Respiratory Flashcards
What can tachypnea suggest in adult?
Tachypnea increases the likelihood of pneumonia and cardiac disease.
What does cyanosis in the lips, tongue, and oral mucosa signal indicate?
Hypoxia
In what conditions does clubbing of the nails occur in?
bronchiectasis, congenital heart disease, pulmonary fibrosis, cystic fibrosis, lung abscess, and malignancy
What is an ominous sign of upper airway obstruction?
Audible high-pitched inspiratory whistling, or stridor is an ominous sign of upper airway obstruction in the larynx or trachea that requires urgent airway evaluation.
What can lateral displacement of the trachea indicate?
Can indicate possible pneumothorax, pleural effusion, or atelectasis.
What can accessory muscle use indicate?
signals difficulty breathing from COPD or respiratory muscle fatigue
What can a symmetrical lung expansion indicate?
pleural effusion
What does Impaired respiratory movement on one or both sides or a unilateral lag (or delay) chest in movement suggest?
- Normal chest movement should be equal and symmetrical
- Unilateral impairment or lagging suggests pleural disease from asbestosis or silicosis; it is also seen in phrenic nerve damage or trauma.
What are the common signs of a fractured rib?
Tenderness, bruising, and bony “stepoffs”
Carefully palpate any area where the patient reports pain or has visible lesions or bruises
What conditions can cause a unilateral decrease or delay in lung expansion?
Unilateral decrease or delay in chest expansion occurs in chronic fibrosis of the underlying lung or pleura, pleural effusion, lobar pneumonia, pleural pain with associated splinting, unilateral bronchial obstruction, and paralysis of the hemidiaphragm.
How would you assess for lung expansion?
Test chest expansion. Place your thumbs at about the level of the 10th ribs, with your fingers loosely grasping and parallel to the lateral rib cage
What is tactile fremitus?
- Fremitus refers to the palpable vibrations that are transmitted through the bronchopulmonary tree to the chest wall as the patient is speaking and is normally symmetric
- Fremitus is typically more prominent in the interscapular area than in the lower lung fields and easier to detect over the right lung than the left. It disappears below the diaphragm.
What does decreased fremitus indicate?
When the transmission of vibrations from the larynx to the surface of the chest is impeded by a thick chest wall, an obstructed bronchus, COPD, or pleural effusion, fibrosis, air (pneumothorax), or an infiltrating tumor.
What does asymmetrical tactile fremitus indicate?
- Asymmetric decreased fremitus raises the likelihood of unilateral pleural effusion, pneumothorax, or neoplasm
- This is associated with a decreased transmission of low frequency sounds
What does asymmetrical increased tactile fremitus indicate?
asymmetric increased fremitus occurs in unilateral pneumonia which increases transmission through consolidated tissue.
Describe vesicular breath sounds and where they are usually heard
- They are soft and low pitched breath sounds heard throughout inspiration, continue without pause through expiration, and then fade away about one third of the way through expiration.
- Heard over most of both lung fields
Describe Bronchovesicular breath sounds and where they are usually located on ascultation.
- They are heard with inspiratory and expiratory breath sounds and are about equal in length, at times separated by a silent interval.
- They are Often heard in the 1st and 2nd interspaces anteriorly and between the scapulae
What do bronchial breath sounds sound like and where are they located?
- They are louder, harsher, and higher in pitch, with a short silence between inspiratory and expiratory sounds.
- Expiratory sounds last longer than inspiratory sounds.
- They are heard Over the manubrium, (larger proximal airways)
What do trachial breath sounds sound like and where are they located?
- Loud harsh sounds
- They are heard over the trachea in the neck
