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Physical Exam (DL) > RESP > Flashcards

RESP Flashcards

1
Q

What is the sternal angle?

A

2nd Rib

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2
Q

What is the needle insertion for pneumothorax?

A

2ICS (MCL)

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3
Q

Chest Tube insertion point?

A

4ICS (MAL)

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4
Q

Where are the nipples?

A

4ICS, just lateral to MCL

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5
Q

Inferior tip of Scapula?

A

7th rib or ICS

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6
Q

Anterior Lungs- apex rises ____ above the clavicle

Lower border crosses the ____ rib at MCL and the ____ rib at the MAL

A

2-4 cm

6th rib

8th rib

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7
Q

Posterior lungs- lower border lies about ____

A

T10 Spinous process

*descends on inspiration

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8
Q

Posterior lung fissure sits at approx ______

A

T3 Spinous process

*no right-middle lobe shown posteriorly

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9
Q

Where does the trachea bifurcate

A

Bifurcates at the sternal angle anteriorly and T4 posteriorly

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10
Q

What are the accessory muscles that help with heavy breathing or with certain disease or injuries?

A

Parasternals
Scalenes
Sternomastoids
Abdominal muscles

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11
Q

normal breathing rate
What can influence it?
Inspiration/expiration time?

A

12-20 in adult (F slightly higher rates than M).

20-30 in child.

30-60 in newborn.

metabolic rate, emotional state, neurological disorders, obstructive disease

*Insp: 1.5-2 s.
Pause: 2 s.
Exp: 1.5-2 s.

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12
Q

DEF:

Simply - increased respiratory rate

A

Tachypnea

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13
Q

DEF:

Any breathing pattern that reduces CO2 in the blood due to the increased rate and depth of respiration.

A

Hyperventilation

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14
Q

Is Bradypnea a problem?

A

Not if perfusion is preserved as demonstrated by ABG

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15
Q

__________ : deep, labored sighing respirations, whether rate be normal, slow, or fast
What causes it?

A

Kussmaul Breathing:

A compensatory response to metabolic acidosis (MEG’s LARD).

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16
Q

________________ cyclic hyperventilation followed by compensatory apnea

A

Periodic (Cheyne-Stokes) Breathing:
Respirations are interrupted by periods of apnea.
In each cycle, the rate and amplitude of successive breaths increase to maximum, then progressively
diminish into the next apneic period.

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17
Q

If chest pain is said to be pleuritic, it means that it is caused by ____________

A

The movement of breathing

18
Q

Def:
Dyspnea worse with upright posture
What can cause it?

A

Platypnea:

Pericarditis.

19
Q

What might cause a normal chest to be wider than it is deep

A

aging or COPD (AP > L)

20
Q

clubbing of fingernails can signal ….

A

Chronic lung disease

21
Q

What is pectin excavated?

What does it do to organs inside?

A

Funnel chest
depression in lower sternum

compresses heart and great vessels and may cause murmurs

22
Q

Name for pigeon chest

A

Pectus Carinatum

Sternum displaced anteriorly, increasing the AP diameter, while the adjacent costal cartilages are depressed.

23
Q

Thoracic Kyphoscoliosis

A

Abnormal spinal curvatures and vertebral rotation deforming the chest

Kyphosis is a condition of over-curvature of the thoracic vertebrae

Scoliosis is a condition in which a person’s spine curves laterally

24
Q

Signs of Respiratory Compromise

A

Retractions of the interspaces and use of accessory muscles (SCM and scalenes) during inspiration.

Pursing or cyanosis of the lips.

Nasal flaring.

25
Q

Pay particular attention to the ____________ in patients reporting anterior chest pain to evaluate the possibility of ________

A

costochondral junctions

costochondritis

26
Q

chest expansion exam should take place at what rib level?

A

10th

27
Q

Why would tactile femitus be decreased or absent?

Increased?

A

areas of plural effusion or pneumothorax

areas of consolidation (pneumonia)

28
Q

percussion only penetrates how far

A

5-7cm into the chest

29
Q

Where should you percuss the 6th and 7th posterior

A

4th and 5th ICS along the PAL

30
Q

CVAT

Tenderness suggest…

A

renal malady such as pyelonephritis or kidney stones

31
Q

_______: Soft and low-pitched sounds heard through inspiration, fade away about one-third of the way through expiration, heard over most of both lungs

Duration: Inspiratory longer than expiratory.

A

Vesicular

32
Q

________: Louder and high in pitch with a short silence between inspiration and expiration; heard over the manubrium (if at all)

Duration: Expiratory longer than inspiratory.

A

Bronchial

33
Q

______: Very loud and high in pitch, heard over the trachea in the neck (Darth Vader)

Duration: Inspiratory = Expiratory.

A

Tracheal

34
Q

_________ is the phenomenon of the patient’s voice remaining loud (bronchial) at the periphery of the lungs or sounding louder than usual over a distinct area of consolidation, such as in pneumonia.

A

Bronchophony

May be caused by a solidification of lung tissue around the bronchii - which may indicate lung cancer -
or by fluid in the alveoli, such as with pneumonia

35
Q

An exaggerated form of bronchophony.
Patient whispers “ninety nine” as you auscultate different areas.

Pulmonary consolidation transmits whispered syllables distinctly, even when the pathologic process is too small to produce bronchial breathing.

This sign is valuable in detecting ______________

A

Whispered Pectoriloquy

early pneumonia, infarction, and atelectasis.

36
Q

A form of bronchophony in which the spoken “Eee” is changed to “Ay,” which has a nasal or “bleating” quality E to A transition.

Most commonly this indicates ________

A

Egophony

pneumonia

37
Q

adventitious sounds include:

What do they mean?

A

Crackles- nonmusical
May be from abnormalities of the lungs (pneumonia, fibrosis, early CHF) or of the airways (bronchitis,
bronchiectasis).

Wheezes and Rhonchi- musical
Wheezes relatively high-pitched with shrill quality suggest narrowed airways from asthma, COPD, or
bronchitis.

Rhonchi are lower-pitched with a snoring quality suggesting secretions in the larger airways.

Friction Rub-
grating sound made from 2 plural surfaces rubbing

38
Q

Clearing of sounds after coughing suggest…..

A

inspissated (thickened) secretions such as bronchitis.

39
Q

What causes most cases of pneumococcal pneumonia?

A

Streptococcus pneumoniae

40
Q

CDC recommends immunizations for:

A

All adults > 65.
People ages 2-64 with chronic illnesses, esp if at increased risk for pneumococcal infection (sickle-cell
anemia, cardiovascular and pulmonary disease, diabetes, cirrhosis, or leaks of CSF).
Anyone with or about to receive a cochlear implant.
Immunosuppressed > 2 yo including those receiving steroids, radiation, or chemotherapy.

Physical Exam (DL) (3 decks)

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