Pulmonary Eval Flashcards
Normal FEV1/ FVC ratio
0.75 to 0.8
FEV1/ FVC value for RLD
more than >0.8
FEV1/ FVC value for obstructive lung disease
< 0.7
Forced midexpiratory flow value range
25 to 75
is the volume of air exhaled in middle 1/2 of FVC
clubbed fingers are the enlargement of —– ——. The body doesn’t get enough O2 and compensates with swelling
capillary beds
This postural impairment makes it difficult for the lungs to expand
kyphosis
Facial signs of pulmonary distress are nasal flaring, sweating, —– ( skin), enlarged —–
paleness
focused or enlarged pupils
JVD is associated with ——-
Cor pulmonale
hyperinflated chest ratio
AP diameter ( xiphoid process to vertebrae) to transverse diameter
1:1
barrel chest
rib angles should measure at —– *
rib angles attach to vertebrae at about —-
90 * rib angle
45* degree vertebrae attachment
larger rib and vertebral angles leads to ——-
**air trapping **
this stretches diaphragm causing it to be flatter and less efficient
—- SCM and/or adaptive —- of the SCM muscles may indicate a —- pulmonary condition
hypertrophy
shortening
chronic
RR for infants
30 - 60 breaths/ min.
12 to 18 year olds RR
12 to 20 breaths / min
Eupnea: rate, depth, rhythm
normal for all
Bradypnea: rate, depth, and rhythm
slow rate
shallow or normal depth
regular rhythm
Tachypnea: rate and depth
fast rate
shallow depth
Hyperpnea: rate, depth, and rhythm
normal rate,
increased depth, and
regular rhythm
Hyperventilation: rate, depth, and rhythm
results in decreased ——
fast rate
increased depth
regular rhythm
decreased arterial carbon dioxide
This is when speech is interrupted for a breath. It identifies how many words can be said before next breath
dyspnea of phonation
These are abnormal noises that can only be heard with a stethoscope
adventitious breath sounds
This lung sound is continous but high pithched
wheeze
This lung sound is a subtype of a wheeze. It has a low pitch and implies an obstruction of the airway
Rhochi
This adventitious lung sound is discontinous and sound like brief burst of popping bubbles
Crackles
This lung sound is heard on the inhale and exhale. It sounds like 2 pieces of leather or sandpaper
pleural rub
A productive cough is common with —–
A nonproductive cough is common with ——
productive cough: infection
nonproductive cough: lung neoplasm
This type of breathing is not coordinated and is not efficient.
Paradoxical breathing
during paradoxical breathing the chest moves —- instead of —– during inhalation
moves inward instead of outward
The trachea moves —- the collapsed side in Atelectasis
towards
partially collapsed area, NOT a collapsed lung
T or F: pneuthorax the trachea will deviate away from the collapse side
True
Tachypnea, ipsilateral crackles and wheezes, decreased tactile femitus, distant or absent breath sounds all indicate ——-
pneumothorax
In crepitus the hallmark sign is increasing edema from in the —- > —- to —- with rice cripsy feeing and crackling skin is palpated
chest > scapula > neck
to face
The PT places their hands on patient and feel for vibrations in the chest from the words. This is called
Tactile Fremitus
tactile fremitus provides info on —- lungs and thoracic cavity
density
In tactile fremitus for pneumothroax and pleural effusion are increased or decreased
decreased
this prevents lung expansion –> creates more space in the lung prevents sound transmission
Mediate Percussion: striking an air filled surface ( lung) will produce what kind of sound?
striking a fluid or tissue filled cavity will produce what kind of sound?
air filled - Reasonant sound
fluid filled - dull sound
What sound would be associated with thoracic air increases ( air trapping)? This is associated with emphysema and pneumothroax?
hyper-reasonant or tympanic
What conditions are associated with decreased thoracic air?
atelectasis
pleural effusion
mucus
Pronounced and prolonged expiration would associated with what pathology
obstructive airway disease
what elicited sound test involves increased reasonance of voice sounds ?
Egophony
say “eeeee”
normal and abnormal finding with egophony
Healthy: hear “eeeee”
Unhealthy: nasal A or “goat call” sound ausculation
what elicited sound test looks at abnormal transmission from lungs to bronchi
Bronchophony
say “99”
Increased loudness upon whispering
Whispered Pectoriloquy
whisper 1,2,3
healthy test for Whispered Pectoriloquy
not understood
abnormal/ unhealthy test for Whispered Pectoriloquy
understood 1,2,3
where are Vesicular breath sounds heard are? are they abnormal or normal?
Now from the pulmonary exam lab
Normal
heard over most of peripheral lung fields
reduction in vesicular sound volume indicates
reduced ventilation
prolonged exhale sound indicates
airway obstruction
bronchial sounds are found where?
over / close to the trachea
aka tracheal sounds
Broncho-vestibular sounds are found where? what do they represent?
lateral to trachea
interscapular region ( L)
represent conituum of sounds from** larger airways**
Narrowing of airways ( aka bronchospasms, bronchial edema, adherent secretions…) produce what type of adventitious lung sound
High pitched wheeze
Fluid (mucous) in the larger or conducting airways produce what type of adventitious lung sound
Rhonchi ( low pitch/ coarse)
