Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MBBS IV - Medical and Surgical Demonstration > Respiratory Exam > Flashcards

Respiratory Exam Flashcards

You may prefer our related Brainscape-certified flashcards:
USMLE® Step 1 flashcards
1
Q

3 respiratory diseases asso. with clubbing

A

Bronchial carcinoma
Bronchiectasis
Pulmonary fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Cough qualities:

  • Bovine
  • Rattling
  • Muffled wheezing
  • Barking
  • Whooping

Suggestive with what pathologies?

A
  • Bovine: lack of explosive onset > Vocal cord paralysis
  • Rattling: Increased bronchial secretions
  • Muffled wheezing: Airway obstruction
  • Barking = acute upper airway obstruction
  • Whooping = pertussis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Wheezing during breathing.

Difference in wheezing between inspiration and expiration?

A

Wheezing = airway narrowing

Wheezing during inspiration/ Stridor = Upper airway obstruction

Wheezing during expiration = Lower airway obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Respiratory cause of elevated JVP?

A

Increased right heart pressure: Pulmonary hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Explain changes in breath sounds caused by pneumonia/ area of consolidation?

A

Bronchial breath sound: High frequency, with silent pause between inspiration and expiration

Pneumonia/ consolidation causes lung cavities to be filled with fluid or solid&raquo_space; Increase sound transduction > Increase upper airway breath sounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Differentiate Biphasic, early inspiratory, mid-inspiratory and pan-inspiratory inspiratory crackles

A

Biphasic = bronchiectasis (coarse)

Early inspiratory = small airway obstructive diseases (eg. COPD)

Mid inspiratory = pulmonary oedema

Pan-inspiratory = Diffuse fibrosis (fine), pulmonary edema (medium), Pneumonia, lung abscess, TB, COPD secretions (coarse)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Differentiate anatomical location related to coarse or fine crackles

A 
Coarse = Large airway/ bronchi 
Fine = Small airway/ Bronchioles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Changes in vocal resonance in consolidation and pleural effusion compared to normal?

A

Normal = muffled sound, dampened by air-filled lung cavities

Consolidation: Inflammatory exudate and fibrosis transduce sound much better = Increase vocal resonance

Pleural effusion: space between auscultation and lung is increased by fluid = Quieter vocal resonance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Differentiate causes of tenacious, purulent, and brown sputum

A

Tenacious - Asthma

Purulent - Bronchial inflammation (infection)

Brown - Intra-alveolar hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Physical findings:

  • Reduced chest wall movement
  • Dull percussion note
  • Increase bronchial breath sound
  • Increased vocal resonance
  • Pan-inspiratory or late inspiratory crackles

Dx?

A

Consolidation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Physical findings for Consolidation?

  • Chest wall movement
  • Percussion
  • Vocal resonance
  • Breath sound
  • Any crackles
A
  • Reduced chest wall movement
  • Dull percussion note
  • Increase bronchial breath sound **
  • Increased vocal resonance **
  • Pan-inspiratory or late inspiratory crackles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Physical finding

  • Reduced chest wall movement
  • Chest wall flattening
  • Mediastinum and tracheal deviation
  • Reduced breath sounds

Dx?

A

Lung collapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Physical findings for Lung collapse?

A
  • Reduced chest wall movement
  • Chest wall flattening
  • Mediastinum and tracheal deviation **
  • Reduced breath sounds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Physical finding

Mediastinal shift 
Reduced chest wall movement 
Stony dullness on percussion 
Reduced vocal fremitus 
Reduced breath sounds

Dx?

A

Pleural effusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Physical findings for Pleural effusion

A

Mediastinal shift
Reduced chest wall movement

Stony dullness on percussion***

Reduced vocal fremitus
Reduced breath sounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Physical findings

  • Mediastinum shift
  • Hyper-resonance on percussion***
  • Reduced breath sounds
  • Reduced vocal resonance and vocal fremitus

Dx?

A

Large or tension pneumothorax

17
Q

Key difference in sign between tension pneumothorax and pleural effusion

A

Tension pneumothorax = Hyper-resonant on percussion

Pleural effusion = fluid-filled = Stony dull on percussion

18
Q

Physical findings:

  • Tracheal deviation
  • One-sided chest wall flattening with reduced movement
  • Dull on percussion
  • Bronchial breath sounds +ve
  • Crackles

Dx?

