Respiratory Exam Flashcards

1
Q

General Inspection

A

Body habitus, well/unwell, breathless- pursed lip breathing (COPD)

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2
Q

Nails

A

Clubbing

Koilonychia

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3
Q

Clubbing

A

Interstitial lung disease, lung cancer, bronchiectasis

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4
Q

Koilonychia

A

Iron deficiency anaemia causing shortness of breath

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5
Q

Hands

A
Temperature and cap refill
Peripheral cyanosis 
Tar staining
Flapping tremor 
Fine tremor
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6
Q

Temperature and Cap Refill

A

Perfusion

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7
Q

Peripheral Cyanosis

A

Hypoxia

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8
Q

Tar Staining

A

Smoking

Smell

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9
Q

Flapping Tremor

A

Severe CO2 retention

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10
Q

Fine Tremor

A

Excessive beta 2 agonist use

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11
Q

Face

A

Cushingoid

Long term steroid use

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12
Q

Eyes

A

Horner’s- ptosis and miosis
Conjunctival pallor
Iritis, conjunctivitis

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13
Q

Horner’s

A

Ptosis and miosis

Pancoast tumour pressing on sympathetic chain of nerves in the chest

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14
Q

Conjunctival pallor

A

Anaemia

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15
Q

Iritis, conjunctivitis

A

TB, sarcoidosis

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16
Q

Mouth

A

Central cyanosis

Hypoxia

17
Q

JVP

A

RHF, overload, massive PE, tension pneumothorax, cardiac tamponade, SVC obstruction

18
Q

Tracheal Tug

A

Trachea pulled down on inspiration due to hyperinflation

COPD

19
Q

Tracheal deviation

A

Deviates towards: collapse, pneumonectomy

Deviates away: tension pneumothorax, very big effusion

20
Q

Cricosternal Distance

A

2-3 finger breadths

Reduced with hyperinflation

21
Q

Lymph Nodes

A

Anterior and posterior triangles, supraclavicular and axilla (lymph drainage from chest wall)

22
Q

Chest Inspection

A

Deformity and symmetry
Scars
Respiratory pattern
Intercostal drawing

23
Q

Scars

A

Thoracotomy, chest drain, radiotherapy tattoo

24
Q

Deformity and symmetry

A
Barrel chest - hyperinflation
Pectus excavatum (funnel chest) - developmental defect
Pectus carinatum (Pigeon chest) - increase respiratory effort 
Paradoxical movement chest/ abdo - COPD or obstruction
25
Q

Respiratory Pattern

A

Prolonged expiratory phase - signs of smoking related lung disease if coupled with pursed lips breathing

26
Q

Intercostal drawing

A

COPD due to hyperinflation

27
Q

Palpation

A

Expansion
Parasternal heave
Apex beat

28
Q

Parasternal Heave

A

Cor pulmonale

29
Q

Apex Beat

A

Collapse

Tension penumothorax

30
Q

Percussion

A

Resonant- normal
Hyper resonant- pneumothorax, emphysematous bullae
Dull- consolidation, collapse, alveolar fluid, pleural thickening, neoplasm
Stony dull- extreme dullness over a pleural effusion

31
Q

Breath sounds

A

Vesicular- normal
Diminished: local- effusion, tumour, pneumothorax, pneumonia, collapse/ global- COPD
Bronchial (darth vader breathing)- consolidation, upper boarder of pleural effusion
Wheeze (usually expiratory): polyphonic- asthma, COPD, monophonic- carcinoma or foreign body
Crepitations (crackles like velco)- infection, fluid or fibrosis
Rub (footstep in fresh snow)- pneumonia, PE with infarction

32
Q

Vesicular

A

Normal

33
Q

Diminished Breath Sounds

A

Local- effusion, tumour, pneumothorax, pneumonia, collapse

Global- COPD

34
Q

Bronchial Breathing

A

Darth Vader breathing
Consolidation
Upper boarder of pleural effusion

35
Q

Wheeze

A

Usually expiratory
Polyphonic- asthma/ COPD
Monophonic- carcinoma or foreign body

36
Q

Crepitations

A

Crackles like velcro

Infection, fluid or fibrosis

37
Q

Rub

A

Footsteps in fresh snow
Pneumonia
PE with infarction

38
Q

Vocal Resonance

A

Rarely performed in clinical practice
‘say 99 everytime I place my stethoscope on your chest’
Increased- consolidation
Reduced- effusion, pneumothorax

39
Q

Sacral and ankle oedema

A

Right heart failure