Respiratory

Question 1

Trachea position?

Answer 1

In middle of neck and suprasternal notch of manubrium
Divides at sternal angle (T4/T5)

Question 2

Trachea displacement towards the side of the lung lesion?

Answer 2

Upper lobe collapse
Upper lobe fibrosis
Pneumectomy

Question 3

Trachea displacement away from side of the lung lesion?

Answer 3

Extensive pleural effusion
Tension pneumothorax
Chest expansion

Question 4

Chest expansion anterior wall level?

Answer 4

Below 5th and 6th ribs
Normal movement 5cm

Question 5

Expansion on posterior chest wall level?

Answer 5

10th thoracic vertebrae

Question 6

Unilateral decreased expansion?

Answer 6

Pneumothorax
Pleural effusion
Collapsed lung
Consolidation

Question 7

Bilateral decreased extension?

Answer 7

Asthma or COPD

Question 8

Reasons for hyper-resonance?

Answer 8

Pneumothorax
Hollow bowels
COPD

Question 9

Reasons for hypo-resonance?

Answer 9

Pleural effusion (stoney dull)
Lung tumour (flat/dull)
Consolidation (flat/dull)
Collapse (flat/dull)

Question 10

Bronchial sounds?

Answer 10

High pitch
Between C7 and T3
Expiratory > inspiratory
Distinct pause

Question 11

Vesicular sounds

Answer 11

Low pitch
Inspiratory > expiratory
No pause

Question 12

Reduction in intensity of vesicular sounds?

Answer 12

Airway obstruction
Shallow breathing
Hyperinflation
Pneumothorax
Pleural effusion
Pleural thickening
Obesity

Question 13

Prolonged expiration phase?

Answer 13

Asthma or chronic bronchitis

Question 14

Anterior percussion and auscultation points?

Answer 14

Supraclavicular (use bell)
2nd ICS
4th ICS
6th ICS
Axillae

Question 15

Posterior percussion and auscultation points?

Answer 15

Levels of trapezius
Level of spine of scapulae
Level of 10th/11th rib

HUG THEMSELVES

Question 16

Tactile vocal fremitus?

Answer 16

Patient says “99” whilst you feel each auscultation point

Question 17

Decrease in tactile vocal fremitus?

Answer 17

Decrease in density
Pneumothorax
COPD
Pleural effusion

Question 18

Increase in tactile vocal fremitus?

Answer 18

Increase in density
Consolidation in pneumonia
Tumour

Question 19

Cervical lymph nodes?

Answer 19

Submental
Submandibular
Preauricular
Postauricular
Occipital
Superior deep cervical
Inferior deep cervical
Supraclavicular

Question 20

Cervical lymphadenopathy?

Answer 20

Lung cancer metastasising to lymph nodes
Tuberculosis
Sarcoidosis

Question 21

Triangle of safety for drains borders?

Answer 21

1. Lateral edge of pectoralis major
2. Base of axilla
3. 5th ICS
4. Lateral edge of latissimus dorsi