resp assessment Flashcards
Principal mm inspiration
external intercostals
diaphragm
accessory mm inspiration
SCM
scalenes
pec minor
active breathing mm
internal intercostals
the abs
assessing resp
Patient history, physical exam, lab tests
patient history on resp ass
chart, interview, social assessment
physical exam resp
IPPA, functional mobility, cardiac assessment
lab tests resp
chest x ray
ECG
exercise test
4 principals of assessment resp
position of patient
draping patient
room set up
biomechanics of you
whats IPPA
inspection, palpation, percussion, ausculation
inspection in IPPA
Lines HR, BP, BR Head (pain? alter? speech? skin? lips?) Breathing type Cough, Sputum
clubbing assessment
connect index nails see a gap your good
palpation IPPA
THUMBS MIDSTERNAL LINE BREATH IN
precision IPPA
taps
normal lung sound
resonant (chest)
pleural fluid sound
dull (patella)
air sound
hyper resonant (stomach)
how many points of auscaltion
11 front, 14 back
types of breath sounds
normal, diminished, asset, bronchial, wheeze etc..
indication of lung consolidation
patient whisper and examiner hears whisper
bronchophany
patient says 99 and hear with greater clarity
epiphany
patients says e but you hear a
signs of lung consolidation
whispered, bronchophany,egop hany
hyperpnea
deep breaths
rate normal or tacky
apnea
cessation of breath
cheyne stokes
apnea with tacky
red/brown sputum mean
blood
yellow green sputum mean
infection
orthopnea
SOB laying flat
Clubbing looking for
appearance
angle
girth
space
diaphragm of stethoscope for
vibrating body , high frequency
bell of stethoscope for
vibrating skin, low frequency
gold standard of aus. listen to ___
lobes
bronchial heard when ___
crackles heard when_____
Wheezing heard when____
hallow
fluid/ obstruction
narrowing
stridor heard when ____
tracheal obstruction
pleural rub is ___
sound of stepping on snow
AP or PA most standard
PA
AP disadvantages
mediastinum magnified
hard to take full breathing
position compromised
T/F rotation is always abnormal of the long side
NO short
is left rotation shortened what do you see
rotation to left, increase heart size
is right rotation shortened what do you see
rotation to right, decreased heart size
how to know if heart is enlarged
make A and B lines (heart and thoracic border)
should be half
how to check mediastinum shift
border each lung to thoracic, should be 2:1
mediastinal or trachea shifting could indicate:
volume inc or dec
increase in volume shift ____ decrease in volume shift ___
shift away
shift towards
mediastinum landmarks
pulmonary artery
general vascularity
where is hila typically found
1-2 rib counts below inferior aspect of arch of aorta
volume decrease conditions
collapse / atectatsis
volume increase conditions
consolidation
pleural effusion
pneumothorax
COPD
pneumothorax
total colapse
atelectasis
collapse or close, part of all of lung
little to no volume
features of atelectasis on X-ray
shifts toward the decrease
silhouette signs
white
consolidation
anything that fills alveolar
opaque
pleural effusion
fluid in pleural
costophrenic angle effected or opaque / shift in opposite direction
general features of consolation or pleural effusion
opaque
siloutte signs
shift away from volume increase
pneumothorax general features
air in space, dark area
emphysema on xray
horizontal flat diaphragm
pear shaped hart
