Pulmonary Physical Findings

Question 1

What are physical findings normally?

Answer 1

Percussion: resonant
Breath sounds: vesicular over most of lung fields
Adventitious sounds: none
Fremitus, etc.: normal fremitus

Question 2

What are physical findings in chronic bronchitis?

Answer 2

Percussion: resonant
Breath sounds: vesicular
Adventitious sounds: rhonchi, crackles, wheezing
Fremitus, etc.: normal fremitus

Question 3

What are physical findings in emphysema?

Answer 3

Percussion: hyperresonant
Breath sounds: decreased (bc less lung tissue)
Adventitious sounds: none
Fremitus, etc.: decreased fremitus (doesn’t travel as well in air)

Question 4

What are physical findings in pulmonary edema?

Answer 4

Percussion: resonant
Breath sounds: vesicular
Adventitious sounds: course crackles (esp end inspiration), occasional wheeze
Fremitus, etc.: normal fremitus

Question 5

What are physical findings in consolidation (as in pneumonia or hemorrhage)?

Answer 5

Percussion: dull
Breath sounds: decreased
Adventitious sounds: late inspiratory crackles
Fremitus, etc.: increased fremitus, bronchophony, egophony, whispered pectoriloquy

Question 6

What are physical findings in atelectasis (as in lobar obstruction from mass, mucus, foreign object)?

Answer 6

Percussion: dull (less air)
Breath sounds: decreased to absent
Adventitious sounds: none
Fremitus, etc.: trachea may be shifted toward involved side if large area of lung affected

Question 7

What are physical findings in pleural effusion?

Answer 7

Percussion: dull
Breath sounds: decreased to absent
Adventitious sounds: possible pleural rub
Fremitus, etc.: decreased fremitus (may be increased at top of effusion)

Question 8

What are physical findings in pneumothorax?

Answer 8

Percussion: hyperresonant
Breath sounds: decreased to absent
Adventitious sounds: none
Fremitus, etc.: decreased fremitus

Question 9

What are physical findings in asthma?

Answer 9

Percussion: resonant to hyperresonant
Breath sounds: obscured by adventitious sounds
Adventitious sounds: wheezing, rhonchi, crackles
Fremitus, etc.: decreased fremitus

Question 10

What are physical findings in upper airway obstruction (as in croup, laryngeal edema, laryngomalacia)?

Answer 10

Percussion: resonant
Breath sounds: vesicular, decreased if severe obstruction
Adventitious sounds: stridor
Fremitus, etc.: normal fremitus

Question 11

fluid in lung tissue ______ (increases/decreases) transmission of sound and tactile fremitus?

ex. consolidation

Answer 11

increases

Question 12

fluid or air outside of lung (in pleural space) ______ (increases/decreases) transmission of sound and tactile fremitus?

ex. pleural effusion, pneumothorax

Answer 12

decreases

Question 13

how does DLCO change for asthma? for COPD?

Answer 13

asthma: increased or normal
COPD: decreased

Question 14

what is considered abnormally low DLCO?

Answer 14

<60%

Question 15

how can we use DLCO to differentiate between asthma and COPD?

Answer 15

in asthma will not have decreased DLCO

in emphysema, will have low DLCO