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Physical Assessment 1 > Pulmonary > Flashcards

Pulmonary Flashcards

1
Q

which muscles are used during quiet breathing

A

dia

external intercostal

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2
Q

forced expiration uses which muscles

A

internal intercostal

abdominal

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3
Q

name the four accessory muscles

A

SCM
Scalene
Pec minor
trapezius (posterior)

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4
Q

when a diamond shape is formed using the two nails of opp hands, this is a finding of?

A

NORMAL

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5
Q

clubbing is a sign of?

A

pulmonary fibrosis
cystic fibrosis
bronchogenic carcinoma

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6
Q

erythema nodosum

  • define
  • where would it be seen
A

anterior tibial aspect

inflammation of the skin

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7
Q

Panniculitis

A

painful red nodular areas

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8
Q

triad for horners syndrome

A

ptosis
miosis
HEMIfacial anhidrosis–>decr sweating on one side of the face

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9
Q

a bounding pulse or abnormally strong pulse can be an indication of ________ retention

A

CO2

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10
Q

what would the pulse of a PT with CO2 retention feel like

A

bounding or abnormally strong

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11
Q

on the R lung, the horizontal fissure sep which lobes

A

superior and middle

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12
Q

on R lung, the oblique fissure sep which lobes

A

Middle and inferior

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13
Q

the only fissure sep the lobes of the L lung is?

A

oblique fissure–sep superior and inferior lobes

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14
Q

define resonant sound

A

low pitch, hollow sound

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15
Q

what sound is normally heard on percussion

A

Resonant sound

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16
Q

what is indicative of lung pathology when percussing?

A

hyperresonance and/or dullness

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17
Q

which two lung pathologies do you think of when you hear a dullness and/or hyperrsonance during percussion

A

plerual effusion and pnx

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18
Q

name the two normal breath sounds

A

bronchial

vesicular

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19
Q

describe bronchial breath sounds

A

tubular and hollow

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20
Q

where do you hear bronchial breath sounds

A

large airways in anterior chest

*over manubrium

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21
Q

describe vesicular breath sounds

A

soft
low pitched
rustling

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22
Q

where do you hear vesicular breath sounds

A

over most of the lung tissue area

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23
Q

rales/crackles indicative of?

A

fluid in small airways

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24
Q

wheezing/rhonchi indicative of?

A

constriction or inflammation

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25
Q

pleural rubs occur when?

A

inflamed pleural surfaces slide agains once another during respiration

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26
Q

stridor indicates?

A

upper airway obstruction

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27
Q

during percussion, the fingers go where

A

in the intercostal spaces and NOT the ribs

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28
Q

how to test for bronchophony

  • what is it testing for
  • what is an abnormal result?
A

*testing for consolidation
ask PT to say 99 while auscultating the chest area
*abn=incr sound transmission

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29
Q

how to test for agophony

  • what is it testing for
  • what is an abnormal result?
A

*tests for lung consolidation
ask the PT to say “E” while auscultating
*when “E” sound changes to an “A” sound—>abn

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30
Q

how to test for whispering pectoriloquiy
what does it test for
abnomrla result

A

ask PT to whisper “99”

+ consolidation=sound heard better through scope as you auscultate

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31
Q

2nd rib is _____ the 2nd intercostal space

A

RIB=above

Space=BELOW

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32
Q

how to find 2nd rib

A
  1. place finger in suprasternal notch
  2. 5 cm (2 inches) down to sternal angle
  3. rib is adjacent to that
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33
Q

how many pairs of ribs attach to sternum?

A

first 7 ribs

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34
Q

which ribs are floating ribs?

A

11 and 12

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35
Q

what is the sternal angle

A

where manubrium joins body of the sternum

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36
Q

how to count the ribs on posterior side

A

start at 12th rib and work up

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37
Q

inferior tip of _____ lies at the level of the ___th rib or interspace

A

scapula

7th rib

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38
Q

if you flex you neck, which Cervical vertebra is most protruding

A

C7

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39
Q

what is anotehr term for “top” of lung

A

apex

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40
Q

during inspiration, the lungs ________

and expiration?

A

descend–insp

go back up into norm position–expiration

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41
Q

where does each lung recieve deoxygenated blood from?

A

pulm artery

42
Q

pulm artery brings ____ blood to ____

A

deoxy blood to lungs

43
Q

what carries oxygenated blood to LA

A

pulm veins

44
Q

pulm veins carries ____ blood to _____

A

oxygenated

LA

45
Q

supra=?

A

above

46
Q

Infra=?

A

below

47
Q

Inter=?

A

b/w

48
Q

supraclavicular means?

A

above clavicles

49
Q

interscapular means?

A

b/w scapula

50
Q

trachea bifurcates into?

A

right and left main bronchus

51
Q

which bronchus is wider, shorter and more vertical?

