Pulmonary Flashcards
1
Q
Dull to Percussion
A
Consolidation, pneumonia, lung tumors, atelectasis
2
Q
Increased resonance to percussion
A
hyperinflated lungs, asthma, emphysema, pneumothorax
3
Q
Special Landmarks
A
- 2nd ICS for needle insertion for tension pneumo
- 4th ICS for chest tube insertion
- T4 for the lower margin of an endotracheal tube on CXR
4
Q
Tracheal Breath Sounds
A
- loud, high pitched sounds heard over upper trachea
- inspiratory & expiratory phases are equal, a pause between phases
5
Q
Bronchial Breath Sounds
A
- harsh, high pitched sounds, heard over main bronchus
- inspiratory phase is slightly shorter than expiratory phase w/ a pause between phases
- almost same as tracheal
6
Q
Broncho-Vesicular Sounds
A
- Normal sound heard over the carina area and between upper scapula
- less intense and lower pitched than tracheal
- insp & exp phases equal, no pause between phases
7
Q
Vesicular
A
- soft, breezy low pitched sounds heard over the peripheral lung fields
- insp phase is longer than exp phase, no pause between
8
Q
Pleural Friction Rub
A
-Creaking or grating type of sound that occurs when pleural surfaces are inflamed & roughened edges rub together during breathing
9
Q
Left sides HF
A
- Increased pressures in pulmonary veins causes congestion and interstitial edema (around the alveoli) bronchial mucosa may become edematous
- late insp crackles in the dependent portions of the lungs; possible wheezes
10
Q
Chronic Bronchitis
A
- Bronchi are chronically inflamed and productive cough is present. Airway obstruction may develop
- Possible coarse crackles
- possible wheezes & ronchi
11
Q
Lobar pneumonia (consolidation)
A
- alveoli fill w/ fluid as in pneumonia
- dull over the airless areas of percussion
- Bronchial breath sounds over involved area
- Late insp crackles over involved area
- Increased tactile fremitus over involved area
- egophony, bronchophony and whispered pectoriloquy
12
Q
whispered pectoriloquy
A
- ask patient to whisper 1, 2, 3
- over consolidated areas the lung loses its selective transmitter quality…sounds are transmitted to the chest wall with clarity
13
Q
Partial Lobar obstruction (atelectasis)
A
- when a plug (from mucus or a foreign object) obstructs bronchial air flow, affected alveoli collapse & becomes airless
- Dull percussion over airless area
- Trachea may be shifted toward involved side
- breath sounds usually absent when bronchial plug persists. (exception include right RUL atelectasis where adjacent tracheal sounds can be transmitted)
14
Q
Pleural effusion
A
- Fluid accumulates in pleural space & separates air-filled lung from chest wall, blocked the transmission of breath sounds
- Percussion is dull to flat
- trachea can be shifted toward unaffected side in large effusion
- Decreased to absent breath sounds, but bronchial may be heard near top of large effusion
- possible pleural rub sounds
15
Q
Pneumothorax
A
- air leaks into pleural space, usually unilaterally, the lung recoils away from the chest wall. Pleural airs blocks transmission sound
- Hyperresonant percussion or tympanitic over the pleural air
- Trachea can be shifted toward unaffected side if tension pneumo
- decreased to absent breath sounds and possible pleural rub over pleural air
