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PD Block 2 > Pulmonary > Flashcards

Pulmonary Flashcards

1
Q

What region does the RUL sit

A

Anterior

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2
Q

Where is the apex of the lung

A

4cm above the 1st rib, T1 posteriorly

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3
Q

Where is the base of the lung

A

Posteriorly T12 on inspiration

T9 on expiration

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4
Q

Respiration

A

Exchange of gases between lungs and air

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5
Q

Ventilation

A

Movement of air into and out of the lungs, eventually moves gases(inhalation/exhalation)

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6
Q

Hyperventilation

A

Increased rate and depth of breathing, greater than 20 a minute

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7
Q

Hyperpnea

A

Deep labored breathing

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8
Q

Kussmaul

A

Rapid, deep, labored breathing

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9
Q

Hypopnea

A

Abnormally shallow respirations

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10
Q

What does a caved in sternum suggest

A

restrictive disease

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11
Q

What is an indented sternum called

A

Pectus excavatum

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12
Q

Pectus carinatum

A

When the sternum is bulged out. aka pigeon chest, obstructive disease

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13
Q

What does clubbing indicate

A

Pulmonary or cardiac difficulties. EX: emphysema, lung cancer, or congenital heart disease

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14
Q

Pleural friction rub

A

Feels like a coarse grating vibration during inspiration, caused by inflammation of pleural surfaces.

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15
Q

When does vocal/tactile fremitis increase

A

When there is consolidation of lung tissue, like pneumonia or cystic fibrosis

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16
Q

When does vocal/tactile fremitis decrease

A

When lung tissue is replaced by fluid or air. Like pneumothorax or pleural effusion

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17
Q

What conditions cause the trachea to deviate towards the affected lung

A
  1. Atelectasis
  2. pneumonectomy
  3. pleural fibrosis
  4. agenesis of the lung
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18
Q

What conditions cause the trachea to deviate away from the affected lung

A
  1. thyroid enlargement

2. pleural effusion

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19
Q

When percussing and you hear a hyperresonant sound, what might that indicate

A

emphysema, pneumo, asthma….means there is excess air in the lungs

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20
Q

When percussing and you hear a dull sound, what might that indicate

A

Pneumonia, atelectasis, pleural effusion….more dense material

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21
Q

Vesicular breath sounds

A

Low, intensity and pitch, heard on sides and lower lobes in healthy lungs

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22
Q

Bronchovesicular sounds

A

Heard over main bronchi and upper lungs. Medium pitch, inspiration and expiration equal

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23
Q

Bronchial/tubular sounds

A

Highest pitch, usually only heard over the manubrium. Abnormal if heard over the normal lung fields

24
Q

Crackles

A

Discontinuous, abnormal popping respirations heard normally during inspiration. Excess secretions in small airways

25
Q

Rhonci

A

Loud, low coarse sounds like a snore. Usually continuous caused by rattling of secretions in large airways

26
Q

Wheezes

A

Musical noise that sounds like a squeak, continuous. Swelling or obstruction, heard most often in upper lungs

27
Q

what is another name for the angle of Louis

A

The manubriosternal junction

28
Q

What level is the horizontal fissure at

A

5th rib axillary

4th rib anteriorly

29
Q

What do you inspect for during the respiratory exam

A
  1. Shape and symmetry of the chest
  2. Symmetry of chest wall during inspiration
  3. ap/lateral diameter
  4. RR and depth of breathing
  5. Cyanosis or clubbing
30
Q

Initial palpation looks for?

A
  1. Crepitus

2. Pain on chest (holding chest while pt breathes)

31
Q

How do you test for tactile fremitus

A

Place ulnar surface of the hand on the chest and have pt say 99. Go all the way down, AP, lateral, posterior

32
Q

What does increased tactile fremitus indicate

A

Means there is more fluid or a mass in the lung. (Sound vibration travels better through dense material)

33
Q

What are you listening for with percussion

A

A change from resonance to hyper or dull sounds.

34
Q

If you hear hyper resonance over the lungs what does that mean

A

Increased amount of air in the lungs

35
Q

If you hear dullness in the lungs, what does that mean

A

Indicative of a mass, fluid, or consolidation

36
Q

What is diaphragmatic excursion

A

The measurement of the diaphragm between inspiration and expiration. done using percussion

37
Q

Egophony

A

special test, pt says e, will sound like a (goat) heard with emphysema

38
Q

Pectoriloquy

A

pt says 1,2,3 whispered words will be clear. Indicates pneumonia, cystic fibrosis

39
Q

Broncophony

A

Bronchial sounds, determined by vocal femitus. If louder and clearer it is indicative of consolidation

40
Q

What should the ratio of AP to Lateral be

A

.70-.75, if not, then it is most likely a barrel chest

41
Q

Barrel chest

A

AP diameter is larger than lateral diameter

42
Q

Flail chest

A

Chest wall becomes separated from the rib cage, causes paradoxical breathing (rib fxs)

43
Q

Scoliosis

A

Lateral curvature of the spine

44
Q

Kyphosis

A

Rounded curvature of the spine

45
Q

Gibbus

A

Sharp angular (90 degrees) deformity associated with a collapsed vertebra from osteoporosis

46
Q

Lordosis

A

Excessive inward curvature of the spine

47
Q

Pulsus paradoxus

A

Exaggerated decrease in the amplitude and rate of systolic pressure during inspiration and an increase during expiration

48
Q

Stridor

A

High pitched, piercing sound heard during inspiration due to obstruction in trachea or larynx.

49
Q

Paroxysmal nocturnal dyspnea

A

attacks of severe SOB and coughing that wakes the pt up

50
Q

orthopnea

A

SOB or sensation of breathlessness while lying down

51
Q

Tracheal breath sounds

A

High pitched, harsh, heard over neck and trachea…darth vader

52
Q

How would you determine if it is a pleural or pericardial friction rub

A

Have pt hold their breath. If the sound continues it is a pericardial rub

53
Q

What do you look for during INSPECTION

A
  1. Shape/symmetry
  2. AP/lateral diameter
  3. Trachea midline
54
Q

What are you listening for with percussion

A

Normal resonant sounds

55
Q

What are you looking for with palpation

A
  1. Areas of pain
  2. crepitus
  3. Respiratory expansion (diaphragmatic excursion)
  4. Tactile fremitus - symmetry important

PD Block 2 (6 decks)

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