Pulmonary Semiology Flashcards
Coarse/Wet crackles
Insp sounds from fluid oscillating in small airways
Pneumonia, HF,
fine crackles
Insp sounds of opening of small airways
Intersittial dz, bronchiolotis, HF
Velcro-like in late insp - lung fibrosis
Pelural rub
Pleuritis and from inflamed pleura rubbing during inspiration
Rough and course that should be auscultated at position of max pain
Rhonchi
Lower- piutched sounds in suggested secretion in larger airways
Can be insp or exp
Bronchitis or bronchopenumonia
Wheezes
High pitched sounds meaning narrowed small airways and can be insp or exp
Typical or asthma
Dahls sign
ABove the knee, patches of hyperpigmentation caused by constantly resting hands or elbows to improve insp mechanical advantage in pts with severe COPD
Dextrocardia
Chronic resp sx - consider katageners syndrome
Bronchiectasis, sinusitis, infertility, and situs inveruss due to MT defect
Hoovers sign
Insp inward motioin of inf rib cage…indicated severe lung hyperexpansion (COPD)
Lupus pernio
Sarcoidosis
Usually multiple papuler and nodular red-violet lesions involving central face
Recur after tx and associated with resp involvement
Pectus excavatum
Depressed sternum that can produce restitctive throacic impairment and apparemtn cardiomegaly on chest Xray
Resp failure findings
Paradoxial breathing - with pt supine, chest and abdomen SHOULD rise together….here they are dyssynchronys due to fatigue of diaphragm…can also be seen in bilateral diaphrag paralyti…Do NOT confuse with reverse paradox seen with low cervical spinal cord injury
Acc muscle use - Scalene, SCM< and trapeziues (in that order)
Diaphoresis - high symp tone
Stridor
Insp sqeuaks or rhonchi heard over trachea…correlates wiht narrowing of airway above throacic outlet (laryngeal edeam)
Tracheal shift
Asses above suprasternal notch
Means volume loss (atelectasis, lung resection, obstructing tumor) or inc pressure on opp side (pneumothorax, hemothroax, massive pleural effusion)
