Respiratory

Question 1

inspection of respiratory what are you looking for

Answer 1

• deformities, scars, drains - remember to check the bask as well
• respiratory efforts - such as coughs sneezes, wheezes, sputum
• ask the patient to take a deep breath
• check respiratory rate

Question 2

what does the trachea deviate towards

Answer 2

1. Upper lobe fibrosis
2. Lobe collapse (atelectasis), particularly upper lobe
3. Pneumonectomy

Question 3

what does the trachea deviate away from

Answer 3

1. Tension pneumothorax
2. Large pleural effusion
3. Large masses

Question 4

when people say 99 what is vibration increased by and what is it decreased by

Answer 4

i. Vibration is increased in consolidation

ii. Vibration is decreased in pneumothorax, collapse, COPD, and effusions

Question 5

where is the oblique fissure

Answer 5

• it is in the left and right lung
• upper border of the lower lobe
• third thoracic spine T3 to 6th costal cartilage anteriorly
  (approximately the medial border of the scapula when the arm is above the end

Question 6

where is the horzitonal fissure

Answer 6

• it is in the right lung

- horizontal line from sternum at 4th costal cartilage to the oblique fissure

Question 7

What are the lymph nodes

Answer 7

• submental
• submandibular
• pre-auricular/partoid
• posterior auricular
• occipital
• anterior cervical
• posterior cervical
• deep cervical
• supraclavicular

Question 8

why do you examine these lymph nodes

Answer 8

• you examine these lymph nodes as this is where the lungs drain into

Question 9

what can cause the upper or lower mediastinum (trachea_ to shift

Answer 9

• being pushed away from an abnormality - e.g. tension

- being pulled toward an abnormality - lobar collapse

Question 10

where does the bifurcation of the trachea occur

Answer 10

Level with Manubrio-sternal joint

Question 11

what is the apex beat

Answer 11

Lowermost and outermost position that the cardiac impulse can be felt

Question 12

what is the normal lung values

• inspiration reserve volume
• tidal volume
• expiratory reserve volume
• reisdual volume

in men and in women

Answer 12

in men

• 3.1
• 0.5
• 1.2
• 1.2

in women

• 1.9
• .0.5
• 0.7
• 1.1

Question 13

what is the normal lung capacities

• vital capacity
• inspiratory capacity
• functional residual capacity
• total lung capacity

in men and in women

Answer 13

in men

• 4.8
• 3.5
• 2.3
• 5.8

in women

• 3.1
• 2.4
• 1.8
• 4.2

Question 14

what is chestier expansion for

Answer 14

• lung volumes
• may pick up signs of collapse
• look at symmetry

Question 15

what is percussion looking at

Answer 15

when percussing there are various variations of sound that you can hear

• normal
• hyper-resonant - pneumothorax
• dull - lobe collapse and pneumonia
• stony dull - pleural effusion

Question 16

where is the heart

Answer 16

3rd to 5th rib spaces to the left of the sternum

Question 17

why do you do 99

Answer 17

Fremitus is increased in areas of consolidation and decreased with pneumothorax or pleural effusion due to alterations in the
tissue transmitting sounds

Question 18

what are the different types of sounds that you can hear

add what pathogolgies these relate to

Answer 18

Breath sounds
o Normal(vesicular)
 o Reduced
o Absent
o Bronchial breathing

Crackles
o Fine
o Course

• wheeze
• Pleural Rub