RESP - ASSESSMENT

Question 1

What are the principle and accessory muscles for the inspiratory phase

Answer 1

Principle: External intercostals + diaphragm
Accessory: SCM, Scalenes, Pec minor

Question 2

What are the muscles for the expiratory phase

Answer 2

Internal intercostals, abdominals

Question 3

When are muscles active during the expiratory phase

Answer 3

only during active breathing/expiration (NOT quiet breathing)

Question 4

What does ippa stand for

Answer 4

inspection
Palpation
percussion
Auscultation

Question 5

What do you look at for inspection

Answer 5

• Lines and values on monitor
• Position of patient
• head: facial expression, orientation, speech, skin (pallor, cyanosis, scars), lips (colour + pursed lip breathing), nose (flaring of nostrils)
• Neck: accessory muscle use + jugular vein distension
  Chest: Scars, chest wall deformities, muscle wasting, what type of breather, check movement/breathing pattern
• Limbs - colour, clubbing, edema
• Cough: weak strong productive
• Sputum: colour, smell, amount, texture
• breathlessness: respiratory distress, orthopnea

Question 6

What causes clubbing

Answer 6

oxygen not getting to extremities

Question 7

What is clubbing a sign of

Answer 7

chronic respiratory disease

Question 8

What are 4 things you are palpating for

Answer 8

1. Chest wall expansion
2. Tactile fremitus
3. Tracheal position
4. Rates - RR, HR, BP

Question 9

Tactile femitus indicates…

Answer 9

secretion retention

Question 10

Normal lung sounds are ____

Answer 10

resonant

Question 11

What do dull sounds indicate

Answer 11

consolidation/pleural fluid

Question 12

What do hyper-resonant sounds indicate

Answer 12

air

Question 13

How does the diaphragm work? what type of sounds does it best pick up?

Answer 13

by listening to vibrating body sounds and picks up high frequency sounds better

Question 14

How does the bell work? what type of sounds does it best pick up?

Answer 14

by listening to vibrating skin sounds and picks up low frequency sounds better

Question 15

how many auscultation points are there total?

Answer 15

25

Question 16

What are the 5 types of breath sounds

Answer 16

1. Normal
2. Diminished
3. Absent
4. Bronchial
5. Adventitious

Question 17

What are the 4 types of adventitious breath sound

Answer 17

1. Crackles
2. Wheezes
3. Stridor
   C. Pleural rub

Question 18

What does a bronchial breath sound sound like

Answer 18

Hollow breath sound, short pause between inspiration and expiration. heard when air is travelling through larger airways

Question 19

What creates the sound of crackles

Answer 19

the movement of mucus or fluid or the late opening of airways

Question 20

What are inspiratory crackles associated with

Answer 20

diffuse airway obstruction and/or atelectasis

Question 21

What are expiratory crackles associated with

Answer 21

edema, fibrosis, and partial or full consolidation

Question 22

Crackles can be categorized as _____ or _____

Answer 22

fine or coarse

Question 23

what breath sound is referred to as musical snoring

Answer 23

wheezes

Question 24

What is a stridor sound like? what is it associated with?

Answer 24

loud musical sound of constant pitch associated with laryngeal or tracheal obstruction

Question 25

What is a pleural rub sound like? what causes it?

Answer 25

creaking leathery sound or stepping on fresh compact snow, due to pleural irritation

Question 26

What are the 3 types of vocal resonance

Answer 26

• Whispered pectoriloquy
• Bronchophany
• Egophany

Question 27

What is whispered pectoriloquy? what is it indicative of?

Answer 27

patient whispers a word and examiner hears the whispers loud and clear. indication of lung consolidation

Question 28

What is broncophany? what is it indicative of?

Answer 28

patient verbalizes “99” or “toy boat” in a normal voice and you will hear the words with greater intensity and clarity. Indication of lung consolidation

Question 29

What is egophany? what is it indicative of?

Answer 29

patient verbalizes “e” in a normal voice and you hear a high pitched “a”. an indication of lung consolidation