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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
What is crepitus?
Coarse vibrations felt on inspiration.
26
What does crepitus suggest?
Pleural friction rub d/t inflammation of the pleura SubQ emphysema
27
Tactile Fremitus is what?
Palpable vibration of the chest wall from verbalization of "99"
28
Use what surface of the hands for detecting tactile fremitus?
Palmar or ulnar surface of hands
29
Best place tactile fremitus is felt is where?
Posteriorly at the 2nd or 3rd ICS
30
Normal tactile fremitus should be?
equal bilaterally absent over the precordium
31
Abnormal tactile fremitus is increased with? Suggesting what?
increased solidity or consolidation of the underlying lung tissue such as pneumonia, tumor, or pulmonary fibrosis
32
Abnormal tactile fremitus is decreased with?
abnormal fluid or air-filled spaces such as extensive bronchial obstruction, pleural effusion, pneumothorax
33
How to assess thoracic expansion?
Place your thumbs along the spinal processes at the level of the T10 ribs Watch your thumbs move during deep breathing
34
Less than anticipated movements in thoracic expansion occurs with?
COPD pleural effusions
35
Asymmetry in thoracic expansion occurs with?
atelectasis pneumothorax fibrosis
36
Percussion: may be ___ or ___ Can be heard over ___ ___ ___
direct; indirect the entire chest
37
Percussion: Compare all areas ___, using on side as the patients control for the other side.
Bilaterally
38
Percussion: Percuss the ___ ___ moving systematically from ___ to ___ and ___ to ___
intercostal spaces top; bottom medial; lateral
39
Percussion: Ask patient to bend his head forward and fold his arms across his chest to move the ___ ___ exposing more of the ___ for ___.
scapulae laterally chest percussion
40
Percussion: Provides an estimate of relative amounts of ___, ___, ___ ___ in a space and is helpful in identifying the?
air fluid solid matter margins of organs, including the lungs
41
Percussion between the ribs categorize the findings as: Dull means?
fluid or solid
41
Percussion between the ribs categorize the findings as: Resonant means?
Normal finding
42
Percussion between the ribs categorize the findings as: Hyperresonant means? Occurs with?
mostly air pneumothorax emphysema asthma
43
Hyperresonant suggests air trapping which occurs with?
COPD
44
Dullness is detected over the actual site of ___ and ___ ___ and over ___ or the ___ ___
atelectasis pleural effusions tumors consolidated pneumonia
45
Percussion of posterior chest: Percuss in what directions? Compare what? Note what? Locate area of ___ ___ on both sides.
side to side and top to bottom one side to the other location and quality of sounds diaphragmatic dullness
46
Percussion of anterior chest: Go from? Avoid what in women note dullness over which locations?
side to side breast tissue dullness over the liver and cardiac areas
47
Auscultation: What are tracheal sounds?
Harsh
48
Auscultation: What are vesicular sounds?
soft, low pitched loudest during inspiration
49
Auscultation: What are bronchial sounds?
loud, expiratory louder and longer
50
Auscultation: What are bronchovesicular sounds?
inspiration is equal to expiration
51
Normal breath sounds are considered abnormal under what conditions?
if they are heard in areas where they are not expected
52
What are crackles (Rales)?
caused by air flowing by fluid
53
Crackles are heard more often during?
inspiration
54
Crackles are characterized as?
coarse vs fine
55
What to note about crackles?
Timing in respiratory cycle Location Does it clear with cough or position change?
56
Rhonchi originate where?
in large airways
57
Ronchi are what pitched sounds?
low pitched
58
Rhonchi are caused by?
Air passing over a solid or thick secretion (bronchitis/pneumonia)
59
Wheezes can be heard when?
During inspiration and expiration
60
Wheezes are what pitch of sound?
high pitched, musical quality
61
Wheezes are caused by?
air flowing through constricted passage-ways
62
Wheezes can be heard where?
unilateral and bilateral
63
What diseases cause wheezing?
asthma bronchitis COPD
64
Pleural friction rub occurs most commonly where?
outside the airways
65
When does pleural friction rub occur during the respiratory cycle?
late inspiratory and early expiratory phases
66
What lung fields does pleural friction rub occur most often?
lower anterolateral
67
What conditions cause pleural friction rub?
pneumonia malignancy
68
Additional Auscultation techniques: Vocal Resonance Tests to find consolidation include?
Bronchophony Egophony Whispered Pectoriloquy
69
What is the expected normal finding while auscultating vocal resonance?
volume and clarity of the transmitted speech sounds are uniform throughout the lung fields
70
What is an increased volume in one area during vocal resonance auscultation? What does it suggest?
Bronchophony which suggests an area of consolidation or effusion
71
What does increased clarity of whispered sounds in vocal resonance auscultation indicate?
positive for pectoriloquy another indication for consolidation
72
What is Egophony? What does a positive test indicate?
Have the patient say E while auscultating, if "A" is heard with a nasal-quality its a positive test indicating consolidation

AHA (10 decks)

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