Resp exam Flashcards
What are the cardiac causes of clubbing?
- subacute bacterial endocarditis
- congenital cyanotic heart disease
- left atrial myxoma
What are the respiratory causes of clubbing?
- suppurative lung disease (bronchiectasis, TB, abscess)
- lung cancer (non-small cell)
- pulmonary fibrosis
What are the non-cardiac, non-resp causes of clubbing?
- IBD
- primary biliary cirrhosis
- idiopathic
What are we looking for in the hands?
- clubbing
- pallor of palmar creases
- radial pulse
- signs of peripheral cyanosis
- tobacco staininng
- C8-T1 lesion
What are we looking for in the general inspection?
- sick or not sick
- oriented, confused or drowsy
- resp distress?
- sputum mug?
- oxygen?
What is the difference between peripheral and central cyanosis?
peripheral: circulatory insufficiency
central: resp insufficiency
What does an increased percussion note indicate?
- pneumothorax, hyperinflation, lung cyst
What does a decreased percussion note indicate?
- consolidation, collapse, dense fibrosis, pleural fluid, thickening (
What do increased breath sounds indicate?
- “bronchial breathing”
- sign of consolidation
Reduced breath sounds?
airflow obstruction or hyperinflation
- pleural effusion of pneumothorax
- thick chest wall
- lung collapse
What causes a wheeze?
- asthma, chronic bronchitis, pulmonary oedema, foreign body, lung tumour
What causes creps?
- pulmonary oedema, pulmonary fibrosis, pneumonia, bronchiectasis, atelectasis
What causes a pleural rub?
- inflammation (infective and non-infective)
- tumour
What is a normal forced expiratory time?
- less than 3 seconds
- more than 6 secs indicates airflow obstruction
What other regions should be examined in the resp exam?
- heart - for features of pulmonary htn
- abdomen - features of right heart failure, liver mets
- legs - features of right heart failure, DVT
What are the signs of consolidation?
- no shift in trachea
- small change in chest movement
- bronchial breathing
+/- creps - vocal resonance
