Resp Exam Flashcards
What angle for resp exam
45
Pulse abnormalities in a resp exam
Bounding in retention
Pulsus paradoxus in tampon add
1 resp cause of raised JVP
Pulmonary hypertension - often due to COPD or ILD
Also CHF can cause
2 resp causes of plethoric complexion
Polycythaemia in COPD
CO2 retention e.g. in COPD
3 signs of horners in resp exam
Ptosis (eyelid droops)
Miosis (constricted pupil)
Enopthalmos (sunk into eye socket)
Midline sternotomy scar
Cardiac valve replacement
coronary artery bypass graft
Axillary thoractomy scar
Chest drain!
Infraclavicular scar
Pacemaker insertion
Posterolateral thoracotomy scar
Lobectomy, pneumonectomy, oesophageal surgery
4 chest wall deformities
Asymmetry (e.g. pneumonectomy)
Pectus excavatum (sunken sternum)
Pectus carinatum (sternum protrudes)
Hyperexpansion (barrel chest)
Displaced apex beat causes resp exam
Right ventricular hypertrophy e.g. COPD, ILD
Large pulmonary effusion
Tension PT
What makes vocal resonance louder and quieter
Increased volume in increased tissue density (e.g. consolidation, tumour, lobar collapse)
Decreased volume in fluid/ air outside the lung e.g. pleural effusion
End of bed resp exam
Age
SOB
Cyanosis
Cough
Wheeze
Stridor
Pallor
Cachexia
Objects:
Oxygen delivery
Sputum pot
Cigs
Mobility aids
Notes/ charts
Hands resp exam
LOOK:
- cyanosis
- tar staining
- thin/ bruised skin of steroid use
- joint swelling of RA
FEEL:
- clubbing of ILD, cancer, CF, bronchiectasis
- temp
- HR (resp rate also)
Move:
- fine tremor
- axterixis (flapping tremor)
Face on resp exam
- plethoric complexion of polycythaemia
- conjunctival pallor (anaemia)
- ptosis, miosis and enopthalmos of Horner’s Sx
- central cyanosis
- oral candidiasis
