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Year 3 > Respiratory examination > Flashcards

Respiratory examination Flashcards

1
Q

What should you look for during general inspection of the patient in a resp exam?

A

Colour change (cyanosis/pallor), shortness of breath, cachexia, resp rate, scars, added sounds

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2
Q

What should you look for during general inspection of the bedside in a resp exam?

A

Cigarettes, oxygen/ oxygen masks, nebulisers, inhalers, sputum pot, cigarettes, vape

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3
Q

What should you look for when inspecting the hands in a resp exam?

A 
Tar staining
Clubbing
Peripheral cyanosis
Flap/ tremor
Temperature
Small muscle wasting
Dilated veins
Cap refill
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4
Q

What are the respiratory causes of clubbing?

A

Low blood oxygen
Lung cancer
Pulmonary fibrosis
Bronchiectasis

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5
Q

Does COPD cause clubbing?

A

NO

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6
Q

What may cause a fine tremor of the hands in the context of a resp exam?

A

Drugs like salbutamol

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7
Q

What do dilated veins of the hand suggest in a resp exam?

A

Hypercapnia

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8
Q

How do you test for asterixis and what would a positive test mean?

A

Ask them to hold out their hands and cock them back, if they flap they may have co2 retention

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9
Q

How should you take the pulse and resp rate?

A

Take the radial pulse for 15 secs then the resp rate for 30 secs, don’t tell them you are taking the resp rate

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10
Q

If the pulse is irregular how long should you take it for?

A

30 seconds/ a minute (just longer than 15 seconds)

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11
Q

What are the main causes of tachycardia in a resp exam?

A

Infection
Pulmonary embolism
Asthma

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12
Q

Why may conjunctival pallor be relevant in a resp exam?

A

It is a sign of anaemia which occurs if there is significant shortness of breath

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13
Q

What is whiteness of the tongue called medically?

A

Oral candida

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14
Q

What common medication does not cause oral candida? (but people often think it does)

A

Inhaled salbutamol

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15
Q

What causes oral candida?

A

Inhaled steroids

Amoxicillin

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16
Q

What are the 3 notable features of Horner’s syndrome?

A

Ptosis
Anhydrosis
Decreased pupil size

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17
Q

What is the significance of Horner’s syndrome when identified in a resp exam?

A

It could be due to lung cancer, specifically a pancoast tumor which is an apical cancer

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18
Q

What will polycythemia do to someones complexion?

A

Cause it to be plethoric/ruddy due to widened blood vessels

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19
Q

What examinations are done on the neck in a resp exam?

A

Tracheal position

JVP

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20
Q

What causes the trachea to deviate away from the problematic side?

A

Tension pneumothorax

Pleural effusion

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21
Q

What causes the trachea to deviate towards the problematic side?

A

Lobar collapse

Pneumonectomy

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22
Q

On inspection what will a scar under the pecs near the midline of the axilla indicate?

A

Lateral thoracotomy

23
Q

When inspecting the chest what should you always ask the patient to do?

A

Lift their arms to see any subtle or hidden scars

24
Q

What is the medical name for a funnel shaped chest and what causes it?

A

Pectus excavatum

Congenital condition or from connective tissue disease

25
Q

What is the medical name for pigeon shaped chest?

A

Pectus caranatum

26
Q

When inspecting the chest what should you look for?

A

Respiratory distress (are they using their accessory muscles or anything)
Shape of chest (asymmetry, hyperexpansion, pectus excavasum or carinatum)
Scars (make sure to check axilla)
Chest drains

27
Q

What do you palpate for in a resp exam?

A

Apex beat

Chest expansion

28
Q

What causes a displaced apex beat?

A

Right ventricular hypertrophy
Large pleural effusion
Tension pneumothorax

29
Q

What causes asymmetrical chest expansion?

A

Pneumothorax, pneumonia, pleural effusion

30
Q

What causes reduced chest expansion?

A

Pulmonary fibrosis

31
Q

What is hyperresonant to precussion?

A

Air

32
Q

What is dull to percussion?

A

Consolidation

33
Q

What are pleural effusions to percussion?

A

Stony dull

34
Q

What does increased vibration over one area during tactile vocal fremitus indicate?

A

Increased tissue density eg tissue density, mass

Lobar collapse

35
Q

What does decreased vibration over one area during tactile vocal fremitus indicate?

A

Pneumothorax

36
Q

What are the 3 main types of breath sounds?

A

Bronchial
Vesicular
Reduced

37
Q

What are added breath sounds?

A

Wheeze and crackles

38
Q

What causes a wheeze?

A

Narrowing of airways eg due to narrowing or secretions

39
Q

What causes an expiratory wheeze commonly? Which condition is this seen in?

A

Narrowing of smaller airways

Often seen in asthma

40
Q

What is wheeze on inspiration referred to as?

A

Stridor

41
Q

What causes an inspiratory wheeze?

A

A larger airway eg due to foreign body

42
Q

What are the 2 types of crackles?

A

Coarse and fine

43
Q

What causes coarse crackles?

A

Pneumonia (consolidation)

44
Q

What causes fine crackles?

A

Pulmonary fibrosis

45
Q

What causes increased volume when vocal resonance is tested?

A

Increased tissue density eg consolidation, tumor, lobar collapse

46
Q

What causes decreased volume when vocal resonance is tested?

A

Fluid or air outside of lungs eg pleural effusion or pneumothorax

47
Q

What should you look for when inspecting the back?

A

Kyphosis or scoliosis

48
Q

What may kyphosis and scolios cause in relation to a resp exam?

A

Reduced lung capacity

49
Q

Why may sacral oedema or peripheral oedema be relevant in a resp exam?

A

They are signs of cor pulmonale

50
Q

What is cor pulmonale?

A

The right side of the heart fails

51
Q

Why does cor pulmonale arise?

A

Blood vessels constrict where there is less oxygen and dilate where there is more oxygen so if someone has chronically low oxygen the blood vessels supplying the right side of the heart will constrict

52
Q

What are the respiratory causes of lymphadenopathy in the neck?

A

Metastatic lung cancer
TB
Sarcoidosis
Viral upper resp tract infections

53
Q

What investigations may one do after a resp exam?

A

X-ray
Sputum pot
Oxygen levels

Year 3 (104 decks)

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