Respiratory

Question 1

Cheyne-Stokes Breathing

Answer 1

Abnormal breathing pattern
tachypnea 
Gradual hyperpnea, then hypopnea 
Followed by periodic apnea 
Hypoperfusion of the brain 
often seen on Heart Failure

Question 2

Abnormal resp breathing pattern (deep, rapid breathing) seen in patients with metabolic acidosis (DKA)

Answer 2

K - ketoacidosis (DKA)
U- Uremia
S - Sepsis 
S - Sacylic Acid
M - Methanol 
A - Aldehyde
U 
L - Lactate

Question 3

Accessory muscles of breathing

Answer 3

supraclavicular (scalene and SCM)
Intercostal M
Subcostal

these try to compensate when Diaphragm is affected. Can be seen during an asthma attack when exhalation is hard due to bronchospam

Question 4

Crepitus

Answer 4

indication of subcutaneous emphysema

Question 5

Transudate vs exudate

Answer 5

transudate: fluid leaking from blood vessels
exudate: fluid leaks from inflammation of the pleura and lung

CHF, pneumonia, malignances, PE : pleural effusion seen

Question 6

Empyema

Answer 6

abscess in the lung parenchyma

not emphySema

Question 7

Rhonchi

Answer 7

low pitched wheezes, snoring quality

Suggest secretions in large airways

Question 8

CTAB

Answer 8

Clear to Auscultation Bilaterally

quick on SOAP note

Question 9

pathologies associated with unilateral absence/decreased breath sounds

Answer 9

Pneumothorax

lung full of fluid (hemothorax, empyema)

Question 10

Stridor

Answer 10

InspIratory sound but can be expiratory/biphasic

Question 11

Stridor

Answer 11

Predominantly InspIratory sound but can be expiratory/biphasic

• narrowed UPPER airway
• louder in neck than chest wall
• high pitched wheeze

causes: croup, epiglottis, upper airway foreign body, anaphylaxis

Medical emergency

Question 12

sound produced by rapid airflow through a narrowed BRONCHIAL airway

Answer 12

WhEEzing (an Expiratory sound but can be inspiratory/biphasic)

causes: asthma, COPD, RAD (Reactive airway disease)

Question 13

sound produced by a small airway closed during expiration, “popping” open during inspiration

Answer 13

Crackles

causes: Pneumonia, CHF, Atelectasis, pulm fibrosis, asthma bronchiectasis, COPD

Question 14

Pulse Oximetry

Answer 14

measures peripheral arterial oxygen saturation (SpO2)
—amount of O2 loaded on Hb

known as “5th vital sign”

Question 15

causes of a bad waveform during pulse oximetry

Answer 15

improper placement, hypoperfusion, hypothermia, motion artifact

Question 16

end tidal CO2

Answer 16

concentration of CO2 in exhaled air at the end of respiration (PETCO2)

Question 17

atelectasis

Answer 17

loss of lung volume due to collapse of lung tissue (alveoli). Remaining lobes will look expanded to compensate for the lost volume

Question 18

• inflamed and roughened pleasurable surfaces grate against each other due to friction
• sounds like creaking usually during expiration but can occur in both phases of respiration

Answer 18

Pleural Frictional rub

Question 19

Upper lung Chapman point

Answer 19

3rd ICS

Question 20

Lower Lung Chapman point

Answer 20

4th ICS