A

Localized pulmonary fibrosis

19
Q

Physical findings for Localized pulmonary fibrosis

A
  • Tracheal deviation
  • One-sided chest wall flattening with reduced movement
  • Dull on percussion
  • Bronchial breath sounds +ve
  • Crackles
20
Q

Respiratory cause of wrist tenderness and swelling

A

Hypertrophic pulmonary osteoarthropathy (HPO):
→ Paraneoplastic periosteal inflammation at distal ends of bones
D/dx: primary CA lung, pleural fibromas, idiopathic

21
Q

Pulmonary cause of wasting of small muscles of hand and finger abduction weakness

A

compression and infiltration of T1 lower

trunk by Pancoast tumour

22
Q

Scar type and purpose: midline

along sternum

A

Midline sternotomy

→ CABG
→ Lung transplant

23
Q

Scar type and purpose: long diagonal

posterior scar on thorax

A

Thoracotomy

→ Pneumonectomy
→ Lobectomy
→ Lung transplant
→ Thoracoplasty

24
Q

Scar type and purpose: three 2-3cm scars around MAL

A

Video-assisted thoracoscopy (VATs)

→ Bx of lymph nodes
→ Lung reduction surgery
→ Pleurodesis

25
Q

Signs of dyspnoea (2)

A

Use of accessory respiratory muscles: sternocleidomastoids, platysma, strap muscles of neck

In-sucking : in-drawing of intercostal and supraclavicular spaces during inspiration

26
Q

5 characteristic signs of COPD

A

Use of accessory muscles

In-drawing of intercostal and supraclavicular spaces

Pursed-lip breathing (positive airway pressure)

Lean forward with arms on knees

Tracheal tug

27
Q

D/dx mediastinal deviation

A

→ Volume loss lesion if towards side of lesion

  • Lobar collapse
  • Lobar fibrosis
  • Pnuemonectomy

→ Space-occupying lesion if away from side of lesion

  • Pleural effusion
  • Tension pneumothorax
  • Other masses, eg. retrosternal goitre
28
Q

Percussion finding:

  • Resonant
  • Hyper-resonant
  • Dull
  • Stony dull

Causes?

A

□ Resonant over normal lung

□ Hyperresonant over hollow structure, eg. bowels,
pneumothorax

□ Dull over solid structure, eg. consolidation, liver, lung
collapse

□ Stony dull over fluid-filled structure eg. pleural effusion

29
Q

Differentiate Vesicular and Bronchial breath sounds:

- Origin of sounds

A

Origin
- Vesicular (normal) sounds:
Origin: flow vortices in small airway (inspiration),
large airway (expiration)

  • Bronchial breath sounds:
    Origin: turbulent flow in large airways
30
Q

Differentiate Vesicular and Bronchial breath sounds:

- Quality of sound

A

Vesicular (normal) sounds:

  • faint, low-pitched rushing sound
  • Inspiratory phase longer and louder
  • Gentle beginning and end
  • No gap between inspiratory and expiratory phases

Bronchial breath sound:

  • higher-pitched, hollow, blowing quality
  • Audible gap between inspiratory and expiratory phases*****
  • Expiratory phase louder and higher pitch
31
Q

Causes of bronchial breath sound

A

Common
- Lung consolidation*******

Uncommon

  • Localized pulmonary fibrosis
  • Above pleural effusion
  • Collapsed lung
32
Q

D/dx decreased unilateral breath sound

A 
□ COPD, esp emphysema
□ Pleural effusion
□ Pneumothorax
□ Pneumonia
□ Large neoplasm
□ Collapsed lungs
33
Q

Cause of fine, medium and coarse crackles?

A

Fine crackles indicates airway instability = pulmonary fibrosis

Medium crackles indicates disruption of surfactant function = pulmonary oedema

Coarse crackles indicates excess bronchial secretions = bronchiectasis

34
Q

Causes of loud, muffled and quiet vocal resonance

A

Loud - consolidation
Muffled - normal
Quiet - Pleural effusion

MBBS IV - Medical and Surgical Demonstration (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions