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Respiratory > Respiratory exam > Flashcards

Respiratory exam Flashcards

1
Q

What would you look for general inspection?

A
  • Medications
  • Supplemental oxygen supply
  • Sputum pot
  • Does the patient have expiratory wheeze at rest?
  • Does the patient have stridor?
  • Does the patient looked cyanosed, pale and sweaty?
  • Is the patient SOB/pain or any discomfort?
  • Is the patient using their accessory muscles for breathing while at rest?
  • Depth of breathing normal or symmetrical?
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2
Q

What would you look for when inspecting hands?

A
  • Warmth
  • Vasodilation
  • Peripheral cyanosis
  • Clubbing
  • Tar staining
  • Koilonuchia
  • Asterixis
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3
Q

How do you check pulse?

A
  • Feel the pulse on both sides.

- If normal, check pulse on one hand.

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4
Q

How do you obtain a pulse?

A
  • Count the number of beats in 15 seconds.

- Multiply this number by 4 to calculate your bpm.

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5
Q

How do you obtain a respiratory rate?

A
  • Count the number of breaths for a 30 seconds.

- Multiply the number by 2 to get respiratory rate.

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6
Q

What would you look for when inspecting the face?

A
  • Central cyanosis
  • Polycythemia
  • Conjunctival pallor
  • Horner’s syndrome
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7
Q

When inspecting the neck, what will you look for?

A
  • Assess the JVP

- Examine for lymphadenopathy

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8
Q

What would you look for when doing a general inspection of the chest wall?

A
  • Surgical scars
  • Deformity
  • Superior cena caval obstruction
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9
Q

Where can apex heart beat be located?

A

5th left intercostal space on mid-clavicular line

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10
Q

When is vocal fremitus performed?

A

If dullness is detected upon percussion on mid axillary line.

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11
Q

How is vocal fremitus performed?

A
  • By placing edge of your hand on the chest.
  • Ask the patient to say 99
  • Vibrations transmitted through the lung substance and are felt by the hand.
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12
Q

What is Vocal resonance?

A

The sound of the patient’s voice detected through the stethoscope.

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13
Q

What are possible of decreased fremitus?

A
  • Excess air in lungs

- Increased thickness of chest wall

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14
Q

What are possible causes of increased fremitus?

A
  • Lung consolidation
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15
Q

What further investigation will you offer after respiratory exam?

A
  • SpO2
  • Blood pressure
  • Assess NEWS chart
  • Spirometry
  • Inspect contents of sputum pot
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16
Q

What symptoms would patients with pneumonia present with?

A
  • Cough
  • Sputum
  • Fever
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17
Q

What would you feel upon palpating someone with pneumonia?

A
  • Increased tactile fremitus

- Decreased chest expansion (unilateral)

18
Q

What would you feel upon percussion someone with pneumonia?

A

Dull

19
Q

What would you listen upon auscultation of someone with pneumonia?

A
  • Bronchial breathing
  • Crackles and wheeze
  • Increased resonance
20
Q

What symptoms would patients with pneumothorax present with?

A
  • Dyspnoea
  • Chest pain
  • Increased JVP
21
Q

What would you feel upon palpating someone with pneumothorax?

A
  • Decreased tactile fremitus
  • Tracheal deviation (away from affected side)
  • Decreased chest expansion (Unilateral)
22
Q

What would you feel upon percussion someone with pneumothorax?

A

Hyper-resonant

23
Q

What would you listen upon auscultation of someone with pneumothorax?

A
  • Decreased vesicular breath sounds

- Added sounds might be present

24
Q

What symptoms would patients with pleural effusion present with?

A
  • Dusponea
  • Mild non-productive cough
  • Chest cough
25
Q

What would you feel upon palpating someone with pleural effusion?

A
  • Decreased tactile fremitus

- Tracheal deviation (away from affected side)

26
Q

What would you feel upon percussion someone with pleural effusion?

A

Stony dull

27
Q

What would you listen upon auscultation of someone with pleural effusion?

A
  • Decreased vesicular breath sounds
  • Crackles at the upper edge of the effusion
  • Pleural friction rub
  • Muffled vocal resonance
28
Q

What symptoms would patients with COPD present with?

A
  • Chronic smoking
  • Repeated chest infections
  • Dyspnea
  • Cough
29
Q

What would you feel upon palpating someone with COPD?

A

Decreased chest expansion (bilaterally)

30
Q

What would you feel upon percussion someone with COPD?

A

Hyper-resonant

31
Q

What would you listen upon auscultation of someone with COPD?

A
  • Decreased vesicular breath sounds
  • Added sounds may include:
    - Wheeze and crackles
32
Q

What is the cause of paroxysmal cough?

A
  • Chronic bronchitis
  • Asthma
  • Pulmonary vasculitis
33
Q

What is the cause of associated stridor cough?

A
  • Tracheal obstruction
34
Q

What is heamoptysis?

A

Coughing up blood from the lungs or bronchial tubes.

35
Q

What are common causes of heamoptysis?

A
  • Bronchial carcinoma
  • Pulmonary tuberculosis
  • Pulmonary embolism
  • Pulmonary edema
  • Upper respiratory tract infection (acute bronchitis)
36
Q

How would you Inspect contents of sputum pot?

A
  • Colour
    • Yellow/green - related to an infection
    • Pink/red/bloody - related to an infection or cancer
    • White - allergies, asthma, viral infections
    • Charcoal/grey - Environmental factors (coal mine and/or factory workers or heavy smokers)
    • Brown - chronic lung disease, cystic fibrosis
  • Consistency
    • Highly viscous sputum with plugs - Asthma
    • Viscous sputum - viral respiratory infections
  • Odour
    • Offensive smell - Lung abscess
37
Q

What conditions are associated with increased effort of breathing?

A
  • COPD
  • Asthma
  • Pneumonia
  • Pneumothorax
  • Pulmonary embolism
  • Congestive cardiac failure
38
Q

Suggest examination findings of someone with emphysema

A
  • The patient may be distressed and sitting forward
  • Increased respiratory rate
  • Pursed, pink lips
  • Hyper-inflated chest (barrel chest)
  • Use of accessory muscles and intercostal in-drawing
  • Quiet chest on auscultation; occasional wheeze may be present
39
Q

Suggest examination findings of someone with asthma

A
  • Maybe normal between attacks
  • During attack:
    - Patient may be sitting forward
    - Distressed
    - Acute dyspnoea
    - Hyper-inflated chest
  • Wheeze throughout the chest on auscultation
40
Q

Suggest examination findings of someone with COPD

A
  • The patient may be distressed and sitting forward
  • Use of accessory muscles and intercostal in-drawing
  • Bounding pulse and coarse tremor of fingers
  • Prolonged expiratory phase and expiratory wheezes
  • Downward displacement of liver
41
Q

Name one cause of displacement of apex beat

A

Pneumothorax

Respiratory (5 decks)

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