PHYSICAL EXAMINATION OF RESPIRATORY SYSTEM Flashcards
Peripheral cyanosis:
C:cold
O:obstruction
L:Lvf and shock
D:dec cardiac output
Central cyanosis:
P:polycythemia
A:altitude
L:lung disease
M:met-sulfhemogloinemia
S:shunt
Edema:
Right ventricular failure—
cor pulmonale
Chronic bronchitis:
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
Emphysema:
Permanent enlargement and destruction of airspaces distal to the terminal bronchiole
-older and thin
-severe dyspnea
-quiet chest
-x-ray:hyperinflation with flattened diaphragm
Horner syndrome:
Pancoast tumor
Chemosis:
-SVC obstruction
-COPD –Hyperthroidism
Neck lymph nodes:
-TB
-lymphoma
-sarcoidosis
-malignancy
Dilated veins
SVC obstruction
Clubbing nails:
— lung cancer
—TB
—empyema
—abscess
—fibrosing alveolitis
—bronchiectasis
Wasting of small muscles of hand
pancoast
tumour
Causes of clubbing:
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
Barrel chest:
emphysema
Pectus excavatum
funnel chest
Pectus carinatum
pigeon chest
Eupnea:
Normal breathing patterns and rate
Causes :balance diet and healthy life
Tachypnea:
Fast and shallow braath
Causes:fever,anxiety,exercise,shock
Biot:deep breath with periods of apnea
Causes:Spinal meningitis ,head injury
Kussmaul
Fast and deep breath
Causes:renal failure,diabetic keto acidosis
Bradypnea:
Slow and shallow breath
Causes:Slow drugs,metabolic disorders
Sighing
Frequently interspersed sighs
Causes:anxiety,dyspnea,and dizziness
Cheyn-strokes:
Varying periods of breaths
Causes:brain tumors and inhuries ,heart failure
Central sleep apnea
Breathing with apnea
Causes:Heart and kidney failure
Chyne stokes breathing:
cyclical variation
in the depth of respiration with period of
apnoea.
Use of accessory muscle in breathing
status asthmaticus
Tenderness:
fractured ribs,metastasis ,
neuralgia
Pushed trachea
–pneumothorax
-pleural effusion
Pulled trachea
fibrosis
–collapse
Tactile fremitus
● Increased in—pneumothorax
–emphysema
● Decreased—pleural effusion
Resonant
Normal aerated lung
Tympanitic
Superficial lung cavity
Submpany :(boxy note)
Above pleural effusion or consolidation
Hyperresonant
Pneumothorax
Dull
Pulmonary consolidation or collapse,thickened pleura,tumor or raised diaphragm
Flat:
Pleural effusion
Vesicular breath sounds
—. normal
–insp. twice that of expiration
–no pause
Bronchial breath sounds:
-inspiration is shorter than expiration
—gap between insp. and exp.
Increased breath sounds in:
–consolidation
—large cavity near the surface
Decreased breath sounds in
—COPD
—Pleural effusion
–pneumothorax
Wheezing
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..
Fine Crackles
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.
Coarse Crackles
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.
Squawks
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.
Pleural rub
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.
Stridor
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.
Crepitations
—fine —heart failure
–fibrosing alveolitis —coarse—bronchiectasis
–infections
