 20

Slow and shallow breath
Causes:Slow drugs,metabolic disorders

Question 21

Sighing

Answer 21

Frequently interspersed sighs
Causes:anxiety,dyspnea,and dizziness

Question 22

Cheyn-strokes:

Answer 22

Varying periods of breaths
Causes:brain tumors and inhuries ,heart failure

Question 23

Central sleep apnea

Answer 23

Breathing with apnea
Causes:Heart and kidney failure

Question 24

Chyne stokes breathing:

Answer 24

cyclical variation
in the depth of respiration with period of
apnoea.

Question 25

Use of accessory muscle in breathing

Answer 25

status asthmaticus

Question 26

Tenderness:

Answer 26

fractured ribs,metastasis , neuralgia

Question 27

Pushed trachea

Answer 27

–pneumothorax -pleural effusion

Question 28

Pulled trachea

Answer 28

fibrosis --collapse

Question 29

Tactile fremitus

Answer 29

● Increased in---pneumothorax --emphysema ● Decreased---pleural effusion

Question 30

Resonant

Answer 30

Normal aerated lung

Question 31

Tympanitic

Answer 31

Superficial lung cavity

Question 32

Submpany :(boxy note)

Answer 32

Above pleural effusion or consolidation

Question 33

Hyperresonant

Answer 33

Pneumothorax

Question 34

Dull

Answer 34

Pulmonary consolidation or collapse,thickened pleura,tumor or raised diaphragm

Question 35

Flat:

Answer 35

Pleural effusion

Question 36

Vesicular breath sounds

Answer 36

—. normal --insp. twice that of expiration --no pause

Question 37

Bronchial breath sounds:

Answer 37

-inspiration is shorter than expiration ---gap between insp. and exp.

Question 38

Increased breath sounds in:

Answer 38

--consolidation ---large cavity near the surface

Question 39

Decreased breath sounds in

Answer 39

---COPD ---Pleural effusion --pneumothorax

Question 40

Wheezing

Answer 40

This is the sound of wheezing when auscultating breath or lung sounds. It can be heard when there is an airway obstruction such as when you listen to a patient with mild to moderate asthma during an exacerbation. Wheeze is mainly expiratory and occurs during both phases..

Question 41

Fine Crackles

Answer 41

are high pitched sounds mostly heard in the lower lung bases. This can be abnormal findings on physical exam suggestive of things like congestive heart failure, pneumonia or pulmonary fibrosis.

Question 42

Coarse Crackles

Answer 42

are low pitched lungs sounds heard in pathologies such as chronic bronchitis, bronchiectasis, pneumonia, and severe pulmonary edema. Compared to fine crackles, they are often louder, longer in duration and lower in pitch.

Question 43

Squawks

Answer 43

short inspiratory wheezes (200 ms; 200 - 300 Hz) in late inspiration often preceded by late inspiratory crackles. Squawks are found in: pulmonary fibrosis, pneumonitis, pneumonia, allergic alveolitis and bronchiolitis obliterans. They are produced by the oscillations of peripheral airways in deflated lung zones opened in late inspiration.

Question 44

Pleural rub

Answer 44

is nonmusical, short,. biphasic (inspiro-expiratory) explosive sound (grating, rubbing, creaky, or leathery). It occurs due to inflamed pleural surface rubbing each other during breathing.

Question 45

Stridor

Answer 45

loud, high-pitched, mainly inspiratory,.musical sound produced by upper respiratory tract obstruction. It is different from wheezing: It is louder over the neck than chest wall. In expiration, it is biphasic. Stridor is caused by the turbulent flow passing through a narrowed segment of the upper respiratory tract.

Question 46

Crepitations

Answer 46

---fine ---heart failure --fibrosing alveolitis ---coarse—bronchiectasis --infections