Respiratory Flashcards

Question

What does assymetrical chest expansion mean? retraction? unilateral lagging?

Answer 1

Asymmetrical expansion: pleural effusion Retraction: severe asthma, COPD, or upper airway obstruction (stridor?) Unilateral lagging: pleural disease (asbestosis, trauma, or phrenic nerve damage)

Answer 2

Sign of respiratory distress Can see in Asthma, COPD, Airway obstruction, Viral illness (RSV)

Answer 3

Place thumbs at level of 10th ribs, fingers loosely grasping and parallel to lateral rib cage, slide them medially just enough to raise a loose fold of skin on each side bw your thumb and spine Ask the patient to inhale deeply, watch the distance bw your thumbs as they move apart during inspiration and feel for the range and symmetry of the rib cage as it expands and contracts

Answer 4

Palpable vibrations (use ball of hands or ulnar surface), have patients say 99 or 1-1-1- Decreased or absent: COPD, pleural changes increased: pneumonia (consolidation)

Answer 5

Fluid or solid tissue replaces air-containing lung or occupies space beneath percussing fingers • Lobar pneumonia (alveoli filled with fluid and blood cells) • Pleural accumulations: emphysema

Answer 6

Chronic bronchitis COPD (especially emphysema) • Asthma

Answer 7

• Large Pneumothorax • Large air-filled bulla in lung (COPD/Emphysema)

Answer 8

3-5.5 cm  Pleural effusion  High diaphragm secondary to: atelectasis or phrenic nerve paralysis

Answer 9

Generally an inspiratory sound but can be expiratory or biphasic. Result form a narrowing in the upper airway Common Causes  Croup  Epiglottitis  Upper airway foreign body  anaphylaxis

Answer 10

Generally an expiratory sound but can be inspiratory or biphasic Continuous musical sounds Caused by rapid airflow through a narrowed bronchial airway Common Causes  Reactive airway disease (RAD)  Asthma  COPD

Answer 11

An inspiratory sound Continuous musical sounds Thought to be caused by small airway closed during expiration, “popping” open during inspiration Common causes  Pneumonia, CHF, Atelectasis, pulmonary fibrosis, bronchiectasis, COPD, Asthma

Answer 12

the loss of lung volume due to the collapse of lung tissue (alveoli) Can be seen post-surgery  Post surgical fever consider atelectasis as the cause IS(incentive spirometer) - helps with atelectasis, treatment and prevention

Answer 13

Breath out all the way, breath in slowly and as deep as you can, move the ball inside the spirometer as high as you can. when you can't breathe in anymore, hold breath for 2-5 seconds

Answer 14

 words are muffled and indistinct to auscultation  whispered words are faint and indistinct, if heard at all  when patient says “ee”, you hear a muffled long E on auscultation

Answer 15

spoken words get louder

Answer 16

whispered words are louder and clearer during auscultation

Answer 17

when patient says “ee” it sounds like “A” (which is nasal and localized)

Answer 18

AKA sit inside a box and see how well your lungs work: | helpful to diagnose obstructive vs restrictive, NONINVASIVE

Answer 19

``` A - Adequate, Airway Bones Cardiac Size Diaphragms Effusions, Endotracheal Tube, EKG Fields, Fissures, Foreign Body Great vessels Gastric bubble Hilar masses Impression ```

Answer 20

2 anterior posts, 1 right middle post, 4 posterior posts

Answer 21

1) vesicular breath sounds: soft, low pitched, heard through inspiration, 1/3 of expiration 2) bronchovesicular sounds: intermediate intensity and pitch, inspiration=expieration 3) bronchial sounds: loud and high pitched, expiratory > inspiratory 4) tracheal: loud, high pitched inspiration=expiration