pulm exam Flashcards
what is tidal volume?
air inspired during normal, relaxed breathing
what is inspiratory reserved volume?
additional air that can be forcibly inhaled after inspiration of a normal tidal volume
inspired over and above tidal volume
what is expiratory reserve volume?
the additional air that can be forcibly exhaled after the expiration of a normal tidal volume
expired over tidal volume
what is residual volume?
volume of air that remains in lungs after expiratory reserve volume is exhaled
always present in lungs
what is total lung capacity?
maximum amount of air that can fill the lungs
TLC = VC + IRV + ERV + RV
what is vital capacity?
total amount of air that can be expired after fully inhaling
VC = TV + IRV + ERV
what is inspiratory capacity?
maximum amount of air that can be inspired
IC = TV + IRV
what is functional residual capacity?
amount of air remaining in the lungs after a normal expiration
FRV = ERV + RV
in restrictive lung diseases, will the lung volumes be increased or decreased?
everything is decreased except FEV1 is normal
what are two examples of restrictive lung diseases?
pneumonia, pulmonary fibrosis
in obstructive lung diseases, what lung volume values are increased?
tidal volume, FRC, RV, TLC
air is stuck in the lungs
is FEV1 increased or decreased in obstructive lung disease?
decreased
what is FEV1?
forced expiratory volume in 1 second
how can you help prevent airway collapse for ppl with COPD?
pursed lip breathing
dorsal kyphosis, A-P diameter increased, respiratory rate (RR) increases are signs of what?
COPD
according to COPD Gold classification, what stage is FEV1 > 80%, with or without chronic sx (cough, sputum production)?
Stage 1: Mild
according to COPD Gold classification, what stage is FEV1 50-80%, with or without sx?
Stage II: Moderate
according to COPD Gold classification, what stage is FEV1 30-50%, with or without sx?
Stage III: Severe
according to COPD Gold classification, what stage is FEV1 < 30 %, with chronic respiratory failure and severe dyspnea?
Stage IV: very severe
what percent is FEV1/FVC in each stage of COPD
< 70% in each stage
what breath sound would be a low pitch sound all over the thorax?
vesicular
what breath sound would be high pitched, loud, over the manubrium, with expiratory sounds longer than inspiratory sounds?
bronchial
what breath sound is very loud, high pitches, over the trachea, and has equal inspiratory and expiratory durations?
tracheal
what breath sound has intermediate pitch and intensity and is heard between 1st and 2nd interspace anteriorly and between the scapulae?
broncho-vesicular
if you hear an S3 heart sound, which high pitched abnormal breath sound is most likely associated with CHF?
crackles
there is congestion and fluid collection leading to crackles, will hear brief, discontinuous popping
what conditions is wheezing associated with?
COPD and asthma
it’s caused by airway obstruction
what abnormal respiratory sound is low pitched, rattling and resembles snoring?
Rhonchi
ronquidos is spanish for snoring
what abnormal respiratory sound would you expect to hear with COPD, bronchiectasis, pneumonia, chronic bronchitis, or cystic fibrosis?
rhonchi
what abnormal respiratory sound would indicated pleural inflammation?
pleural rub
auscultated in lower lateral chest area
what voice sound is an increased resonance with greater clarity and loudness of spoken words? example “99”
bronchophony
clearer sounds are abnormal, indicated consolidation
what voice sound happens when “E” sounds change to a long, nasal sounding “A”
Egophony
can be d/t lung consolidation/pneumonia
what voice sound is an increased loudness of whispering? You would recognize whispered words 1,2,3
whispered pectoriloquy
what is atelectasis?
lug collapse
what is emphysema?
trapping of air
what is pneumothorax?
compression of lungs d/t air build up, lungs can’t fully expand
normal range for pH in arterial blood gas?
7.35-7.45
normal range of PaCO2?
35-45 mmHg
acidic
normal range of HCO3?
22-26
alkaline
in acidic conditions, what are the arterial blood gas values?
pH <7.35
PaCO2 >45
HCO3 <22
in alkaline conditions, what are the values of pH, PaCO2, and HCO3?
pH >7.45
PaCO2 <35
HCO3 >26
ROME
Respiratory
Opposite
Metabolic
Equal
if pH is normal, is it uncompensated or compensated?
compensated
if PaCO2 is normal, is it metabolic or repiratory?
metabolic
if HCO3 is normal, is it metabolic or respiratory?
respiratory
if HCO3, PaCO2 and pH are all not normal, is it compensated, uncompensated, or partially compensated?
partially compensated
in COPD, is CO2 increased or decreased?
increased bc it can’t get out
oxygen is low, and pH is low
what is a later manifestation of cystic fibrosis?
anorexia
meconium ileus and acute bronchitis are early manifestations of what?
cystic fibrosis
during vigorous exercise, PO2 ________.
decreases acutely
name the pulmonary condition: acute episodes of airways narrowing and swelling, and may produce extra mucus, triggering coughing and a wheezing sound when you breath out.
asthma
obstructive
name the pulmonary condition: obstructive condition in which inflammation and irritation of the bronchial tubes occurs, causing mucus build up. commonly caused by smoking
chronic bronchitis
commonly caused by smoking
name the pulmonary condition: infection of one or both the lungs, alveoli fill with fluid or pus, making it difficult to breathe
pneumonia
restrictive
name the pulmonary condition: abnormal permanent enlargement of air spaces distal to the terminal bronchioles, accompanied by the destruction of alveolar walls, leading to reduced gas exchange and progressive air trapping
emphysema
name the pulmonary condition: build up of excess fluid between the layers of the pleura outside the lungs
pleural effusion
“water on the lungs”
music studio example (thick walls)
name the pulmonary condition: collapsed lung where air leaks into the space between your lung and chest wall. there is still some air left in the lungs though
pneumothorax
name the pulmonary condition: complete or partial collapse of the entire lung or area of the lung, alveoli become deflated. commonly occurs after surgery.
atelectasis
no air left
fremitus (vibration) will be louder when there is more or less air?
less
in pleural effusion, fremitus will be ____ and percussion will be ____
low, dull
percussion will be _______ when there is more air (big drum)
hyperresonant
when a lot of fluid is present, percussion will be ____
dull
when an adult (8+) collapses and there are two adults present, what should you do? what if you are alone?
one calls 911 and the other starts CPR
if you are alone call 911 first the start CPR
order of actions for when an adult collapses?
check for responsiveness
Compression
Airway
Breathing
if a child collapses and you are alone, what do you do?
start CPR, if no change after 2 min call 911
order of actions for when a child collapses?
check for responsiveness
Airway
Breathing
Compression
SOB (dyspnea) and shallow breathing (tachypnea) are hallmark signs of?
DVT/PE
swelling of LE, anxiety, fever, excessive sweating, cough, and blood in the sputum are other signs of?
DVT/PE
pulsating in the abdomen and abdominal bulge is a sign of?
AAA
tenderness of McBurney’s point, pain in the RLQ, and mild fever are signs of?
appendicits
left neck and jaw pain along with chest pain are signs of?
cardiac arrest
6 P’s: pain, palpable tenderness, paresthesia, pallor, paresis, pulselessness are signs of
acute compartment syndrome
saddle anesthesia, loss of bowel bladder function, urine retention, LE weakness are signs of?
cauda equina
sudden hives, ithcing, SOB, rapid or weak pulse are signs of
anaphylaxis
excessive thirst, confusion and difficulty concentrating and fruity odor in breath are signs of
DKA
high body temp (over 104), AMS, hot, dry skin, tachycardia, headache, cold and clammy skin are signs of
heat stroke
