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Physical Diagnosis Exam 2 (Lauren) > Pulmonary And Chest Assessment > Flashcards

Pulmonary And Chest Assessment Flashcards

1
Q

Where is the angle of Louis

A

Located approximately 5cm below the sternal notch

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2
Q

Which rib is lateral to the sternal angle/angle of Louis?

A

2nd rib

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3
Q

Where are the apexes of the lungs?

A

2-4cm ABOVE the clavicle

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4
Q

What is a normal respiration rate?

A

14-20 breaths/min

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5
Q

What does stridor sound like?

A

High pitched, usually inspiration wheeze

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6
Q

What does stridor indicate?

A

Obstruction in trachea or larynx

Foreign body or airway disease

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7
Q

What is a common cause of stridor in kids?

A

croup

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8
Q

What can cause tracheal deviation?

A

Pleural effusion

Pneumothorax

Tumor

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9
Q

What does accessory muscle indicate

A

Respiratory distress

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10
Q

What is pectins excavatum?

A

Concave chest

Aka: “funnel chest”

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11
Q

What is pectus carinatum

A

Convex chest

aka “pigeon chest”

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12
Q

What conditions cause barrel chest?

A

COPD

Aging

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13
Q

What is bradypnea

A

Slow breathing (<12 breaths/min)

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14
Q

What is tachypnea?

A

Rapid breathing (>20 breaths/min)

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15
Q

What can cause bradypnea?

A

Diabetic coma

Drug induced respiratory depression

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16
Q

What can cause tachypnea?

A

Restrictive lung disease

Elevated diaphragm

Pain

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17
Q

What is the breathing pattern seen with metabolic acidosis?

A

Kussmaul breathing-faster deeper respirations

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18
Q

What kind of breathing:

Periods of gradually increasing and decreasing depth of respiration’s with periods of apnea

A

Cheyenne-Stokes breathing

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19
Q

What are causes of Cheyne-stokes breathing ?

A

Normal in sleeping children

Normal in elderly

Heart failure

Uremia

Brain damage

Drug-induced

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20
Q

What kind of breathing:

Rapid and deep respiration

A

Kussmaul breathing

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21
Q

What kind of breathing:

Irregular, unpredictable, shallow or deep, with intermittent apnea

A

Biot’s breathing

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22
Q

What can cause Biot’s breathing?

A

Respiratory depression

Brain damage

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23
Q

What is the difference between Cheyne-stokes and biot’s breathing

A

Cheyne-stokes is cyclical

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24
Q

What can cause increased fremitus?

A

Pneumonia/consolidation

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25
Q

What can cause decreased fremitus (vibration)?

A

Obstructed bronchus

COPD

Pleural effusion

Lung fibrosis

Pneumothorax

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26
Q

What type of percussion tone:

Intensity: Very loud

Pitch: Low

Duration: Long

A

Hyper-resonant

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27
Q

What type of percussion tone:

Intesnity: Loud

Pitch: Low

Duration: Long

A

Resonant

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28
Q

What type of percussion tone:

Intensity: loud

Pitch: high

Duration: moderate

A

Tympanic

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29
Q

What type of percussion tone:

Intesnity: medium

Pitch: moderate

Duration: moderate

A

Dull

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30
Q

What type of percussion tone:

Intensity: soft

Pitch: high

Duration: short

A

Flat

Sponge bob

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31
Q

What is a normal place to hear a “resonant” percussion tone?

A

Healthy lungs

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32
Q

What is a normal place to hear a “hyper-resonant” percussion tone?

A

Never normal

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33
Q

What is a normal place to hear a “tympanic” percussion tone?

A

Gastric bubble

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34
Q

What is a normal place to hear “dull” percussion tone?

A

Liver

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35
Q

What is a normal place to hear a “flat” PErcsussion tone?

A

Muscle

36
Q

What is an abnormal cause of a “hyper-resonant” percussion tone?

A

COPD

Pneumothorax

37
Q

What is an abnormal cause of a “resonant” percussion tone?

A

Chronic bronchitis

38
Q

What is an abnormal cause of a “tympanic” percussion tone?

A

Large pneumothorax

39
Q

What is an abnormal cause of a “dull” percussion tone?

A

Pneumonia

Pleural effusion

40
Q

What is an abnormal cause of a “flat” percussion tone?

A

Pleural effusion

41
Q

What do “tracheal” breath sounds sound like?

A

Inspiration and expiration are about equal

(very loud and high pitched)

42
Q

What is a “bronchial” breathing pattern?

A

Expiration longer than inspiration

Loud and high pitched

43
Q

What does a “broncho-vesicular” breathing pattern sound like?

A

Inspiration and expiration about equal

44
Q

What does a “vesicular” breathing pattern sound like?

A

Inspiration is longer than expiration

Relatively low pitched

45
Q

Where would you place your stethoscope to hear the “tracheal” breathing pattern?

A

Over the trachea in the neck

46
Q

Where would you place your stethoscope to hear the “bronchial” breathing pattern?

A

Over the manubrium

47
Q

Where would you place your stethoscope to hear the “broncho-vesicular” breathing pattern?

A

Anteriorly: 1st and 2nd intercostal spaces

Posterior: interscapular

48
Q

Where would you place your stehtoscpe to hear the “vesicular” breathing pattern?

A

Most of the peripheral lung

49
Q

What is bronchophony?

A

When a patient says 99 during auscultation, voice sound is louder

50
Q

What can bronchophny indicate?

A

Pneumonia

Atelectasis

Tumors

51
Q

What does egophony sound like?

