Respiratory Flashcards
Some things you look for at the bed side
Sputum pot, inhalers, nebuliser
What might cause wasting of the intrinsic muscles
T1 nerve invasion by an apical lung cancer
Cause of a fine tremor
Beta agonists eg. Salbutamol
Flapping asterixis is seen when
Respiratory failure
Bounding pulse could mean
CO2 retention
When is pulses paradoxus seen
Sever obstructive airways disease and cardiac tamponade
What is cardiac tamponade
Effusion in the pericardium
Raised JVP indicates
Cor pulmonale
Raised non pulsatile JVP seen when?
What other features
Superior vena cava obstruction due to lung cancer
Oedema of the face and neck
What is horner’s syndrome?
Signs
Damage to the sympathetic trunk
Miosis (constricted pupil), ptosis (a weak, droopy eyelid), apparent anhidrosis (decreased sweating), with or without enophthalmus (inset eyeball).
What is chemosis
Possibly due to
Eye irritation
Hypercapnia 2* to COPD
Facial swelling is seen in
SVC obstruction
Which way does the trachea deviate with pathology ? Eg. Of each
Towards pulmonary fibrosis or collapse
Away from effusion or tension pneumothorax
When would tactile vocal femitus be increased? Decreased?
Consolidation (sound travels quicker through solid)
Effusion / pneumothorax
Lungs hyper resonant ?
Dull?
Pneumothorax
Consolidation / effusion
When would you hear corse crackles?
Fine crackles?
Consolidation / oedema
Pulmonary fibrosis
Cachexia features of
Malignancy , TB
Stridor is obstruction of
Large airways
Respiratory causes of clubbing
Cancer, fibrosing alveolits, abscess, bronchiectasis, empyema
Wasting of small muscles of hand could be
Lung cancer involving brachial plexus
Red, warm, clammy palms may indicate
Co2 retention
Horners syndrome could be due to
Apical lung cancer compressing sympathetic nerves in neck
Ipsilateral pupil contraction And partial ptosis (drooping eyelid
Raised JVP due to?
Respiratory cause
Right heart failure
Cor pulmonale
Causes of pectus carinatum (pigeon chest)
Childhood asthma or rickets
Causes of pectus excavatum (funnel chest)
Congenital
Normal air entry sound is
Vesicular
What are bronchial breath sounds ?
Associated with?
Loud inspiratory and blowing expiratory
Long consolidation and pulmonary fibrosis
Cause of wheezes
Exhalation sounds caused by narrowed airways
Early inspiratory crackles indicate
Obstruction in central airways
Late inspiratory crackles indicate?
Shrunk lungs - lung fibrosis, pneumonia, heart failure
What is pleural rub? How may it differ from secretary cause of crackles
Creaking sound of inflamed parietal pleura rubbing over visceral
Remains unchanged after coughing and often has localised pain
When would you get ankle oedema with respiratory disease
Cor pulmonale
Mid axillary scar
Posterior chest scar
Chest drain
Lobectomy
Bluish discolouration of nails indicated o2 sats of
Flapping tremor seen in
Co2 retention - type 2 resp failure eg. COPD
Raised JVP indicates
Pulmonary hypertension
Fluid overload
…..
Barrel chest seen in
COPD
Types of percussion sound
Resonant - normal
Dull - consolidations , fluid tumour, collapse
Stony dull - pleural effusion
Hyper resonant - reduced density eg. Pneumothorax
Auscultation sounds
Wheeze - asthma / COPD
Coarse crackles - pneumonia / fluid
Fine crackles - pulmonary fibrosis
Lymph nodes raised in respiratory exam
Tb / lung ca
To finish resp exam
O2 sats Provide o2 if indicated Request CXR if abnormality noted Peak flow assessment. Arterial blood gas if indicated Full cv exam if indicated
