RESP EXAMINATION Flashcards
What pathologies is a productive cough associated with?
Pneumonia
Bronchiectasis
COPD
CF
What pathologies is a dry cough associated with?
Asthma
Interstitial lung disease
What is a Wheeze often associated with?
Asthma
COPD
Bronchiectasis
What is an example of an acute and chronic cause of stridor?
Acute: Foreign body inhalation
Chronic: subglottic stenosis
Why do we observe the colour of the hands in Resp Examination?
Cyanosis of the hands may suggest underlying hypoxaemia
Why do we look for tar staining in the hands for a Resp Examination?
Caused by smoking
Which is a signficiant risk factor for respiratory disease (e.g. COPD, lung cancer)
Why do we look for skin changes in the hands for a Resp Examination?
Bruising and thinning of the skin can be associated with long-term steroid use
Why do we look for joint swelling or deformity for a Resp Examination?
May be associated with rheumatoid arthritis which has several extra-articular manifestations that affect the resp system (e.g. pleural effusions/pulmonary fibrosis)
What respiratory conditions is finger clubbing associated with?
Lung cancer
Interstitial lung disease
Cystic fibrosis
Bronchiectasis
What is a fine tremor normally associated with?
Typically associated with beta-2-agonist use (e.g. salbutamol)
What is the most likely respiratory cause of Asterixis?
CO2 retention in conditions that result in type 2 respiratory failure (e.g. COPD)
What are some of the other causes of asterixis?
Uraemia
Hepatic encephalopathy
What are the two main pulse abnormalities for a Resp Examination?
Bounding Pulse
Pulsus Paradoxus
What is a bounding pulse associated with?
Underlying CO2 retention (e.g. type 2 respiratory failure)
What is Pulsus Paradoxus?
Pulse wave volume decreases signficantly during the inspiratory phase
What is Pulsus Paradoxus a sign of?
A late sign of:
Cardiac tamponade
Severe acute asthma
Severe Exacerbations of COPD
What is a respiratory rate of fewer than 12 breaths per minute referred to as?
Bradypnoea (e.g. opiate overdose)
What is a respiratory rate of more than 20 breaths per minute referred to as?
Tachypnoea (e.g. acute asthma)
What are the respiratory causes of a raised JVP?
Pulmonary hypertension: causes right-sided heart failure, often occuring due to COPD or interstitial lung disease
What is a Plethroic Complexion?
A congested red-faced appearance associated with polycythaemia (e.g COPD) and CO2 retention (e.g. type 2 resp failure)
What is Conjuntive pallor suggestive of?
Underlying anaemia
What is Oral Candidiasis associated with?
Steroid inhaler use due to local immunosuppression
What is Asymmetry of the chest associated with?
Pneumonectomy (e.g. lung cancer)
Thoracoplasty (e.g. TB)
What is Hyperexpansion of the chest associated with?
Chronic lung diseases such as asthma and COPD
What are the causes of tracheal deviation?
The trachea deviates away from tension pneumothorax and large pleural effusions
The trachea deviates towards lobar collapse and pneumonectomy
What are the causes of abnormal cricosternal distance?
A distance of fewer than 3 fingers suggests underlying lung hyperinflation (e.g. asthma, COPD)
What are the respiratory causes of a displaced apex beat?
Right ventricular hypertrophy (e.g. pulmonary hypertension, COPD, interstitial lung disease)
Large pleural effusion
Tension pneumothorax
What are the respiratory causes of symmetrical reduced chest expansion?
Pulmonary fibrosis reduces lung elasticity restricting overall chest expansion
What are the respiratory causes of Asymmetrical reduced chest expansion?
Pneumothorax
Pneumonia
Pleural effusion
All cause ipsilateral chest expansion
What does a dull percussion note suggest?
Increased tissue density
E.g. cardiac dullness, consolidation, tumour, lobar collapse
What does a stony dullness suggest?
Caused by an underlying plerual effusion
What is Hyper-resonance?
The opposite of dullness
Suggestive of decreased tissue density
E.g. pneumothorax
What are the two different types of Abnormal tactile vocal fremitus?
Increased vibration over an area suggests increased tissue density (e.g. consolidation, tumour, lobar collapse)
Decreased vibration over an area suggest the presence of fluid or air outside of the lung (e.g. pleural effusion, pneumothorax)
What are Bronchial breath sounds?
Harsh-sounding
Insipration and expiration are equal and there is a pause between
Associated with consolidation
What do quiet breath sounds suggest?
Reduced air entry into that region of the lung
E.g. pleural effusion, pneumothorax
What are coarse crackles?
Discontinous, brief, popping lung sounds typically associated with pneumonia, bronchiectasis and pulmonary oedema
What are Fine end-Inspiratory crackles?
Similar to the noise when separating velcro
Associated with pulmonary fibrosis
What are the two types of abnormal vocal resonance?
Increased volume over an area suggests increased tissue density (e.g. consolidation, tumour, lobar collapse)
Decreased volume over an area suggests the presence of fluid or air outside of the lung (e.g. pleural effusion, pneumothorax)
What are the respiratory causes of lymphadenopathy?
Lung cancer with metastases
TB
Sarcoidosis
What can erythema nodosum be associated with?
Sarcoidosis