A

When patient says E it sounds like A

52
Q

What can cause egophony?

A

Pneumonia

Atelectasis

Tumors

53
Q

What does the presence of bronchophony or egophony indicate?

A

Lung consolidation/collapse

54
Q

What are adventitious breath sounds?

A

SOunds that are ~superimposed~ on usual breath sounds

55
Q

Name the sound:

Intermittent

Non-musical

Brief

Velcro-like sounds

A

Crackles

56
Q

What causes the sound of crackles

A

Small airways popping open during inspiration or when air bubbles flow through secretions or closed airways

57
Q

What are possible causes of crackles?

A

Bronchitis

pulmonary fibrosis

CHF

58
Q

What sound:

Longer

Musical

Low pitched, snoring “wheeze”

A

Rhonchi

59
Q

What sound:

High-pitched

Hissing

Shrill

Whistling

A

Wheeze

60
Q

What can cause rhonchi?

A

Secretions in large airways

61
Q

What can cause wheezes?

A

Asthma

COPD

chronic bronchitis

Bronchus obstruction

62
Q

What is the term for an inspiratory wheeze?

A

Stridor

63
Q

What sound:

Crackle-like creaking sounds

A

Pleural friction rub

64
Q

What causes pleural friction rub?

A

Inflamed pleural surfaces rubbing together

65
Q

What is mediastinal crunch aka “Hamman’s sign”

A

Precordial crackles in sync with heartbeat, not respiration

Often caused by mediastinal emphysema

66
Q

What position should the patient be in for you to listen to mediastinal crunch/Hamman’s sign?

A

Left lateral position

67
Q

WHat is a pleural effusion?

A

Fluid collection within the chest but outside the lung, casing lung compression

68
Q

What is a pneumothorax?

A

Air collection within the chest but outside the lung, causing lung compression

69
Q

What is COPD?

A

Overdistention of distal airspaces, resulting in limited exploratory flow and lung hyperinflation
(Can’t get air out)

70
Q

What is consolidation/infiltrate?

A

Alveoli filled with fluid/blood/pus increasing the density and opacity of the lung tissue

SHIT IN LUNGS

71
Q

What does a normal, air filled lung sound like on:

Percussion

Breath sounds

Transmitted Voice Sounds

Tactile Fremitus

A

Resonant

Mostly vesicular over large bronchi (bronchovesicular) and trachea (bronchial)

Normal

Normal

72
Q

What does consolidation/pneumonia sounds like on:

Percussion

Breath sounds

Transmitted voice sounds

Tactile fremitus

A

Percussion: dull over affected area

Breath sounds: bronchial over involved area, crackles

Transmitted Voice Sounds: increased.
Bronchophnoy- present (spoken words clearer, louder)
Egophony: present (e to a present)
Whispered pectoriloquy: present (whispers sound loud)

Tactile fremitus: increased

73
Q

What will pleural effusion sound like on:

Percussion

Breath sounds

Transmitted voice sounds

Tactile fremitus

A

Percussion: dull to flat over fluid

Breath sounds: decreased to absent over fluid, possible pleural rub

Transmitted voice sounds: decreased to absent

Tactile fremitus: decreased to absent

74
Q

What will pneumothorax sound like on:
Percussion

Breath sounds

Transmitted voice sounds

Tactile fremitus

A

Percussion: hyperresonant or tympanic over pleural air pocket

Breath sounds: decreased to absent over pleural air pocket, possible pleural rub

Transmitted voice sounds: decreased to absent over air pocket

Tactile fremitus: decreased/absent over pleural air pocket

75
Q

What does COPD sound like on
Percussion

Breath sounds

Transmitted voice sounds

Tactile fremitus

Inspection

A

Percussion: diffusely hhyperresonant

Breath sounds: decreased to absent

Transmitted voice sounds: decreased

Tactile fremitus: decreased

Inspection: increased AP diameter, possible accessory muscle use

76
Q

What will asthma smound likes on:
Percussion

Breath sounds

Transmitted voice sounds

Tactile fremitus

Inspection

A

Percussion: resonant to diffusely hyperresonant

Breath sounds: obscured by high pitched wheezes, possible crackles

Transmitted voice sounds: decreased

Tactile fremitus: decreased

Inspection: possible accessory muscle use

77
Q

What will chronic bronchitis sounds like on
Percussion

Breath sounds

Transmitted voice sounds

Tactile fremitus

A

percussion: resonant (normal)

Breath sounds: vesicular (normal), possible crackles, wheezes or rhonchi

Transmitted voice sounds: normal

Tactile fremitus: normal

78
Q

What is a “sighing” breathing pattern?

A

Periodic deeper breaths

79
Q

What is “obstructed breathing”?

A

Prolonged expiration due to increased airway resistance

Ex: asthma, COPD

80
Q

What is crepitus?

A

Crackling sound/feeling

81
Q

What does subcutaneous emphysema feel like?

A

Rice crispies under the skin

82
Q

What can cause subcutaneous emphysema?

A

Lung injury, thoracic surgery

83
Q

What is the difference between flat and dull percussion tones?

A

Flat: over fluid/bone/muscle

Dull: over solid (liver)

84
Q

What kind of adventitious lung sound will commonly clear with a cough?

A

Rhonchi

85
Q

Which is heard during inspiration and which is heard during expiration:

Wheeze vs stridor

A

Wheeze: expiration

Stridor: inspiration

Physical Diagnosis Exam 2 (Lauren) (3 decks)

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