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Cardiopulmonary Laboratory > Pulmonary Examination > Flashcards

Pulmonary Examination Flashcards

1
Q

Normal respirations, with equal rate and depth, 12-20 bpm

A

Eupnea

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2
Q

Slow respirations <10 bpm

A

Bradypnea

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3
Q

Fast respirations, >24 bpm, usually shallow

A

Tachypnea

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4
Q

Respirations that are regular but abnormal in depth and increase in rate

A

Kusmaul’s Respirations

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5
Q

Irregular respirations of variable depth (usually shallow) followed by periods of apnea

A

Biots Respiration

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6
Q

Gradual increase in depth of respirations followed by gradual decrease and then a period of apnea

A

Cheyne-Strokes Respiration

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7
Q

Absence of breathing

A

Apnea

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8
Q

What should you take note in the Hx of the patient?

A
  1. Demographics
  2. Lifestyle
  3. Occupation
  4. Genetic Predisposition
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9
Q
  1. A pulmonary disease that is transmitted by and autosomal recessive trait.
  2. What trait is this?
  3. Dx test to diagnose this condition.
  4. What is the implication of no. 3?
A
  1. Cystic Fibrosis
  2. Cystic Fibrosis Transmembrane Conductance Regulator on Chromosome 7; long arm
  3. Chloride Sweat Test
  4. A chloride concentration of greater than or equal to 60 mEq/L in sweat of a child is positive for CF.
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10
Q
  1. A condition due to constant remodelling of airways in the pulmonary system.
  2. Give me the factors of this condition
  3. What symptoms does this condition presents?
    4.What deformity does this patient have if she/he have this condition?
A
  1. Chronic Obstructive Pulmonary Disease
  2. Host (Alpha 1 Antitrypsin gene dysfunction) and Environmental Factors
  3. Hypoxemia and Hypercapnea
  4. Barrel Chest Deformity
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11
Q

Stage 1- Mild COPD

A
  1. FEV1/FVC <70%
  2. FEV1 is greater than or equal to 80% predicted
  3. S&Sx: With or without chronic symptoms
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12
Q

Stage 2- Moderate COPD

A
  1. FEV1/FVC<70%
  2. 50% is less than or equal to FEV1 less than 80% predicted
  3. Often with SOB with exertion
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13
Q

Stage 3- Severe COPD

A
  1. FEV1/FVC < 70%
  2. 30% less than or equal to FEV1 less than or equal to 50% predicted
  3. With greater SOB, decreased exercise capacity, exacerbation
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14
Q

Stage 4- Very Severe COPD

A
  1. FEV1/FVC < 70%
  2. FEV1 is less than 30% predicted FEV1 less than 50% with chronic respiratory failure
  3. Impaired QOL, may be life threatening
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15
Q

Variables of Prognosis of COPD Using BODE Index

A
  1. FEV1 (% predicted)
  2. 6 minute walk test (meters)
  3. MMRC Dyspnea Scale
  4. BMI
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16
Q

Breathlessness only on strenous exercise

A

MMRC Dyspnea Scale Grade 0

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17
Q

Breathless when hurrying on the level or walking up in a slight hill

A

MMRC Dyspnea Scale Grade 1

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18
Q

Walks slower than other people of same age on the level due to SOB or need to stop for breath when walking at own pace

A

MMRC Dyspnea Scale Grade 2

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19
Q

Short of breath after walking few minutes on the level or about 100 yards (90m)

A

MMRC Dyspnea Scale Grade 3

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20
Q

Too breathless to leave the house, or breathless when dressing or undressing

A

MMRC Dyspnea Scale Grade 4

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21
Q

A deformity that the sternume projects forward and downward like the heel of the boot, increasing anteroposterior dimension of the chest.

A

Pigeon Chest or Pectus Carinatum

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22
Q

A congenital deformity that results from the sternum projecting posteriorly by an overgrowth of ribs.

A

Pectus Excavatum

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23
Q

The sternum projects forward and upward so that the anterposterior diameter is increased.

A

Barrel Chest Deformity

24
Q

Chest Expansion Normal Difference When Using a Measuring Tape

A

3 to 7.5 cm (1-3 inches)

25
Q

Landmarks in performing Chest Expansion Test in Upper Lobes

A

Thumbs at the sternal notch, remaining fingers placed above the clavicle

26
Q

Landmarks in performing Chest Expansion Test in Middle Lobes

A

Thumbs placed on the xiphoid process, remaining fingers placed on the lateral ribs

27
Q

Landmarks in performing Chest Expansion Test in Middle Lobes

A

Thumbs at lower thoracic spine (T12) back, remaining fingers placed on the lateral ribs

28
Q

What test used for digital clubbing?

