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AHA > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Respiratory: PMH and FH

A

Allergies
Emphysema
Bronchitis
Asthma
Pneumonia
Recurrent infections
TB
Malignancy
Heart Failure
GERD

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2
Q

Respiratory: Habits

A

Smoking
Occupational exposure to toxins
Travel
Pet exposure
Current medications
Recreational drug use

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3
Q

CC: Common Respiratory problems in Primary care

A

Cough
Chest pain
dyspnea
abnormal respiratory rate

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4
Q

Cough
Usually preceded by _____
May be d/t ____ ____ or more general problems
Usually spontaneous response to an ____
May be an indication of ____
Medications?

A

Inspiration
Localized causes
irritant
anxiety
ACE inhibitors

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5
Q

Cough is one of the most common symptoms for which patients seek health care:
Acute cough is classified as?
Chronic cough is classified as?

A

< 3 weeks
>3 weeks

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6
Q

Cough:
Quality of the cough can be?

A

Dry
Wet
Hacking or barking or hoarse

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7
Q

Sputum production questions

A

When did it start?
How long has it been going on?
Has it changed?
Associated symptoms?
Characteristics?
Treatments?

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8
Q

Characteristics of sputum to ask about are?

A

Amount
Color
Odor

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9
Q

HPI Chest Pain

A

Onset
Duration
Precipitating factors
Associated symptoms
Alleviating and aggravating factors

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10
Q

Platypnea is what?
How common is it?
What causes it?

A

Dyspnea that increases in the upright position
Rare
R to L atrial shunting

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11
Q

Additional questions about dyspnea to consider?

A

Severity?
Anxiety related to breathing?
Edema?
Pain?
Associated with CV dysfunction?

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12
Q

What is Hyperpnea?

A

Deep breathing

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13
Q

Components of Resp Physical Exam?

A

Inspection
Palpation
Percussion
Auscultation

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14
Q

Equipment needed for Resp Physical Exam?

A

Stethoscope
Ruler and washable marker
Draping for patient privacy
Optional additional equipment

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15
Q

Inspection components to consider are?

A

Rate, Rhythm, Depth, Effort
Listen for audible wheezing, gurgling
Retractions, accessory muscles
Chest movement

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16
Q

When will you see retractions?

A

asthma
COPD
Pneumonia

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17
Q

additional respiratory inspection components away from chest are?

A

is trachea midline?
Assess face and mouth for cyanosis or pursed lip breathing
Look at the nares for any sings of flaring
smell the patient’s breath
look at the fingers for signs of clubbing

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18
Q

Chest Configurations:
Observe chest for?

A

Asymmetry, deformity, increased A/P diameter
Barrel chest
Pigeon Chest (pectus carinatum)
Funnel Chest (pectus excavatum
Spinal deformity

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19
Q

Asymmetry of chest seen with?

A

Scoliosis
Kyphosis

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20
Q

Increased A/P diameter is seen with?

A

COPD
Pectus Carinatum

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21
Q

Palpation is used to identify?

A

areas of tenderness or deformity

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22
Q

Intercostal tenderness could indicate?

A

Inflamed Pleurae

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23
Q

Costal sternal border pain could indicate?

A

Costochondritis

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24
Q

What is Costochondritis?

A

Inflammation of the cartilage that connects the ribs to the sternum

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25
Q

What is crepitus?

A

Coarse vibrations felt on inspiration.

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26
Q

What does crepitus suggest?

A

Pleural friction rub d/t inflammation of the pleura
SubQ emphysema

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27
Q

Tactile Fremitus is what?

A

Palpable vibration of the chest wall from verbalization of “99”

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28
Q

Use what surface of the hands for detecting tactile fremitus?

A

Palmar or ulnar surface of hands

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29
Q

Best place tactile fremitus is felt is where?

A

Posteriorly at the 2nd or 3rd ICS

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30
Q

Normal tactile fremitus should be?

A

equal bilaterally
absent over the precordium

31
Q

Abnormal tactile fremitus is increased with?
Suggesting what?

A

increased solidity or consolidation of the underlying lung tissue such as pneumonia, tumor, or pulmonary fibrosis

32
Q

Abnormal tactile fremitus is decreased with?

A

abnormal fluid or air-filled spaces such as extensive bronchial obstruction, pleural effusion, pneumothorax

33
Q

How to assess thoracic expansion?

A

Place your thumbs along the spinal processes at the level of the T10 ribs
Watch your thumbs move during deep breathing

34
Q

Less than anticipated movements in thoracic expansion occurs with?

