Respiratory

Question 1

What is Kussmaul’s respiration?

Answer 1

Fast and deep “sigh-like” breaths aka “air hunger” - caused by acidosis e.g. diabetic ketoacidosis.

Question 2

What causes a prolonged expiratory phase?

Answer 2

Significant airway obstruction like COPD or asthma.

Question 3

What causes rapid shallow breathing?

Answer 3

Hyperventilation episodes and interstitial lung disease

Question 4

What is a Cheyne-Stokes breathing pattern?

Answer 4

Respiration increasing in frequency and depth, up to a peak, and then decreasing in frequency and depth down to a period of apnoea

Question 5

What is a normal breathing rate? What is it when it’s below or above this?

Answer 5

Normal rate – 12-20/min.

Below = bradypnoea, above = tachypnoea

Question 6

Where would auscultate or percuss the right upper lobe?

Answer 6

Anterior:
- Apex: auscultate an inch above medial third of clavicle; percuss directly on medial third of clavicle
- 2nd intercostal space at MCL
Posterior:
- 1st intercostal space at medial scapular border
- 3rd intercostal space at medial scapular border

Question 7

Where would auscultate or percuss the left upper lobe?

Answer 7

Anterior:
- Apex: auscultate an inch above medial third of clavicle; percuss directly on medial third of clavicle
- 2nd intercostal space at MCL
- 4th intercostal space at MCL
Posterior:
- 1st intercostal space at medial scapular border
- 3rd intercostal space at medial scapular border

Question 8

Where would auscultate or percuss the right middle lobe?

Answer 8

Anterior only:

• 4th intercostal space at MCL
• 4th intercostal space at MAL

Question 9

Where would auscultate or percuss the left lower lobe?

Answer 9

a

Question 10

Where would auscultate or percuss the right lower lobe?

Answer 10

a

Question 11

What are the surface markings of the right upper lobe?

Answer 11

a

Question 12

What are the surface markings of the left upper lobe?

Answer 12

a

Question 13

What are the surface markings of the right middle lobe?

Answer 13

a

Question 14

What are the surface markings of the left lower lobe?

Answer 14

a

Question 15

What are the surface markings of the right lower lobe?

Answer 15

a

Question 16

What are the surface markings of the left lung as a whole? (AKA the visceral pleura of left lung)

Answer 16

a

Question 17

What are the surface markings of the right lung as a whole? (AKA the visceral pleura of right lung)

Answer 17

a

Question 18

What are the surface markings of the oblique fissure?

Answer 18

a

Question 19

What are the surface markings of the horizontal fissure?

Answer 19

a

Question 20

What are the surface markings of the parietal pleura of the right lung?

Answer 20

a

Question 21

What are the surface markings of the parietal pleura of the left lung?

Answer 21

a

Question 22

What are the borders of the triangle of safety for the insertion of a chest drain?

Answer 22

a

Question 23

Why do you insert a chest drain into the triangle of safety only and not anywhere else in the chest?

Answer 23

To avoid the long thoracic nerve

Question 24

Why would you need to do a chest drain?

Answer 24

a

Question 25

Where would you insert the needle for a chest drain in relation to the two ribs forming the intercostal space?

Answer 25

a

Question 26

What are the surface markings of the mediastinal pleura of the left lung on the anterior chest wall?

Answer 26

a

Question 27

What are the surface markings of the mediastinal pleura of the right lung on the anterior chest wall?

Answer 27

a

Question 28

What does a drum-like sound / resonant sound in percussion indicate?

Answer 28

Air-filled space e.g. Healthy/normal lung

Question 29

What would a dull sound in percussion indicate?

Answer 29

Solid organs (e.g. liver) or fluid (e.g. pneumothorax)

Question 30

What would a hyper-resonant (?) sound in percussion indicate?

Answer 30

a