Resp Flashcards
with any exam what should you first
introduce
confirm px details
explain procedure
gain consent
ask if any pain
clinical exam checklist IPPA?
inspection
palpation
percussion
auscultation
what would form part of your inspection/ what things would you look for before exam?
sputum pots
medication eg inhalers
oxygen masks
nebulisers
sats monitor
oxygen cylinder
what would you inspect the face for
colour
conjunctiva
pallor
tongue
what would you check under the tongue for
central cyanosis
blue
when checking breathing what are you looking for
sob
wheezing
rr
what different things would you check the hands for
clubbing
peripheral cyanosis
tar stains
after checking the radial pulse what would be your next test
co2 retention flap
what would you palpate as you work away from the hands and towards the neck
lymph nodes
which lymph nodes would you palpate
occipital
post auricular
pre auricular
submandibular
submental
anterior cervical
posterior cervical
supraclavicular
what would you inspect the chest for
normal
barrel chest
pectus carinatum
pectus excavatum
/
anterior and posterior symmetry
scars
what might a barrel chest be indicative of
COPD
what is pectus carinatum
breastbone and ribs pushed outward
what is pectus excavatum
ribs and breastbone grow inwards
after observing the chest it will be palpated, what 2 things what you check/ do at this stage
tracheal deviation
chest expansion
to percuss the chest you percuss on the clavicle to give an indication of
resonance in the apex
the lung apex lies immediately beneath what structure
brachial plexus
which areas do you ascultate anteriorally
supra clavicular
infra clavicular
supra mammary
infra mammary
axillary
which areas do you ascultate posteriorally
supra scapular
infra scapular
intrascapular
basal
axillary
after doing the first ascultation on both sides how should it be repeated
ask px to say 99 repeatedly
what does increased volume over a certain area when doing asculatation suggest
increased tissue density due to consolidation, fluid or tumour
how would you get the patient to open the scapula for a better assessment
cross arms in front of them
red flags during examination
blood in sputum
severe or increasing breathlessness
cough over 3 weeks
night sweats
chest pain
orthopnoea
leg oedema
what conditions could be indicative of some of the red flag symptoms
lung cancer
pulmonary htn
hf
what to ask px about sputum- red flags?
any blood in it?
what colour is sputum?
what might nail clubbing be a sign of
smoker
koilonychia is spooning of the nails and suggests what condition
anaemia
is cyanosis in the fingertips peripheral or central
peripheral
what is the first thing that should be inspect in relation to chest after checking lymph nodes
JVP side of neck
