Pulmonary Examination (ETT Criteria)

Question 1

What are Common Vital Sign measurements to obtain during an Examination

Answer 1

HR
BP
RR
Oxygen Saturation (SpO2)

Question 2

Auscultation of The Lungs

Answer 2

Place stethoscope firmly on the patient’s thorax anteriorly, laterally and posteriorly.

Question 3

Types of Normal Breath Sounds

Answer 3

Vesicular; softer, low pitch
Bronchial; louder, high-pitched, more hollow sound

Question 4

What are adventitious breath sounds?

Answer 4

Abnormal breath sounds, not normally heard on auscultation

Question 5

What are Crackles?

Answer 5

AKA Rales

• Sounds like popping, rustling of cellophane
• Can be heard during both inspiration and expiration

Question 6

What are Wheezes?

Answer 6

High pitched coarse whistling sounds, due to a decrease in size of the lumen, creating the wheezing sound.

• Hearing during Expiration “Expiratory Wheeze”

Question 7

For patients with pulmonary dysfunction why is utilizing a formal MMT not advised?

Answer 7

Patients most likely produce a Valsalva Maneuver when performing the test.
- Increases intrathoracic pressure, closing off small airways.
- Causes SOB thus, decreased full participation

Question 8

What measurement should be used in place of a formal MMT?

Answer 8

Functional 5 Times Sit to Stand for determining LE strength.

Question 9

What is the 6-MWT?

Answer 9

Functional Performance Measure:
- Patient instructed to walk as far as they can in 6 minutes
- Patient is allowed to stop and rest during the test. (timer will not stop)

Question 10

Termination Criteria during a Graded Exercise Test: PaO2, PaCO2

Answer 10

Fall in PaO2 > 20 mmHg or PaO2 < 55 mmHg

Rise in PaCO2 > 10 mmHg or PaCO2 > 65 mmHg

Question 11

Termination Criteria during a Graded Exercise Test: Blood Pressure

Answer 11

Increase in DBP 20 mmHg

Systolic Hypertension > 250 mmHg

Decrease in Blood Pressure with increasing Workloads

Question 12

Termination Criteria during a Graded Exercise Test: Symptoms

Answer 12

Symptoms of Fatigue
Leg Pain
Max Shortness of Breath
Reaching Ventilatory Max
Cardiac Ischemia or Arrythmias

Question 13

What phase are Wheezes normally heard?

Answer 13

During the Expiratory Phase

“Expiratory Wheeze”

Question 14

What is Rhonchi?

Answer 14

Continuous, low pitched sounds, that resemble snoring.

Question 15

What is Pleural Rub? What does this indicate?

Answer 15

Occurs with inspiration and expiration, during auscultation in the lower lateral chest areas.

Indications of Pleural Inflammation; Pleurisy

Question 16

Voice Sounds: What is Bronchophony?

Answer 16

Increased Vocal Resonance with greater clarity and loudness of spoken words. e.g 99

(Done during auscultation) - Secretions carrying sounds more clearly

Question 17

Voice Sounds: What is Egophony?

Answer 17

Form of Bronchophony, spoken long “E sound” changes to a long sounding “A Sound”

(Done during auscultation) - Secretions carrying sounds more clearly

Question 18

Voice Sounds: What is Whispered Pectoriloquy?

Answer 18

An increased loudness of whispering. Clarity in hearing whispered words “1, 2, 3”.

(Done during auscultation) - Secretions carrying sounds more clearly

Question 19

What normal breath sound is heard longer during inspiration than expiration?

Answer 19

Vesicular

Question 20

What normal breath sound is hear longer on expiration than inspiration

Answer 20

Bronchial