Respiratory Exam

Question 1

What do you look for in end of the bed inspection

Answer 1

Treatments around the bed
Cyanosis
Shortness of breath
Cough
Wheeze
Stridor - noisy breathing due to obstructed airway
Cachexia - weakness and wasting of the body due to severe chronic illness

Question 2

What do you look for when inspecting the hands

Answer 2

Dorsal:
Peripheral cyanosis

Palmar:
Bruising or thinned skin
Tar staining

Question 3

What is bruising or thinned skin caused by

Answer 3

Long-term steroid use

Question 4

What causes tar staining

Answer 4

Smoking

Question 5

What do you assess for when holding arms out

Answer 5

fine tremor

Asterixis

Question 6

What causes fine tremor

Answer 6

Beta-2 agonist use (salbutamol)

Question 7

What causes asterixis

Answer 7

CO2 retention

Question 8

What is a normal breathing rate

Answer 8

12-20 breaths per minute

Question 9

What causes a raised JVP

Answer 9

Cor pulmonale - abnormal enlargement of the right side of the heart due to pulmonary disease

Question 10

What do you look for when inspecting the face

Answer 10

Central cyanosis (hypoxia)
Conjunctival pallor (anaemia)
Angular stomatitis

Question 11

What do you inspect for when looking at the chest

Answer 11

Chest wall deformities

Scars

Question 12

Which scar locations indicate what

Answer 12

Central chest - sternotomy and thoracotomy

Clavicular - pacemaker

Mid-axillary - Chest drain

Under arms - Lateral thoracotomy

Question 13

What should the cricosternal distance be

Answer 13

3-4 fingers

Question 14

What do reduced lung expansion indicate

Answer 14

Lung collapse

Pneumonia

Question 15

What causes dull resonance in percussion

Answer 15

Consolidation
Collapse
Effusion

Question 16

What are the types of breathing during auscultation

Answer 16

Inspiration stridor
Wheeze
Coarse crackles
fine crackles

Question 17

What causes Inspiration stridor

Answer 17

Upper airway obstruction

Question 18

What causes Wheeze

Answer 18

Asthma and COPD

Question 19

What causes Coarse crackles

Answer 19

Pneumonia and pulmonary oedema

Question 20

What causes fine crackles

Answer 20

Pulmonary fibrosis

Question 21

What can cause increases vocal resonance

Answer 21

Consolidation
Lobar collapse
Tumour

Question 22

What can cause decreased vocal resonance

Answer 22

Pleural Effusion

Question 23

What are the causes of lympadenopathy

Answer 23

Infection
Malignancy
Sarcoidosis - small patches of red and swollen tissue (granulomas) to develop in the organs of the body

Question 24

What cause types of percussion resonance in the posterior chest wall

Answer 24

Dullness: Consolidation or collapse
Stony dullness: Pleural effusion
Hyper resonant: pneumothorax

Question 25

What causes pedal oedema

Answer 25

Right ventricular failure

Question 26

What examinations can you do to finalise findings

Answer 26

Measure O2 saturation

Sputum sample

Question 27

Where is the bifurcation of the trachea

Answer 27

Level with the manubrio-sternal joint

Question 28

Where is the oblique fissure

Answer 28

from T3 to the 6th costal cartilage anteriorly

Question 29

Where is the right horizontal fissure

Answer 29

Horizontal line from the sternum at the 4th costal bone to oblique fissure