Respiratory Exam

Question 1

Hypopnea

Answer 1

decreased depth and rate of respiration

Question 2

bradypnea

Answer 2

regular rhythm but slower than normal rate

Question 3

hyperpnea

Answer 3

increased depth of breath and rate

Question 4

tachypnea

Answer 4

rapid breathing

Question 5

dyspnea

Answer 5

short of breath

Question 6

hypoxia

Answer 6

deficiency in amt of oxygen reaching tissues

Question 7

hypoxemia

Answer 7

oxygen deficiency in arterial blood

Question 8

apnea

Answer 8

no breathing

Question 9

atelectasis

Answer 9

collapse of lung tissue that affects alveoli from normal O2 absorption

Question 10

plesimeter finger

Answer 10

hyperextended middle finger of non-dominant hand in percussion

Question 11

plexor finger

Answer 11

tapping finger for percussion

Question 12

Needle thoracentesis

Answer 12

decompression, second intercostal space, midclavicular line

Question 13

chest tube insertion

Answer 13

4th intercostal space at mid or anterior axillary line in 4th intercostal space

Question 14

landmark for thoracentesis

Answer 14

7th intercostal space

Question 15

What is the order for a respiratory exam?

Answer 15

Inspection, palpation, percussion, auscultation

Question 16

Pulse oximetry

Answer 16

measures peripheral arterial oxygen sat and pulse

Question 17

capnography

Answer 17

measures partial pressure of carbon dioxide in exhaled breath as co2 over time

Question 18

What are some important things to observe in the resp. physical exam?

Answer 18

breathing pattern, accessory muscles, color of fingers and lips, pursed lips, ability to speak, tactile fremitus, etc.

Question 19

Tracheal deviation can be seen…

Answer 19

in pneumothorax, pleural effusion, atelectasis, mass

Question 20

Causes of clubbing include…

Answer 20

congenital heart disease, interstitial lung disease, bronchiectasis, inflammatory bowel disease, lung abscess, cystic fibrosis

Question 21

Barrel Chest

Answer 21

increased AP diameter, seen in COPD

Question 22

chronic bronchitis

Answer 22

Elevated hemoglobin, overweight and cyanotic, peripheral edema

Question 23

emphysema

Answer 23

older and thin, dyspnea, quiet chest, flattened diaphragm

Question 24

Flail chest

Answer 24

paradoxical movements of thorax, inspiration causes inward movement of ribs

Question 25

accessory muscle use

Answer 25

seen in asthma, COPD, airway obstruction, respiratory distress

Question 26

Things to check in palpation

Answer 26

trachea midline, OSE, masses, bruising or tenderness, thoracic expansion symmetrical

Question 27

Tactile Fremitus

Answer 27

palpable vibrations if decreased? COPD, effusions, fibrosis, air, infiltrating tumor if increased? pneumonia

Question 28

How deep is percussion?

Answer 28

5-7 cm

Question 29

Perussion dullness

Answer 29

fluid or solid tissue replaces air-containing lung or occupies space beneath percussing fingers

Question 30

Percussion generalized hyperresonance

Answer 30

hyperinflated lungs, COPD

Question 31

Unilateral hyperresonance

Answer 31

pneumothorax, COPD and emphysema

Question 32

tympanic

Answer 32

abdominal percussion

Question 33

How should a normal lung sound when percussed?

Answer 33

resonant

Question 34

What is diaphragmatic excursion?

Answer 34

measurement of how far lungs are expanded, typically 3-5.5 cm, asymmetry is indicative of diaphragm issue or pleural effusion

Question 35

Where are bronchovesicular sounds heard?

Answer 35

main bronchi, heard equally in inspiration and expiration

Question 36

Where are vesicular sounds heard?

Answer 36

lesser bronchi, bronchioles, and lobes; heart through inspiration

Question 37

Where are bronchial sounds heard?

Answer 37

trachea, heard through expiration

Question 38

Stridor

Answer 38

inspiratory sound, due to narrowing in upper airway

Question 39

Wheezing

Answer 39

expiratory sound, caused by rapid airflow thru narrowed bronchial airway (COPD, asthma)

Question 40

Crackles

Answer 40

inspiratory sound, due to pneumonia, CHF, atelectasis, pulmonary fibrosis

Question 41

Atelectasis

Answer 41

collapse of alveoli, usually post surgical, can cause fever

Question 42

Incentive Spirometry

Answer 42

helps with atelectasis treatment and prevention, practice deep breaths

Question 43

Bronchophony

Answer 43

spoken words get louder when auscultating

Question 44

Whispered pectoriloquy

Answer 44

whispered words louder and clearer during auscultation

Question 45

Egophany

Answer 45

when patient says "ee" it sounds like "a"

Question 46

Pulmonary function test

Answer 46

Diagnose obstructive vs. restrictive diseases

Question 47

Spirometry

Answer 47

measures lung function, gives some lung volumes

Question 48

What are the things important for chest x ray interpretation?

Answer 48

``` Adequate or assessment of quality Airway Bones Cardiac size Diaphragms Effusions Fields and fissures Foreign body Great vessels Gastric bubble Hilar masses Impression ```