Pulmonary exam Flashcards
1
Q
Order of lung exam
A
- inspection
- palpation
- percussion
- auscultation
2
Q
Lobes of lung
A
- Right: 3 lobes
- Left: 2 lobes
3
Q
Health hx affecting lungs
A
- smoking
- sedentary lifestyle
- age
- environmental exposures
- obesity
- family hx
4
Q
Inspection
A
- breathing pattern
- use of accessory muscles
- color of lips and nails
- pt position - tripod is distress
5
Q
tactile fremitus
A
press both hands on chest while pt says “99”
- assess for fluid
6
Q
pathological conditions that alter fremitus
A
- pleural effusion
- Increased with fremitis: consolidation
- absent/decreased with fremitis: COPD, fibrosis, pneumothroax
7
Q
purpose of lung palpation
A
- investigating for painful areas
- fracture feels like pushing on rice krispies
8
Q
Purpose of percussion
A
- detect pleural sounds
- dull = effusion (fluid in pleural cavity)
9
Q
Auscultation sounds: vesicular
A
- soft, low pitched, heard over most of the lungs
10
Q
Auscultation sounds: broncho-vesicular
A
- intermediated sound and pitch, hear often in 1st and 2nd intercostal space
11
Q
Auscultation sounds: bronchial
A
- loud, high pitched sound over manubrium, if at all
12
Q
Auscultation sounds: tracheal
A
- very loud and heard over trachea in neck
13
Q
Auscultation sounds: wheezing
A
- continuous, high pitched with hissing/shrill quality
- suggests narrowed airways
14
Q
Auscultation sounds: crackles/rales
A
- intermittent, non-musical, brief, not cleared by cough
- fine crackles: sounds like rice krispies
- course crackles: sounds like opening velcro
- suggests CHF, pneumonia, pulmonary fibrosis
15
Q
Auscultation sounds: Ronchi
A
- continuous, low pitched with snoring quality
- suggests secretions in airways
- cleared by coughing
16
Q
Auscultation sounds: stridor
A
- loud wheezing, often heard w/out stethoscope
- indicates upper airway obstruction
- considered medical emergency
17
Q
Auscultation sounds: pleural friction rub
A
- dry, rubbing, or grating sounds
- inflammation of pleural surfaces
- heard during inspiration and expiration
18
Q
bronchophony
A
- pt says 99
- Normal: sounds muffled and indistinct
- With consolidation, words sounder louder and clearer
19
Q
Egophony
A
- Patient says “ee”
- Normal: sounds like “ee”
- With consolidation: sound like “a” (nasally sound; e to a)
20
Q
Whispered pectoriloquy
A
- Patient whispers “99”
- Normal: words faint, if heard at all
- With consolidation: whispered words sound louder, clearer
