RESPIRATORY DISEASES

Question 1

o Increased pressure in pulmonary veins
o Causes interstitial edema and congestion
o Bronchial mucosa may become edematous
o Signs
▪ Resonant Percussion and late inspiratory crackles in dependent portion of lungs with possible wheeze

Answer 1

Left-sided Heart Failure

Question 2

o Bronchi are chronically inflamed
o Productive cough is present
o Airway obstruction may develop
o Signs
▪ Resonant percussion, possible scattered coarse crackles in early inspiration and expiration; may have wheeze or rhonchi

Answer 2

Chronic Bronchitis

Question 3

o Alveoli fill with fluid
o Signs
▪ All over involved area
▪ Dull percussion, bronchial breath sounds, late inspiratory crackles, increased tactile fremitus and transmitted voice
• With egophony, bronchophony, and whispered pectoriloquy

Answer 3

Lobar Pneumonia (consolidation)

Question 4

o Plug obstructs bronchial air flow
o Affected alveoli collapse and become airless
o Signs
▪ Dull percussion over airless area; trachea may be shifted toward involved side; breathing sounds usually absent except in right
upper lobe atelectasis where adjacent tracheal sounds may be transmitted; no adventitious sounds; and tactile fremitus and
transmitted voice are usually absent

Answer 4

Partial Lobar Obstruction (atelectasis)

Question 5

o Fluids accumulates in pleural space and separates air-filled lung from chest wall
o Blocks transmission of breathing sound
o Signs
▪ Dull percussion over fluid; trachea shifted toward unaffected side; breathing sounds decreased or absent but bronchial
breathing may be heard near top of large effusion; no adventitious sounds beside possible pleural rub; decreased or absent
tactile fremitus and transmitted voice sounds but may be increased at top of large effusion

Answer 5

Pleural Effusion

Question 6

o Air leaks into pleural space, usually unilaterally
o Lung recoils away from the chest wall
o Pleural air blocks transmission of sounds
o Signs
▪ Hyperresonant percussion, trachea shifted toward unaffected side (if tension pneumothorax)

Answer 6

Pneumothorax

Question 7

o Slowly progressive disorder
o Distal air spaces enlarge, and lungs become hyperinflated
o Chronic bronchitis may precede or follow COPD
o Signs
▪ Diffusely hyperresonant percussion, no adventitious sounds or crackles, wheeze and rhonchi of associated chronic bronchitis

Answer 7

COPD

Question 8

o Widespread airflow obstruction with bronchial hyperresponsiveness and underlying inflammation
o During attacks, as airways close lungs hyperinflate
o Signs
▪ Resonant to diffusely hyperresonant percussion and wheeze with possible crackles

Answer 8

Asthma