A

COPD
pleural effusions

35
Q

Asymmetry in thoracic expansion occurs with?

A

atelectasis
pneumothorax
fibrosis

36
Q

Percussion:
may be ___ or ___
Can be heard over ___ ___ ___

A

direct; indirect
the entire chest

37
Q

Percussion:
Compare all areas ___, using on side as the patients control for the other side.

A

Bilaterally

38
Q

Percussion:
Percuss the ___ ___ moving systematically from ___ to ___ and ___ to ___

A

intercostal spaces
top; bottom
medial; lateral

39
Q

Percussion:
Ask patient to bend his head forward and fold his arms across his chest to move the ___ ___ exposing more of the ___ for ___.

A

scapulae laterally
chest
percussion

40
Q

Percussion:
Provides an estimate of relative amounts of ___, ___, ___ ___ in a space and is helpful in identifying the?

A

air
fluid
solid matter

margins of organs, including the lungs

41
Q

Percussion between the ribs categorize the findings as:
Dull means?

A

fluid or solid

41
Q

Percussion between the ribs categorize the findings as:
Resonant means?

A

Normal finding

42
Q

Percussion between the ribs categorize the findings as:
Hyperresonant means?
Occurs with?

A

mostly air
pneumothorax
emphysema
asthma

43
Q

Hyperresonant suggests air trapping which occurs with?

A

COPD

44
Q

Dullness is detected over the actual site of ___ and ___ ___ and over ___ or the ___ ___

A

atelectasis
pleural effusions
tumors
consolidated pneumonia

45
Q

Percussion of posterior chest:
Percuss in what directions?
Compare what?
Note what?
Locate area of ___ ___ on both sides.

A

side to side and top to bottom
one side to the other
location and quality of sounds
diaphragmatic dullness

46
Q

Percussion of anterior chest:
Go from?
Avoid what in women
note dullness over which locations?

A

side to side
breast tissue
dullness over the liver and cardiac areas

47
Q

Auscultation:
What are tracheal sounds?

A

Harsh

48
Q

Auscultation:
What are vesicular sounds?

A

soft, low pitched
loudest during inspiration

49
Q

Auscultation:
What are bronchial sounds?

A

loud, expiratory louder and longer

50
Q

Auscultation:
What are bronchovesicular sounds?

A

inspiration is equal to expiration

51
Q

Normal breath sounds are considered abnormal under what conditions?

A

if they are heard in areas where they are not expected

52
Q

What are crackles (Rales)?

A

caused by air flowing by fluid

53
Q

Crackles are heard more often during?

A

inspiration

54
Q

Crackles are characterized as?

A

coarse vs fine

55
Q

What to note about crackles?

A

Timing in respiratory cycle
Location
Does it clear with cough or position change?

56
Q

Rhonchi originate where?

A

in large airways

57
Q

Ronchi are what pitched sounds?

A

low pitched

58
Q

Rhonchi are caused by?

A

Air passing over a solid or thick secretion (bronchitis/pneumonia)

59
Q

Wheezes can be heard when?

A

During inspiration and expiration

60
Q

Wheezes are what pitch of sound?

A

high pitched, musical quality

61
Q

Wheezes are caused by?

A

air flowing through constricted passage-ways

62
Q

Wheezes can be heard where?

A

unilateral and bilateral

63
Q

What diseases cause wheezing?

A

asthma
bronchitis
COPD

64
Q

Pleural friction rub occurs most commonly where?

A

outside the airways

65
Q

When does pleural friction rub occur during the respiratory cycle?

A

late inspiratory and early expiratory phases

66
Q

What lung fields does pleural friction rub occur most often?

A

lower anterolateral

67
Q

What conditions cause pleural friction rub?

A

pneumonia
malignancy

68
Q

Additional Auscultation techniques: Vocal Resonance
Tests to find consolidation include?

A

Bronchophony
Egophony
Whispered Pectoriloquy

69
Q

What is the expected normal finding while auscultating vocal resonance?

A

volume and clarity of the transmitted speech sounds are uniform throughout the lung fields

70
Q

What is an increased volume in one area during vocal resonance auscultation?
What does it suggest?

A

Bronchophony which suggests an area of consolidation or effusion

71
Q

What does increased clarity of whispered sounds in vocal resonance auscultation indicate?

A

positive for pectoriloquy another indication for consolidation

72
Q

What is Egophony?
What does a positive test indicate?

A

Have the patient say E while auscultating, if “A” is heard with a nasal-quality its a positive test indicating consolidation

AHA (2 decks)

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