Respiratory Flashcards
Name 8 causes of a chronic cough
asthma
GORD
lung ca
postnasal drip
smoking
COPD
medication
chronic heart failure
What are the layers of tissue called within the Thorax?
lung tissue
visceral pleura
pleural space
parietal pleura
Name 5 symptoms of a PE
Haemoptysis
chest pain
syncope
dizziness
pleurisy
What 3 things might cause a displaced trachea?
tension pneumothorax
large lung mass pneumonectomy
What are 6 causes of a pleural effusion consisting of transudate?
congestiveheart failure
cirrhosis
nephrotic syndrome
pulmonary embolism pericardial disease
What could cause dullness on chest percussion?
Consolidation
what might coarse crackles suggest on auscultation?
Infection
Where does gas exchange occur?
Between the capillaries and alveoli
Where is gas exchange taking place during pulmonary ventilation?
Between atmosphere and lungs
Where is gas exchange taking place during internal respiration?
Between the blood and cells
Name the 2 pleura in the lungs and their location (inner/outer)
Innermost: visceral
Outermost: parietal
Name 5 typical symptoms of a chest infection
Slow onset SoB
Cough
Sputum
Feeling unwell
Temperature
Give 3 typical symptoms of pulmonary embolism, and relevant risk factors
Quick onset SoB
chest pain upon inspiration
haemoptysis
Risk Factors: travel, recent surgery, cancer
Name 7 respiratory clinical signs in the hands
Clubbing: chronic lung disease
Nicotine staining: smoking = increased risk of cardiorespiratory disease
Temperature: hot = pyrexia/infection, warm = CO2 retention, cold = poor perfusion
Cyanosis: hypoxia
Tremor: salbutamol use
Flaps: CO2 retention
Skin changes/thinning: long term steroid use
Name 8 respiratory clinical signs in the face
Pale conjunctiva: anaemia
Central cyanosis: hypoxia
Pursed lips: respiratory distress
Malar Flush: CO2 retention
Ptosis/myosis: Horner’s syndrome - lung cancer
Oral Candida: inhaled steroids
Atrophic glossitis and angular chelitis: anaemia
What may cause reduced chest expansion? 5 answers
Flail segment/rib injury
Pneumothorax
Haemothorax
Large mass or consolidation
Pneumonectomy
Name 3 causes for dull percussion sounds of the lungs, and one for stony dull percussion
Dull: consolidation, tumour, lobar collapse
Stony Dull: Fluid
What may you observe when conducting a general respiratory inspection?
General demeanour
Odour - smoking
Patient look unwell?
Breathlessness
Carers
Gait
Cough
What do you look for when conducting a specific respiratory inspection?
Scars
Barrel Chest
Pectus Excavatum
Scoliosis
Chest Drain
Oxygen Therapy
Inhaler/nebuliser
Accessory muscles
Respiratory rate and pattern
Surgical Emphysema (smooth bulging with crackles)
How do you assess tactile fremitus?
Ask patient to repeat ‘99’
Assess vibrations down lung fields using bony prominences of hands
4 x anterior, 4 x posterior, 2 x side
When might tactile remits be increased?
Consolidation
When might tactile fremitus be reduced or absent?
Pleural Effusion
Pneumothorax
How do you inspect chest expansion?
Firm grip around rib cage, thumbs together - check for expansion and symmetry
What should percussion of the lungs typically sound like?
Resonant
What could cause the lungs to sound hyper-resonant when percussed?
Pneumothorax
What could cause the lungs to sound dull when percussed?
Solid Structure: Mass
Consolidation
What could cause the lungs to sound stony dull when percussed?
Pleural Effusion
What should you ask the patient to do before auscultating the lungs?
Breathe in and out deeply through mouth
What could cause crackles in the lungs?
Fine crackles: pulmonary fibrosis (scarring)
Coarse crackles: pneumonia, bronchiectasis, pulmonary oedema: fluid/not inflating correctly
Unilateral/bilateral depending on which lung affected
When may breath sounds be reduced/absent when auscultating the lungs?
Shallow breathing
Airway obstruction
Pneumothorax
Pleural Effusion
Obesity
What may cause a wheeze?
Narrowed airways
COPD, asthma, bronchiectasis, acute bronchitis
