RESP - ASSESSMENT Flashcards
What are the principle and accessory muscles for the inspiratory phase
Principle: External intercostals + diaphragm
Accessory: SCM, Scalenes, Pec minor
What are the muscles for the expiratory phase
Internal intercostals, abdominals
When are muscles active during the expiratory phase
only during active breathing/expiration (NOT quiet breathing)
What does ippa stand for
inspection
Palpation
percussion
Auscultation
What do you look at for inspection
- 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
What causes clubbing
oxygen not getting to extremities
What is clubbing a sign of
chronic respiratory disease
What are 4 things you are palpating for
- Chest wall expansion
- Tactile fremitus
- Tracheal position
- Rates - RR, HR, BP
Tactile femitus indicates…
secretion retention
Normal lung sounds are ____
resonant
What do dull sounds indicate
consolidation/pleural fluid
What do hyper-resonant sounds indicate
air
How does the diaphragm work? what type of sounds does it best pick up?
by listening to vibrating body sounds and picks up high frequency sounds better
How does the bell work? what type of sounds does it best pick up?
by listening to vibrating skin sounds and picks up low frequency sounds better
how many auscultation points are there total?
25
What are the 5 types of breath sounds
- Normal
- Diminished
- Absent
- Bronchial
- Adventitious
What are the 4 types of adventitious breath sound
- Crackles
- Wheezes
- Stridor
C. Pleural rub
What does a bronchial breath sound sound like
Hollow breath sound, short pause between inspiration and expiration. heard when air is travelling through larger airways
What creates the sound of crackles
the movement of mucus or fluid or the late opening of airways
What are inspiratory crackles associated with
diffuse airway obstruction and/or atelectasis
What are expiratory crackles associated with
edema, fibrosis, and partial or full consolidation
Crackles can be categorized as _____ or _____
fine or coarse
what breath sound is referred to as musical snoring
wheezes
What is a stridor sound like? what is it associated with?
loud musical sound of constant pitch associated with laryngeal or tracheal obstruction
What is a pleural rub sound like? what causes it?
creaking leathery sound or stepping on fresh compact snow, due to pleural irritation
What are the 3 types of vocal resonance
- Whispered pectoriloquy
- Bronchophany
- Egophany
What is whispered pectoriloquy? what is it indicative of?
patient whispers a word and examiner hears the whispers loud and clear. indication of lung consolidation
What is broncophany? what is it indicative of?
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
What is egophany? what is it indicative of?
patient verbalizes “e” in a normal voice and you hear a high pitched “a”. an indication of lung consolidation