A

Schamroth Window Test

29
Q

Muscles that helps in respiration during Forced Inspiration

A
  1. SCM
  2. Upper Traps
  3. Pec. Minor/Major
  4. Ant. and Post. Scalene
  5. Serratus Anterior
  6. External Intercostals
30
Q

Muscles that helps in respiration during Forced Expiration

A
  1. Abdominals
  2. Serratus Post.
  3. Internal Intercostals
31
Q

Hollow, loud, tubular, high pitched sound

A

Bronchial and Tracheal

32
Q

Soft pitch sound

A

Broncho vesicular
Vesicular

33
Q

Fine Discontinued Sounds

A

Crackles/Rales

34
Q

Continuous High or Low pitch sounds

A

Wheezes

35
Q

Snoring

A

Stridor

36
Q

Decrease breath sounds

A

Hyperflation

37
Q

Increase breath sounds

A

Hypointflation/ Atelectasis

38
Q

Crackles of breath sounds

A

Presence of secretions

39
Q

Wheezing breath sounds

A

Constricted Bronchi

40
Q

Balloon Rubbing Breath Sounds

A

Pleuritis/Pleurisy

41
Q
  1. Auscultate posterior chest, ask patient to say “99”.
  2. Normal Result?
  3. Abnormal Result?
A
  1. Bronchophony
  2. Soft and muffled sounds
  3. Loud and clear- lung consolidation
42
Q
  1. Have patient say “ee”
  2. Normal Result
  3. Abnormal Result
A

1, Egophony
2. Soft and muffled sound
3. aa is heard= lung consolidation

43
Q
    • Performed when (+) bronchophony is ausculatated
      * Have patient whisper “123”.
  2. Normal Result
  3. Abnormal Result
A
  1. Whispered Pectoriloquy
  2. Should be faint and muffled
  3. Loud and clear= lung consolidation
44
Q
  1. Associated with Hyperventilation
  2. S&Sx of this condition
A

Dizziness
Early Tetany
Numbness
Tingling
Syncope

45
Q
  1. Associated with hypoventilation
  2. S&Sx of this condition
A
  1. Respiratory Acidosis
  2. Early:
    Headache
    Anxiety
    Restlessness
    Dyspnea

Late:
Disorientation
Somnolence
Coma

46
Q
  1. MC with vomiting
  2. S&Sx
A
  1. Metabolic Alkalosis
  2. Weakness
    Mental Confusion
    Increase DTR
    Muscle Twitching
47
Q
  1. MC with diarrhea, associated with Kusmaul’s Respiration
  2. S&Sx
A
  1. Metabolic Acidosis
  2. Nausea
    Lethargic
    Coma
48
Q

Sputum Color: Red/Scarlet

A

Blood

49
Q

Sputum Color: Rust

A

Pneumonia

50
Q

Sputum Color: Yellow

A

Infection

51
Q

Sputum Color: Green

A

Pus

52
Q

Sputum Color: Pink

A

Frothy; Pulmonary Edema

53
Q

Sputum Color: Purple

A

CA and Neoplasm

54
Q

Sputum Color: Flecked

A

Carbon Particles

55
Q

Sputum Color: Clear

A

Normal

56
Q

Exercise Testing Protocols Used for the patient with Pulmonary Disease

A
  1. Cycle Test
  2. Treadmill Test
  3. 10-meter shuttle test
  4. Walk Test (6-12 minutes)
57
Q

Termination Criteria based on ETT Result

A
  1. Maximal SOB
  2. Leg Pain
  3. Total Fatigue
  4. Signs of insufficient cardiac output
  5. Reaching a ventilatory maximum
  6. Symptoms of fatigue
  7. Increase of DBP of 20 mmHg, systolic HTN greater than 250mmHG
  8. A fall in PaO2 of greater than 20 mmHg or PaO2 less than 55 mmHg
  9. A rise in PaCO2 of greater than 10 mmHg or greater than 65 mmHg
  10. Cardiac ischemia or arrhythmias

Cardiopulmonary Laboratory (5 decks)

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