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OSPE > Resp > Flashcards

Resp Flashcards

1
Q

How do you locate C7?

A

first palpable spinous process

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2
Q

How do you locate T2?

A

Superior angle of the scapula

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3
Q

How do you locate T3?

A

Root of the spine of the scapula

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4
Q

How do you locate T7?

A

Inferior angle of scapula

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5
Q

How do you locate T12?

A

Mid-point between the inferior angle of the scapula and top of iliac bone along the scapular line

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6
Q

How do you locate L4?

A

highest point of the iliac crest

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7
Q

Where is the Xiphisternum?

A

T9

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8
Q

What is the spinous level of the body of the sternum?

A

T5-T8

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9
Q

At what level is the sternal angle

A

T4-T5

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10
Q

What is the spinal level of the jugular Notch

A

T2/T3

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11
Q

Describe how you take the breathing rate

A
  1. say you would take a pulse

2. look at the chest

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12
Q

What is the name if he breathes below the normal rate and above

A

below bradypnea

above tachypnea

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13
Q

What are all the different patterns of breathing?

A
  1. prolongued expiration (regular obstructive)]
  2. fast and deep (Kussmaul)
  3. Cheyne-strokes (increased frequency and depth and then decrease in the frequency and depth)
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14
Q

What is the normal breathing rate

A

12-20 breaths per minute

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15
Q

Demonstrate and percuss the upper lobe

A

apex 2, 4, 6 mid axillary(middle) and 6 mid clavicular (lower lobe) on the right upper, middle lower lobe
left upper upper lower

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16
Q

At what angle does the patient lie when percussing the lungs?

A

45 degrees

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17
Q

What does one need to tell the patient when percussing the posterior side ?

A

cross arms - moves scapula out of the way

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18
Q

Where would you percuss the superior lobe of the lung?

A

ANTERIOR:
2nd intercostal space mid clavicular line
LEFT - 4th intercostal space mid clavicular line

POSTERIOR
1st intercostal
3rd intercostal space near medial border

19
Q

Where would you percuss the apex of the lung

A

above the clavicle

20
Q

Where would you percuss the middle lobe?

A

ANTIRIOR ONLY
MALE: 4 th intercostal space
FEMALE:6th intercostal space mid axillary line ? ICSL?

21
Q

Where would you percuss the inferior lobe of the lung?

A

ANTERIOR
6th intercostal space MCL
POSTERIOR
7th intercostal space scapular line

22
Q

What do you tell your patient when auscultating the lungs?

A

breath through the mouth

23
Q

What are the different types of breathing noises that can be heard when auscultating the lungs?

A 
vestibular breathing (upper, middle, apex, lower)
bronchial breathing (on manubrium, trachea, sternal angle)
24
Q

How should vestibular breathing sound like compared to bronchial breathing?

A

low

bronchial is high pitched

25
Q

What are abnormal sounds that can be heard in the lungs?

A

wheeze crackling and plural rub

26
Q

Describe the border of the entire lung

A
  • 2.5 cm above medial 3rd of the clavicle
  • over sternoclavicular joint
  • down sternal border till Xiphisternal joint
  • 6th ICS
  • 8th MAL
  • T10
27
Q

Describe the superior lobe of the lung

A 
RIGHT
-2.5sm above the medial 3rd of the clavicle
- sternoclavicular joint
- till 4th intercostal space
- lateral spine of the scapula till apex
LEFT
goes until 6th MCL and 4th midaxillary
28
Q

What deviation can be seen in the superior lobe of the lung and how many cm is it?

A

2-3 cm

29
Q

Describe the position of the middle lobe

A

-below 4th intercostal space
- 6th midclavicular line
up to meet 4th intercostal space

30
Q

Describe the inferior lobe of the lung on the RIGHT and LEFT

A

ANTERIORLY
- 6th mid clavicular up to 4th axillary _ anterior border
Posteriorly
- T3/T4 till T10

31
Q

Where is the oblique fissure

A 
ANTERIOR
from 4th midaxillary
to 6th midclavicular
POSTERIOR
T3/T4
32
Q

Where is the horizontal fissure?

A

along 4th intercostal space

33
Q

Describe the surface of the parietal pleura?

A
  • 2.5 cm above medial third of the clavicle
  • over sternoclavicular joint
  • 4th ICS
  • 6th ICS
  • 8th ICS midclavicular
  • 10th midaxillary
  • 12 th posteriorly
34
Q

describe the surface marking of the visceral pleura?

A
  1. 5 cm above medial 3rd of the clavicle
    - over sternoclavicular joint
    - down sternal border till Xiphisternal joint
    - 6th ICS
    - 8th MAL
    - T10
35
Q

Describe the safe triangle ?

