resp Flashcards
what do you see in inspection
tachypnoea, cough, cyanosis, use of accessory muscles. audible wheeze, nasal flaring, sweating, tripod position
bradypnoea
under 12
tachypnoea
over 20
trachea deviation away from lesion
extensive pleural effusion, tension pneumothorax, chest expansion (?)
trachea deviation toward the lesion
upper lobe collapse, upper lobe fibrosis, pneumonectomy
cause of unilateral dec in chest expansion
pneumothorax, pleural effussion, collapsed lung, consolidation
symmetrical decrease in chest expansion
asthma, COPD, fibrosis,
what do you hear when you percuss healthy lung
resonant, loud and low pitched (like for like)
hyper-resonant percussion
excess air, such as pneumothorax, COPD, acute asthma, hollow bowels
hyop-resonant in percussion
not air in lungs: dull- bone/ tumour/ consolidation/ collapse/ liver.
stoney dull: haemothorax/ pleural effusion
what should you hear in ausculation of the lungs?
bronchial breathing- loud, high pitched, equal inspiratory and expiratory phase, heard over manubrium (pause heard over trachea)
-heard outside normal teritory: inc transmission of sound to surface of chest due to consolidation, pleural effusion, pul fibrosis, collapsed lung.
what is vesicular breathing?
lower pitched, rustling sounds, longer inspiraotry phase, no pause between inspiration and expiration, heard all over lungs. dec intensity due to shallow breathing/ pneumothorax
when is tactile vocal fremitus inc density
consolidation/ pneumonia/ tumour/ lobe collapse
when is tactile etc dec density
COPD.
poplyphonic wheeze
asthma, copd, heart failure
monophonic wheeze:
carcinoma, foreign body
what lymph nodes do you palpate
submental, submandibular, parotid, preauricular, post auricular, occipital, superficial cervical, posterior cervical, supraclavicular
what will you hear in COPD
bilateral dec chest expansion, hyper-resonant percussion, polyphonic wheeze, prolonged expiratory phase, dec tactile vocal fremitus. Hyper-inflated chest
what will you hear in pneumothorax
dec chest expansion ipsilaterally, tracheal deviation away if tension, hyper-resonant percussion, dec intensity of breath sounds, dec tactile vocal fremitus on affected side.
what do you hear in lobar collapse
: tracheal deviate to lesion, dec chest expansion ipsilaterally, dullness percussion, dec breath sounds, inc tactile fremitus.
what do you hear in consolidation
ipsilateral dec chest expansion, dullness to percussion, bronchial sounds over consolidation, inc tactile fremitus.
what do you hear in pleural effusion
dec chest expansion ipsilaterally, stoney dull percussion, reduced intensity of breath sounds and tactile vocal fremitus,
what do you hear in fibrosis
bilateral dec in chest expansion and fine end inspiratory crackles, acute asthma: bilateral dec in chest expansion, hyper resonant, expiatory wheeze, prolonged expiratory phase
lung fissure markings
Its surface markings are from the level of the right fourth costal cartilage horizontally to a junction with the oblique fissure at approximately the midaxillary line in the fifth intercostal space.