A

RIGHT

52
Q

why is it more common for things to get lodged in rich bronchus versus left

A

right bronchus=

  • shorter
  • wider
  • more vertical
53
Q

aspirational pneumonia is more common where

A

right middle and lower lobes

*since right main bronchus is shorter, wider and more vertical

54
Q

what causes transudative pleural eff

A 
CHF 
cirrhosis 
nephrotic sundrome 
PE 
hypoalbuminemia
55
Q

what causes exudative PE

A 
pneumonia 
CA 
TB 
viral inf 
PE
autoimmune
56
Q

what causes pain in the trachea or large bronchi

A

bronchitis

57
Q

what cause pain in parietal pleura

A 
pericarditis 
pneumonia 
pnuthx 
plerual eff 
PE
58
Q

what causes pain in esophagus

A

gerd
esophageal spasm
esophageal tear

59
Q

define dyspnea

A

painless but uncomfortable awareness not breathing okay

60
Q

define paraesthesias

A

pins and needles

61
Q

+paraesthesias around mouth, extrems,
+dyspnea
?????

A

anxiety

62
Q

musical respiratory sounds

A

wheezing

63
Q

what does wheezing indicate

A

partial lower airway obstruction from: secretions and tissue inflammation
***airway constriction

  • *asthma
  • FB
64
Q

define acute

A

under 3 weeks

65
Q

define subacute

A

3-8 weeks

66
Q

define chronic

A

over 8 wks

67
Q

what is MC cause of ACUTE cough

A

viral URI

68
Q

list of causes for acute cough (5)

A
  • infection (viral, pneumonia, bronchitis)
  • LHF
  • smoking
  • ACEI tx
  • asthma
69
Q

list of causes for subacute cough (5)

A
  • post infectious cough
  • pertussis
  • acid reflux
  • sinusitis
  • asthma
70
Q

Causes of chronic cough (4)

A

GERD
asthma
post nasal drip or allergies
chronic bronchitis

71
Q

describe mucoid sputum

indicative of?

A

translucent, white or gray

indicative of viral infection, CF

72
Q

translucent, white or gray sputum=?

A

mucoid sputum

73
Q

yellow or green sputum=?

A

purulent sputum

74
Q

desc purulent sputum

indicative of

A

yellow or green

*bac pneumonia

75
Q

what causes foul smelling sputum

A

anaerobic abscess

76
Q

what causes thick and tenacious sputum?

A

CF

77
Q

what causes large volume of purulent sputum?

A

Bronchiectasis

lung abscess

78
Q

what is the first thing we want to r/o if PT has hemoptysis

then r/o what?

A

Malignancy

then other causes:
bronchitis, CF

79
Q

PT has daytime sleepiness you think of ?

A

sleep apnea

80
Q

what is the leading cause of preventable death in us?

A

smoking

81
Q

health promotion with smoking, want to tell your PT it increases your risk of what four diseases?

A

lung CA
CAD
Stroke
PVD

82
Q

second most frequently diagnosed CA in US?

A

lung CA

83
Q

what is the screening test of choice for adults 55-79 with 30 pack year smoking hx, current smoker or quit within 15 years

A

low dose computed tomography (LDCT)

84
Q

influenza vaccine schedule

A

yearly for eveyrone >6MO and older

85
Q

pneumococcal vaccine protects from?

A

strep. pneumonia causing bacterimea, meningitis, pneumonia

86
Q

PCV13 vaccine schedule for peds

A

4 doses

  1. 2 MO
  2. 4MO
  3. 6MO
  4. 12-15MO
87
Q

who should get PCV13 vaccine

A

peds–special schedule

2YO-65YO with chronic conds assoc with high riks of pneumonia

2YO-64YO immunocomp

nursinh home/long term care residents

88
Q

schedule for PCV13 and PPSV23 vaccine

and WHO?

A

> 65 y/o
first get the PCV13
then 1 yr later
get the PPSV23

89
Q

you palpate tender spots ____?

A

LAST

90
Q

where do you place fingers when checking for chest expansion

A

thumbs–level of 10th rib

*thumbs should move apart as chest expands

91
Q

how to check for tactile fremitus—

A

say 99

92
Q

Increased AP diameter=?

A

COPD

93
Q

asymm chest expansion=?

A

large pleural eff

94
Q

costal cartilage tenderness=?

A

costochondritis

95
Q

tenderness over a rib
bruising over a rib
bony “step offs” =?

A

fx rib

96
Q

fremitis increases with? and decreases/absent with?

A

incrs with consolidation—> pneumonia

decrs/absent—>presence of air filled lung tissue (effusion)

97
Q

causes of dullness on percussion

A

fluid outside the lung–effusion

fluid or soft tissue filling parenchyma–>pneumonia, tumor

98
Q

causes of hyperresonance

A

COPD–air trapping

pnx–

99
Q

crackles=?
seen with?
fine crackles with?

A

fluid in alveoli and airways
EX: pulm edema, pneumonia

fine crackles with fibrosis

100
Q

rhonchi

  • define
  • caused by?
  • seen with?
A

gurgling type noise

fluid in larger and med size airways

bronchitis, pneumonia

101
Q

wheezing

  • heard loudest during?
  • caused by?
  • seen with?
A

loudest on expiration
caused by air forced thru narrowed airways
*asthma

exp phase&raquo_space;»»> Inspiratory

102
Q

stridor

  • heard on insp or expiration
  • due to?
  • heard loudest over?

seen with?

A

INSP whistling

tracheal narrowing

heard best over trachea

CROUP
FB aspiration

Physical Assessment 1 (7 decks)

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