Respiratory Flashcards
What are common labs and diagnostics to assess any respiratory complaints?
- ABG
- PFT (Peak flow test or spirometer)
- CT scan
- CXR
- sputum cultures
- sleep studies
- Flu, RSV, Covid
- Bronchoscopy, biopsy
During inspiration what do does the diaphragm, thorax, and lungs do?
Diaphragm contracts
Thorax and lungs expand
During expiration what does the diaphragm, thorax, and lungs and do?
Diaphragm relaxes and rises passively
The chest wall and lungs recoil
During the general survey what are 3 things that we are noting?
Mental state, skin color, and oxygenation status (finger/toenails, lips, tripoding, accessory msl use)
What is pectus excavatum?
Dip in chest cavity
What is pectus carinatum?
Pigeon chest
What is the tactile fremitus test?
Feeling vibrations transmitted through lung tissues and the chest wall when vocal sound is made
What does it mean if fremitus decreases?
The issue is outside of the lung. There is something obstructing transmission of air/vibrations to the viscera.
Pleural effusion, pneumothorax, obstructed bronchus.
What does it mean if fremitus increases?
*hint: over an area of liquid the vibrations will intensify
The issue is inside the lung. It occurs with consolidation or compression of lung tissue.
PNA, tumor, atelectasis
What is the purpose of the percussion test?
To produce audible sounds and palpate vibrations. It demonstrates the quality of air space below the chest wall.
What does resonance mean on percussion?
Air inside a normal lung
What does hyperresonance mean on percussion? With example
Lung can be hyperinflation. COPD and pneumothorax
What is dullness on percussion?
Over dense tissue
What are 3 types of normal breath sounds?
- Bronchial/tracheal (loud sounds over the mandubrium and trachea)
- Bronchovesicular (intermediate sounds over 1st and 2nd intercostal spaces anteriorly and between the scapulae)
- Vesicular (soft sound over lungs)
What are 3 things we listening for on auscultation?
Duration, intensity, and pitch.
5 adventitious breath sounds we may hear on auscultation?
Crackles (rales) , wheezes, Ronchi, stridor, and pleural friction rub.
What 6 things do we assess for in a hospitalized patient?
- Natural vs artificial airway
- ability to cough
- Work of breath
- Shape of chest
- SpO2 and O2 delivery
- Auscultate lung sounds
Respiratory diseases that can cause wheezing?
Reactive airway disease, asthma
What respiratory diseases can be considered with crackles?
PNA, fibrosis, early CHF
Where is the angle of Louis AKA the sternal angle?
Junction between manubrium and sterna body, near 2nd rib
Where are the lung apices on the anterior chest located?
3-4cm above clavicles
What should we assess for in a hospitalized patient? (6)
Natural vs artificial airway, ability to cough, work of breath, shape of chest, spo2 and oxygen delivery system, auscultate lung sounds.
