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MBBCh 3- Clinical Skills > Respiratory Exam > Flashcards

Respiratory Exam Flashcards

1
Q

What is the appropriate patient positioning? (2)

A
  • Undressed to the waist
  • 45°supine or seated
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2
Q

What do you look for on general inspection? (4)

A
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3
Q

What are the types of cough character? (5)

A
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4
Q

Sputum characteristics: (3)

A
  • Colour and volume
  • Purulent/Mucoid/Mucopurulent
  • Blood
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5
Q

Hoarseness: (3)

A
  • Laryngitis
  • Recurrent laryngeal nerve injury
  • Inhaled corticosteroids
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6
Q

Stridor: (3)

A
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7
Q

What is the respiratory examination of the hands?

A
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8
Q

What is HPO?

A
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9
Q

What do you look in the nose?

A
  • Nose
    – Deviated septum, inflammation, engorged turbinates, polyps
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10
Q

What do you look in the mouth?

A
  • Mouth
    – Cyanosis, inflammation (red, swollen pharynx and tonsils ±pus)
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11
Q

What does tenderness over sinuses indicate?

A

Sinusitis

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12
Q

What causes Horner’s syndrome? (3)

A
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13
Q

What is Pemberton’s sign?

A
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14
Q

Tracheal deviation?

A
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15
Q

Tracheal tug?

A
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16
Q

Cor pulmonale:

A
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17
Q

DVT:

A
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18
Q

Shape and symmetry: (3)

A
  • Barrel-shaped chest
    – Increased AP diameter
    – Severe asthma or COPD
  • Pigeon chest (Pectus carinatum)
    – Outward bowing sternum/costal cartilages
    – Chronic childhood respiratory infections and rickets
  • Funnel chest (Pectus excavatum)
    – Developmental defect - depression lower end of sternum
    – Severe: decreased lung capacity
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19
Q

What is Harrison’s sulcus? (2)

A
  • Linear depression lower ribs just above costal margins
    – Severe asthma in childhood and rickets
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20
Q

Hoover’s sign:

A

– On inspiration chest moves in and abdomen out (COPD)
* paradoxical movement
* significant hyperinflation

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21
Q

Kyphosis/Scoliosis/Kyphoscoliosis:

A

Reduced lung capacity when significant

22
Q

Scars: (2)

A
  • previous surgery
  • previous ICD
23
Q

Radiotherapy:

A

Erythema

24
Q

Prominent veins (facial plethora) indicate…

A

SVC obstruction

25
Q

Trauma: (4)

A

⎻ Bruising
⎻ Swelling
⎻ Erythema
⎻ Lacerations

26
Q
  • Symmetry (Anterior and posterior)
  • Expansion
  • Upper lobes :
  • Lower lobes:
A
  • from behind looking down at the clavicles
  • inspect posteriorly
27
Q

Reduced movement

Unilateral:

A
28
Q

Reduced movement

Bilateral:

A
29
Q

Chest expansion: (3)

A
30
Q
  • Apex Beat (Will be covered in CVS)
    ⎼5th ICS just medial to MCL
    ⎼ Displaced
  • Towards side of lesion:
  • Away from lesion:
A
  • collapse lower lobe, localized fibrosis
  • pleural effusion, tension pneumothorax
31
Q

Impalpable apex beat:

A

COPD hyperinflation

32
Q

Cardiomegaly:

Lung pathology:

A
  • Apex beat displaced but trachea central
  • Apex beat central but trachea deviated
33
Q

Vocal fremitus: (5)

A

– Palms placed on the chest wall
– Patient says “99”
– Compare vibrations left and right – Increased in consolidation
– Same as vocal resonance

34
Q
  • Ribs – tenderness: (2)
A

– Fracture (trauma/malignancy)
– Costochondritis(joints)

35
Q
  • Subcutaneous emphysema:
A

– Air tracking from the lungs

36
Q
  • Symmetrical Percussion:
A
37
Q

Stony dull - fluid: (2)

A
  • Pleural effusion
  • Haemothorax
38
Q

Dull: (2)

A
  • Consolidated Lung (fluid in the alveoli)
  • Solid structure
39
Q

Resonant:

A

Normal lung

40
Q

Hyper-resonant: (2)

A
  • Pneumothorax
  • Hollow structure (bowel)
41
Q

Liver dullness:

A

6th ICS MCL

42
Q

Cardiac dullness:

A

Left precordium:
- resonance = hyperinflation (COPD/Asthma)

43
Q

Auscultation:

A
44
Q
  • Normal breath sounds (vesicular): (3)
A
  • Most of chest area
  • Inspiration longer and louder than expiration
  • No gap between inspiration and expiration
45
Q
  • Bronchial breathing: (5)
A
  • Hollow, blowing quality
  • Audible in expiration
  • Gap between inspiration and expiration
  • Sound of turbulence in the upper airway without filtering by the alveoli (bronchial breathing is heard normally over the upper
    airways but not over the lung fields)
  • Consolidated lung (e.g. lobar pneumonia) conducts turbulent sound from the upper airway without filtering
46
Q

Amphoric breathing: (3)

A

– Exaggerated bronchial sounds
– Hollow sound like blowing over a bottle
– Large cavity

47
Q

Intensity of breath sounds
* Normal or reduced
* Reduced = (6)

A
48
Q

Added sounds: (2)

A
49
Q

Wheeze:

A
50
Q

Crackles:

A
51
Q

Pleural friction rub: (3)

A
52
Q

Vocal resonance:

  • Normal =
  • Consolidation =
  • Whispering pectoriloquy =
A

– Normal – muffled sounds

– Consolidation – Numbers become clearly audible (consolidated lung transmits higher frequencies better)

– Whispering pectoriloquy – whispered speech distinctly heard

MBBCh 3- Clinical Skills (6 decks)

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