Respiratory Exam Flashcards
function of internal intercostals vs. external intercostals
internal: depress ribcage → expiration
external: elevate ribs → inspiration
Foamy white sputum can indicate what?
A cardiac problem - L CHF
Pink frothy sputum can indicate what?
Pulmonary edema
restrictive lung disorder characteristics
- lung stiff/fibrotic → takes more effort to breath
- difficulty INHALING
- pulmonary fibrosis, cancer, rib fracture, kyphosis/scoliosis
obstructive lung disorder characteristics
- narrowing/blockage → decrease ventilation → decrease O2, increase CO2
- difficulty EXHALING - air trapping
- asthma, emphysema/chronic bronchitis, pneumonia
emphysema characteristics
-barrel chest deformity
- red: inspiratory muscles require more blood floor
- pursed lips
- thin: breathing requires much more caloric expenditure
chronic bronchitis
- blue
- overweight
- peripheral edema
How will scoliosis or kyphosis impact respiration
Acts as restrictive lung disease due to decreased thoracic expansion
Why should we instruct emphysema patients to not take TOO BIG of a breath
Their lungs are hyper compliant and we don’t want to stretch them further
they cannot exhale
Is accessory respiratory muscle use normal?
No.
All patients should ideally be belly breathers
If there are more then __ ribs fractures, the fracture can open upon inhale and when you exhale it can puncture the lung
3
peripheral cyanosis vs. central cyanosis
central: CHD, CHF, lung disease → blue tongue, lips, warm periphery
peripheral: Low CO, hypovolemic shock → blue and cold extremities
Where can we look to see cyanosis on a patient
Nail beds, lips, tongue, lower eyelid
Symptoms of cor pulmonale
R CHF:
Weight gain
Edema
Distended jugular vein
Fatigue
paradoxical movement patterns
inhalation: chest/belly moves in (instead of out)
exhalation: chest/belly moves out
Kussmaul breathing
short shallow breaths to breathe off CO2 due to diabetic ketoacidosis
*do NOT correct breathing pattern
Cheyne-Stokes Breathing
Gradual increase in breathing depth (hyperpnea)
Then gradual decrease
Followed by a pause in breathing (apnea)
Then the cycle repeats
Think of it like a wave—up, down, stop, repeat.
Where should we hear vesicular breath sounds
What lasts longer, inspiration sound or expiration
Over most of both lungs. Normally
Inspiration is longer than expiration
Where should we hear bronchiole breath sounds
What lasts longer inspiration or expiration?
Over manibrium
Expiration is longer
What are examples of adventitious breath sounds?
Crackles
Wheezing
Pleural rib
Stridor
what does it indicate if you hear bronchial breath sounds in the lung
Potentially a tumor or consolidation, a “non-hollow area”
If you hear decreased breath sounds on one side and increased on the other, which side is the problem?
The decreased side.
Decreased breath sounds r abnormal. Potentially indicating trapped air
Crackles are also called _____ breath sounds
They’re commonly heard during _____
Discontinuous
Inspiration
If you hear crackles during early inspiration, this means what?
Late inspiration?
Early inspiration - bronchitis in large airway
Late inspiration- bronchitis in smaller airways
