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Clinical Methods > Pulmonary I > Flashcards

Pulmonary I Flashcards

1
Q

The interspace between 2 ribs is numbered by the rib ____ it.

A

above

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2
Q

Use the ____ ____ on the chest wall as a guide.

Move laterally to _____ rib then walk down interspaces.

A

sternal angle (Angle of Louis)

2nd rib

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3
Q

Inferior tip of scapula lies at the level of the ____ rib.

A

7th

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4
Q

When the neck is flexed _____ and ____ verterbrae are most prominent.

A

C7 and T1

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5
Q

Precise locations of chest wall:

A
  • midsternal line
  • midclavicular
  • anterior axillary line
  • midaxillary line
  • posterior axillary line
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6
Q

The apex of each lunch rises ___ to ___ cm above the clavicle.

A

2cm to 4 cm

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7
Q

The lower border of the lung crosses the ____ rib at the _________ line and the ______ rib at the _________ line.

A
  • 6th
  • midclavicular
  • 8th
  • midaxillary
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8
Q

Posteriorly, the lower border of the lung lies at the ___ spinous process.

A

T10

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9
Q

The trachea bifurcates into its mainstem bronchi at the levels of the _____ ____ (anteriorly) and ____ (posteriorly).

A

sternal angle

T4

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10
Q

What muscles are used during exercise or in pulmonary diseases? aka accessory muscles

A
  • scalenes
  • trapezius
  • pectoralis major
  • SCM
  • internal intercostals
  • abdominals muscles
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11
Q

Common concerning symptoms to ask patient:

A
  • chest pain
  • dyspnea
  • wheezing (musical sound)
  • cough
  • blood streaked sputum
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12
Q

Sources of chest pain:

A
  • myocardium
  • pericardium
  • aorta
  • trachea/large bronchi
  • parietal pleura
  • chest wall
  • esophagus
  • neck, gall bladder and stomach
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13
Q

Interview: Chest pain ask patient:

ask broadly then narrow down

A
  • Do you have unpleasant feelings in your chest?
  • point to location of pain
  • elicit 7 attributes of pain
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14
Q

Lung tissue has pain fibers. True or false.

A

false, pain in lung arises from inflammation of parietal pleura usually

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15
Q

Non-painful but uncomfortable awareness of breathing that is inappropriate to the level of exertion characterizes:

determine severity based on daily activities:

A

dyspnea

flight of stairs, carrying groceries

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16
Q
  • Makes musical respiratory sounds that may be audible to the patient and others
  • suggests partial airway obstruction from secretions, tissue inflammation, or an airway obstruction

Examples:

A

wheezing

  • asthma
  • emphysema
17
Q

a reflex response to stimuli that irritate receptors in the larynx, trachea, or large bronchi

stimuli:

A

cough

mucus, pus, blood, dust, extremely hot or cold air (basically anything in the throat)

18
Q

coughing up of blood from the lung

confirm source of bleeding! mouth, pharynx, GI

A

hemoptysis

19
Q

Initial survey of patient for the pulmonary exam:

A
  • inspect pt for any signs of respiratory difficulty
  • assess patient’s color for cyanosis
  • listen to breathing
  • inspect the nect
  • observe shape of chest
20
Q

During inspection of the chest:

Note:

A

observe the shape of the patients chest and movement of the chest wall

  • deformities or asymmetry
  • abnormal retraction of the lower interspaces
  • impaired respiratory movement
21
Q

Test ensuring that voice sounds consistent where the stethoscope is applied:

A

tactile fremitus

22
Q

Chest percussion:

hyperextend ______ finger of non-dominant hand.

Strike pleximeter finger with _____ finger and use the wrist to strike

A

middle finger

middle

23
Q

Normal breath sounds

A
  • Vesicular
  • Bronchovesicular
  • Bronchial
24
Q

soft intensity, lower pitched sighing sounds

A

vesicular

normal breath sound

25
Q

moderate intensity and moderate pitched blowing sounds

A

bronchovesicular sound

normal breath sound

26
Q

high pitched harsh sounds moving through the trachea

A

bronchial breath sound

normal breath sound

27
Q

snap, crackle, pop sound

A

rales

aka crackles

28
Q

continuous low-pitched coarse gurgling

A

gurgles aka rhonchi

29
Q

superficial grating sounds not relieved by coughing

A

friction rub

30
Q

continuous high pitched musical sound

A

wheezing

31
Q

Ask the patient to whisper a sequence of words “one, two, three”, only faint sounds are heard.

However, over areas of tissue abnormalit, the whispered sounds will be clear and distinct

A

whispered pectoriloquy

32
Q

Ask the patient to say “99” in a normal voice . Words should be indistinct

A

bronchophony

33
Q

Ask the patient to say the vowel “e” . If the lung tissue is consolidated, the “e” sound will change to a nasal “a”

A

egophony

34
Q

Attributes of pain, use chloride:

A
  • Character
  • Location (unilateral vs. bilateral)
  • Onset (acute or chronic, sudden or gradual)
  • Radiation
  • Intensity
  • Duration
  • Exacerbating

Clinical Methods (9 decks)

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