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Cardiopulm > Pulmonary Evaluation > Flashcards

Pulmonary Evaluation Flashcards

1
Q

FEV/FVC scoring

A

normal: .75-.8
> 0.8 restrictive lung disease
< 0.7 obstructive lung disease

measures max amount of air inhaled and exhaled in determined time

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2
Q

Forced midexpiratory Flow (FEF 25-75)

A

volume of air exhaled over middle half of FVC

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3
Q

Max voluntary ventilation (MVV)

A

“Breathe as deeply and as rapidly as possible for 10, 12, 15 sec”

Measures max amount of air inhaled and exhaled in determined time

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4
Q

Tests of diffusion

A

DL

or

DLco

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5
Q

DLco

A
  • in presence of O2, CO will bind to RBCs, give a tiny dose of CO, and breathe out
  • Take difference of what was inhaled/exhale
  • difference is the gas that has gone from the body

Measures the ability of blood to diffuse gas from the lungs

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6
Q

Why is the supine position difficult for pulmonary patients?

A
  • organs pushing on diaphragm
    • mucous moves back into lungs
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7
Q

T/F: patients often notice that their clubbing is abnormal and painful

A

False

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8
Q

Supplemental O2 considerations

A
  • being used properly
  • flow rate
    • breathe to make use of the supplemental O2
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9
Q

pulmonary:
evaluation of the neck

A
  • hypertrophy of SCM
  • chronic forward bent posture (shortened SCM)
  • JVD
    • position of clavicle
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10
Q

resting chest evaluated for

A
  • symmetry
  • rib angles
    • musculature
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11
Q

chest eval: rib angles

A
  • normally rib angles < 90 deg and attach to vertebrae approx 45 deg angles
  • abnormal angles > 90 deg
    • abnormal vertebral angle > 45 deg
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12
Q

chest eval:

muscle

A

hypertrophy and/or adaptive shortening of SCM = chronic condition

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13
Q

Normal RR (bpm)

A
  • infants: 30-60
  • 3-6 y.o. : 22-34
  • 6-12 y.o. : 18-30
    • 12-18 y.o. : 12-20
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14
Q

Eupnea

A

normal rate, depth, and rhythm

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15
Q

bradypnea

A
  • slow rate
  • shallow or normal depth
    • regular rhythm
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16
Q

tachypnea

A
  • fast rate
    • shallow depth
17
Q

hyperpnea

A
  • normal rate
  • increased depth
    • normal rhythm
18
Q

hyperventilation

A
  • fast rate
  • increased depth
    • regular rhythm

results in decreased arterial CO2

19
Q

Evaluation:
Patient Speech

A
  • dysnpnea on phonation
    • how many words before next breath
20
Q

wheezes

A

continuous high pitched sound

21
Q

rhonchi

A
  • subtype of wheeze
  • low pitched like a snore
    • obstruction of larger airway
22
Q

crackles

A
  • discontinuous adventitious sounds
    • sounds like brief bursts of popping bubbles
23
Q

pleural rub

A

sounds like two pieces of leather/sandpaper

24
Q

pleural rub

A

sounds like two pieces of leather/sandpaper

25
Q

cough assessment

A
  • strength
  • duration
  • effectiveness
    • quality
26
Q

color of mucous indicating bacterial infection

A

yellow, orange, green

27
Q

Paradoxical breathing

A

chest moves inward instead of outward during inhalation

28
Q

paradoxical breathing causes

A
  • airway obstruction
  • mechanical disruption of chest wall
    • phrenic nerve injury
      • diaphragmatic dysfunction
29
Q

cause of flail chest

A

broken ribs

30
Q

atelectasis

A

complete or partial collapse of a lung or lobe.

Trachea moves toward collapsed side

31
Q

pneumothorax

A
  • abnormal collection of air or gas in pleural space causing uncoupling of lung from chest wall
    • air leaks into space and restricts lungs
      • Trachea deviates AWAY
32
Q

Pneumothorax:
signs

A
  • tachypnea
  • assymetric lung expansion
  • distant/absent breath sounds
  • decreased tactile fremitus
    • adventitious lung sounds
33
Q

tumor: deviation of trachea

A

pushed AWAY

34
Q

chest expansion measurements

A
  • children: 2 cm
  • “fit young man”: >5cm
  • severe emphysema: may expand <1cm
35
Q

crepitus:

A
  • increasing edema in chest > scapula > neck to face
    • crispy feeling and crackling when skin palpated
36
Q

cause of crepitus

A
  • air in subcutaneous tissue
  • air leaks out of lungs follows fascial planes and enter subcutaneous later of the skin
    • “ subcutaneous emphysema”
37
Q

egophony

A
  • say “EEEEE”
  • healthy = eeeee
    • unhealthy= nasal A or goal call
38
Q

bronchophony

A
  • say 99 repeatedly
  • healthy = not understandable
    • unhealthy = 99 understood. indicates consolidation
39
Q

whispered pectoriloquy

A
  • whispe 1-2-3
  • healthy = not understood
    • unhealthy = understood

Cardiopulm (20 decks)

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