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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
pleural rubs occur when?
inflamed pleural surfaces slide agains once another during respiration
26
stridor indicates?
upper airway obstruction
27
during percussion, the fingers go where
in the intercostal spaces and NOT the ribs
28
how to test for bronchophony * what is it testing for * what is an abnormal result?
*testing for consolidation ask PT to say 99 while auscultating the chest area *abn=incr sound transmission
29
how to test for agophony * what is it testing for * what is an abnormal result?
*tests for lung consolidation ask the PT to say "E" while auscultating *when "E" sound changes to an "A" sound--->abn
30
how to test for whispering pectoriloquiy what does it test for abnomrla result
ask PT to whisper "99" | + consolidation=sound heard better through scope as you auscultate
31
2nd rib is _____ the 2nd intercostal space
RIB=above | Space=BELOW
32
how to find 2nd rib
1. place finger in suprasternal notch 2. 5 cm (2 inches) down to sternal angle 3. rib is adjacent to that
33
how many pairs of ribs attach to sternum?
first 7 ribs
34
which ribs are floating ribs?
11 and 12
35
what is the sternal angle
where manubrium joins body of the sternum
36
how to count the ribs on posterior side
start at 12th rib and work up
37
inferior tip of _____ lies at the level of the ___th rib or interspace
scapula | 7th rib
38
if you flex you neck, which Cervical vertebra is most protruding
C7
39
what is anotehr term for "top" of lung
apex
40
during inspiration, the lungs ________ | and expiration?
descend--insp | go back up into norm position--expiration
41
where does each lung recieve deoxygenated blood from?
pulm artery
42
pulm artery brings ____ blood to ____
deoxy blood to lungs
43
what carries oxygenated blood to LA
pulm veins
44
pulm veins carries ____ blood to _____
oxygenated | LA
45
supra=?
above
46
Infra=?
below
47
Inter=?
b/w
48
supraclavicular means?
above clavicles
49
interscapular means?
b/w scapula
50
trachea bifurcates into?
right and left main bronchus
51
which bronchus is wider, shorter and more vertical?
RIGHT
52
why is it more common for things to get lodged in rich bronchus versus left
right bronchus= - shorter - wider - more vertical
53
aspirational pneumonia is more common where
right middle and lower lobes | *since right main bronchus is shorter, wider and more vertical
54
what causes transudative pleural eff
``` CHF cirrhosis nephrotic sundrome PE hypoalbuminemia ```
55
what causes exudative PE
``` pneumonia CA TB viral inf PE autoimmune ```
56
what causes pain in the trachea or large bronchi
bronchitis
57
what cause pain in parietal pleura
``` pericarditis pneumonia pnuthx plerual eff PE ```
58
what causes pain in esophagus
gerd esophageal spasm esophageal tear
59
define dyspnea
painless but uncomfortable awareness not breathing okay
60
define paraesthesias
pins and needles
61
+paraesthesias around mouth, extrems, +dyspnea ?????
anxiety
62
musical respiratory sounds
wheezing
63
what does wheezing indicate
partial lower airway obstruction from: secretions and tissue inflammation ***airway constriction * *asthma * FB
64
define acute
under 3 weeks
65
define subacute
3-8 weeks
66
define chronic
over 8 wks
67
what is MC cause of ACUTE cough
viral URI
68
list of causes for acute cough (5)
- infection (viral, pneumonia, bronchitis) - LHF - smoking - ACEI tx - asthma
69
list of causes for subacute cough (5)
- post infectious cough - pertussis - acid reflux - sinusitis - asthma
70
Causes of chronic cough (4)
GERD asthma post nasal drip or allergies chronic bronchitis
71
describe mucoid sputum | indicative of?
translucent, white or gray | indicative of viral infection, CF
72
translucent, white or gray sputum=?
mucoid sputum
73
yellow or green sputum=?
purulent sputum
74
desc purulent sputum | indicative of
yellow or green | *bac pneumonia
75
what causes foul smelling sputum
anaerobic abscess
76
what causes thick and tenacious sputum?
CF
77
what causes large volume of purulent sputum?
Bronchiectasis | lung abscess
78
what is the first thing we want to r/o if PT has hemoptysis then r/o what?
Malignancy then other causes: bronchitis, CF
79
PT has daytime sleepiness you think of ?
sleep apnea
80
what is the leading cause of preventable death in us?
smoking
81
health promotion with smoking, want to tell your PT it increases your risk of what four diseases?
lung CA CAD Stroke PVD
82
second most frequently diagnosed CA in US?
lung CA
83
what is the screening test of choice for adults 55-79 with 30 pack year smoking hx, current smoker or quit within 15 years
low dose computed tomography (LDCT)
84
influenza vaccine schedule
yearly for eveyrone >6MO and older
85
pneumococcal vaccine protects from?
strep. pneumonia causing bacterimea, meningitis, pneumonia
86
PCV13 vaccine schedule for peds
4 doses 1. 2 MO 2. 4MO 3. 6MO 4. 12-15MO
87
who should get PCV13 vaccine
peds--special schedule 2YO-65YO with chronic conds assoc with high riks of pneumonia 2YO-64YO immunocomp nursinh home/long term care residents
88
schedule for PCV13 and PPSV23 vaccine | and WHO?
>65 y/o first get the PCV13 then 1 yr later get the PPSV23
89
you palpate tender spots ____?
LAST
90
where do you place fingers when checking for chest expansion
thumbs--level of 10th rib | *thumbs should move apart as chest expands
91
how to check for tactile fremitus---
say 99
92
Increased AP diameter=?
COPD
93
asymm chest expansion=?
large pleural eff
94
costal cartilage tenderness=?
costochondritis
95
tenderness over a rib bruising over a rib bony "step offs" =?
fx rib
96
fremitis increases with? and decreases/absent with?
incrs with consolidation---> pneumonia decrs/absent--->presence of air filled lung tissue (effusion)
97
causes of dullness on percussion
fluid outside the lung--effusion | fluid or soft tissue filling parenchyma-->pneumonia, tumor
98
causes of hyperresonance
COPD--air trapping | pnx--
99
crackles=? seen with? fine crackles with?
fluid in alveoli and airways EX: pulm edema, pneumonia fine crackles with fibrosis
100
rhonchi - define - caused by? - seen with?
gurgling type noise fluid in larger and med size airways bronchitis, pneumonia
101
wheezing - heard loudest during? - caused by? - seen with?
loudest on expiration caused by air forced thru narrowed airways *asthma exp phase >>>>>>> Inspiratory
102
stridor - heard on insp or expiration - due to? - heard loudest over? seen with?
INSP whistling tracheal narrowing heard best over trachea CROUP FB aspiration

Physical Assessment 1 (7 decks)

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