Pulmonary exam

Question 1

lung fields

anterior
lateral
posterior

Answer 1

anterior - apices to 6-7 ribs
lateral - axilla to 8-9 ribs
posterior - apices to 10-12 ribs

Question 2

fissures

oblique
horizontal

Answer 2

oblique - SP of T3

horizontal - 5th rib of mid axillary line to 4th rib

Question 3

regular pattern of gradually increasing and decreasing tidal volume interspersed with periods of apnea

Answer 3

cheyne stokes

Question 4

irregular breathing with irregular pauses and increasing periods of apnea - similar size breaths

Answer 4

biots

Question 5

irregular breathing with irregular pauses and increasing periods of apnea - variance in deeps of breaths

Answer 5

ataxic

Question 6

increased fremitus indicates what

Answer 6

lung consolidation

pneumonia

Question 7

decreased fremitus indicates what

Answer 7

excess air in lungs 
collapsed lungs 
asthma 
emphysema 
pneumothorax 
pleural effusion

Question 8

fluid collecting in potential space between the lung and chest wall

Answer 8

pleural effusion

Question 9

air filled parenchyma becomes engorged with fluid

Answer 9

consolidation

Question 10

pleximeter
vs
plexor

Answer 10

pleximeter - finger struck

plexor - striking finger

Question 11

auscultation sounds

Answer 11

bronchial - manubrium - loud and high pitched

brochovesicular - mainstem bronchi (1-3 ICS anteriorly) and midscapular area posteriorly

vesicular - most of lung fields - low pitched

Question 12

bronchial sounds are heard when

Answer 12

expiration

if heard anywhere else besides manubrium, then it indicates pneumonia

Question 13

bronchovesicular sounds are heard when

Answer 13

equal during expiration and inspiration

Question 14

vesicular sounds are head when

Answer 14

inspiration

Question 15

crackles or rares describe

Answer 15

fine, popping, crackling, discontinuous

mainly during inspiration

mostly in peripheral lung fields

found in pulmonary edema, CHF, pneumonia, interstitial fibrosis, and any condition involving alveolar tissue

Question 16

wheezes describe

Answer 16

high pitched, squeaking, musical, continuous

mainly during expiration

small airways narrow and spasm

found in asthma, CHF, fibrosis, pneumonia, and TB

Question 17

rhonchi describe

Answer 17

snores, moans, groans

during expiration

large airways narrow

found in bronchitis, bronchospasm

Question 18

asthma

Answer 18

tachpnea, dyspnea

diminished fremitus

hyperresonance

expiratory wheezes

Question 19

bronchitis

Answer 19

possible tachypnea and shallow breathing

tactile fremitus undiminished

resonance

rhonchi auscultation

Question 20

emphysema

Answer 20

labor breathing and barrel chest

diminished fremitus and liver margin displaced

hyperresonance and limited diaphragmatic excursion

diminished breath sounds

Question 21

pneumonia

Answer 21

limited motion and labored breathing

increased fremitus due to consolidation

dullness

crackles, bronchial breath sounds, egophony, bronchophony, whispered pectoriloquy

Question 22

pneumothorax

Answer 22

cyanosis, dyspnea, tracheal deviation

diminished fremitus

hyperresonance

diminished breath sounds