A
  • ant: anterior border of the pectoralis major
  • posterior - latissimus dorsi
  • inferior 5 intercostal space
  • superior : apex of axilla
36
Q

Why do you do a chest drain?

A

pneumothorax, Haemothorax, pleural effusion

37
Q

Describe the surface marking of the mediastinal pleura of the right and left lung on the anterior chest wall

A

RIGHT:

  • right sternal border
  • break at sternal angle
  • Rib 6

LEFT:
indentation from Rib 4-6 of 2-3 cm

38
Q

Demonstrate percussion of upper/lower/middle lobe(s) of right/left lungs

A

ALWAYS BOTH SIDE TO COMPARE

ANTERIOR
1. above clavicle (APEX)

  1. 2nd intercostal space (upperlobe) MCL
  2. 4th intercostal space (upper lobe and middle lobe) MCL
  3. 6th intercostal space (lower lobe) (MAL)

DON’T FORGET THE AXILLA (middle and upper lobe)

POSTERIOR
1. 1st intercostal space medial sternal border (upper lobe)

  1. 3rd intercostal space medial sternal border (upper lobe)
  2. 7th intercostal space scapular line (lower lobe)
39
Q

Describe and demonstrate the surface marking and palpation of the trachea at the
suprasternal notch

A

https://www.google.co.uk/search?q=palpationo+fhte+traches&rlz=1C1GCEJ_enGB814GB814&oq=palpationo+fhte+traches&aqs=chrome..69i57j0l2.4055j0j7&sourceid=chrome&ie=UTF-8#kpvalbx=1

?? put middle finger in the suprasternal notch and rest the index and ring finger the 2 clavicular heads and identify the deviation

40
Q

Demonstrate how you would investigate symmetrical inflation of the lung and describe
the anatomical basis.

A
  • Subject sits upright on a couch
    “would it be alright if I held myhands around your chest to check your breathing”
  • Hands on anterior chest wall just beneath 5th/6th ribs
  • Fingers extended round sides of chest
  • Thumbs meet anteriorly in MSL (mid-sternal line)
  • In females - below breast
  • Ask patient to take a deep breath - thumbs should move at least 5 cm
  • Repeat on posterior chest wall, thumbs meeting in posterior midline T10.
  • Anterior - shows upper and middle lobe expansion
  • Posterior - shows lower lobe expansion

“lungs are expanding symmetrically , as my thumbs moved apart equally in each each direction by about 2-3 cm”
Observe and describe the breathing pattern and the breathing rate.

(What is the normal breathing rate)
Measure rate of movement of anterior chest wall for 60 s

Without subject being aware eg pretend measuring pulse

Normal = 12-20 breaths per min

Rate - normal, rapid, slow

Depth - normal, shallow, deep

Rhythm - regular, irregular
3/21

41
Q

Observe and describe the breathing pattern and the breathing rate.

A

Measure rate of movement of anterior chest wall for 60 s

Without subject being aware eg pretend measuring pulse

Normal = 12-20 breaths per min

Rate - normal, rapid, slow

Depth - normal, shallow, deep

Rhythm - regular, irregular

42
Q

Demonstrate where you would auscultate upper/middle/lower lobe(s) of right/left lungs.

A

ALWAYS BOTH SIDE TO COMPARE

ANTERIOR
1. above clavicle (APEX)

  1. 2nd intercostal space (upperlobe) MCL
  2. 4th intercostal space (upper lobe and middle lobe) MCL
  3. 6th intercostal space (lower lobe) (MAL)

DON’T FORGET THE AXILLA (middle and upper lobe)

POSTERIOR
1. 1st intercostal space medial sternal border (upper lobe)

  1. 3rd intercostal space medial sternal border (upper lobe)
  2. 7th intercostal space scapular line (lower lobe)
    Describe & demonstrate the surface markings of the whole lung
    *Apex at 2-3 cm above medial 3rd of clavicle
  • Over sternoclavicular joint
  • Down sternal border to xiphisternal joint (R6)
  • R6 at MCL
  • R8 at MAL
  • R10/T10 at medial scapular border
  • Up lateral to spine to T1
  • (Left lung, deviation 2-3cm from R4-6)
    5/21
43
Q

Describe & demonstrate the surface markings of the whole lung

A
  • Apex at 2-3 cm above medial 3rd of clavicle
  • Over sternoclavicular joint
  • Down sternal border to xiphisternal joint (R6)
  • R6 at MCL
  • R8 at MAL
  • R10/T10 at medial scapular border
  • Up lateral to spine to T1
  • (Left lung, deviation 2-3cm from R4-6)

OSPE (1 decks)

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