Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

1 Medicine > Respiratory Examination > Flashcards

Respiratory Examination Flashcards

1
Q

What should be looked for at end of the bed?

A 
General appearance
Accessory muscle use, pursed lip breathing
Cachexia/nutritional status 
Oxygen, fluids, meds
Sputum pot (look inside)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is pursed lip breathing a sign of?

A

lower airway obstruction (usually COPD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what does cachexia suggest?

A

copd, malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what should be checked on the hands?

A 
Peripheral cyanosis
Temperature
Dilated veins
Tar staining/ coal dust tattoos
1st wed space wasting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is the temperature of the hands in central cyanosis?

A

warm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the temperature of the hands in peripheral cyanosis?

A

Cold

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is Raynaud’s?

A

Change in peripheries colour to white

Caused by spasm of small arteries restricting blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What does dilation of the blood vessels in the skin suggest?

A

Hypercapnia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what does tar staining/ coal dust tattoos show?

A

Smoker
Mining
Risk for coal-workers pneumoconiosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What does 1st web space wasting on hands suggest?

A

T1 lesion (e.g. pancoast tumour)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what needs to be looked at on the nails?

A

Finger clubbing

Koilonychia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are the respiratory causes of clubbing

A

Interstitial lung disease
Malignancy (bronchogenic carcinoma, mesothelioma)
Suppurative lung disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are the types of suppurative lung disease?

A

Bronchiectasis (pus in the tubes)
Abscess (pus in a collection)
Empyema (pus outside lung)
Cystic fibrosis (pus everywhere)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are the cardiovascular causes of clubbing?

A

Infective endocarditis
Cyanotic congenital heart disease
Atrial myxoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are the gastro causes of clubbing?

A

IBD
Hepatic cirrhosis
GI lymphoma
Coeliac disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is koilonychia a sign of?

A

Iron deficiency anaemia (cause of SOB)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what should be looked for in the wrist?

A

Flapping tremor (asterixis)
Fine physiological tremor
Respiratory rate
Radial pulse (rate and volume)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is asterixis a sign of?

A 
Respiratory failure (CO2 retention)
Hepatic/renal failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what drug can cause a fine physiological tremor?

A

Beta agonist (salbutamol)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

how do you take respiratory rate?

A

Count over 15sec while pretending to take pulse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what may cause a bounding pulse?

A

Hypercapnia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what do you check for on the face?

A

cushingoid (moon face, plethora, acne, hirsute)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what may cause cushingoid face?

A

long term steroid treatment (e.g for cryptogenic fibrosing alveolitis, asthma, COPD, pulmonary fibrosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what should be checked for in the eyes?

A

conjunctival pallor

horner’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what are some signs of horner's in the eyes?
ptosis | miosis
26
what is a cause of conjunctival pallor?
anaemia
27
what are the causes of horner's syndrome?
``` central lesion T1 root lesion brachial plexus lesion neck lesion with cluster headaches ```
28
what may be the cause of central lesion in horner's syndrome?
stroke/tumour/MS | syringobulbia
29
what are the causes of T1 root lesion causing horner's syndrome?
spondylosis | neurofibroma
30
what are the causes of brachial plexus lesion causing horner's syndrome?
pancoast tumour cervical rib trauma/birth injury
31
what are the causes of neck lesion causing horner's syndrome?
tumour carotid artery aneurysm sympathectomy
32
what should be checked for in the mouth?
central cyanosis | candida
33
what are the causes of central cyanosis?
hypoxic lung disease cardiac shunt abdormal Hb- methaemoglobinaemia (drugs, toxins)
34
what are the causes of peripheral cyanosis?
peripheral vascular disease raynaud's syndrome heart failure shock
35
what may cause candida in the mouth?
steroid inhalers | immunocompromised patient
36
what should be checked in the neck?
JVP trachea lymph nodes
37
how should the trachea be palpated?
"im going to feel for your windpipe"- always warn patient position cricosternal distance "take a deep breath in"- any tug on inspiration
38
what may cause trachea deviation?
towards collapse | away from tension/big effusion
39
what is the normal cricosternal distance?
2-3 fingers
40
what may change cricosternal distance?
reduced in hyperinflation --> COPD
41
what should be checked before palpating lymph nodes?
any pain in neck
42
what does tender lymph nodes suggest?
infection
43
what do non-tender raised lymph nodes suggest?
suspicious of malignancy
44
what should be checked on inspection?
anterior-posterior diameter (A-P diameter) scars (check back and sides) deformity of chest/spine intercostal indrawing (Hoover's sign)
45
what can A-P diameter increase be a sign of
hyperinflation (COPD)
46
what scars may be seen on the chest?
thoracotomy (lobectomy/ pneumonectomy) | old chest drain sites
47
what deformities of the chest may be seen?
pectus excavatum pectus carinatum scoliosis
48
what disease may cause pectus carinatum?
asthma
49
what disease may cause hoover's sign?
hyperinflation (COPD)
50
what should be done on palpation of respiratory system?
chest expansion apex beat RV heave
51
what should be assessed in chest expansion?
palpate chest wall in 2 separate places | asymmetry
52
what may cause displacement of apex beat?
mediastinal shift (collapse, tension, big effusion)
53
what may cause RV heave
right ventricular hypertrophy (possible cor pulmonale)
54
how many places should be checked on percussion?
8-10 places
55
where should you start in percussion?
supraclavicular fossae and work down chest
56
how should auscultation be carried out?
1. take deep breath in and out through mouth" any wheeze or crepitations if crepitations heard, ask patient to cough and lsiten again 2. vocal resonance- 99
57
what does increased vocal resonance suggest?
consolidation
58
what does decreased vocal resonance suggest?
collapse effusion pneumothorax
59
what should be done in areas of increased vocal resonance?
whispering pectoriloquy
60
what is whispering pectoriloquy?
whisper 99 every time i touch your chest with stethoscope | whispering would usually not be heard
61
what causes whispering pectoriloquy?
loud conduction of whispered voice due to consolidation
62
what causes wheeze?
small airway obstruction (COPD)
63
what causes crepitations?
fluid in airspaces: secretions, pus, oedema
64
what should be checked on back?
sacral oedema
65
what should be checked on legs?
peripheral oedema
66
what causes sacral and peripheral oedema?
right heart failure (e.g cor pulmonale)
67
what should be done in conclusion?
review observation chart (HR, BP, RR, SpO2, temp) investigation: - peak flow - PFTs - CXR - ABGs to check perfusion
68
what should be done after all anterior tests?
repeat same process posteriorly
69
``` what findings would be found on consolidation? mediastinal shift percussion note breath sounds vocal resonance ```
no change in mediastinal shift percussion dull breath sounds bronchial or low vocal resonance increased
70
``` what findings would be found on collapse/lobectomy/pneumonectomy? mediastinal shift percussion note breath sounds vocal resonance ```
mediastinal shift towards collapse percussion note dull breath sounds decreased on absent vocal resonance decreased or absent
71
what findings would be found on effusion/ raised hemidiaphragm
mediastinal shift away if big percussion node stony dull breath sounds low or absent vocal resonance low or absent
72
what findings would be found on pneumothorax?
mediastinal shift away if tension percussion hyper-resonant breath sounds low or absent vocal resonance low or absent
73
what findings would be found on pneumonectomy?
mediastinal shift towards percussion note dull breath sounds absent vocal resonance absent
74
how do you distinguish between collapse and lobectomy/pneumonectomy?
thoracotomy scar on chest
75
indications for lobectomy/pneumonectomy?
bronchogenic cancer (25% non-small cell lung cancer are resectable) bronchiectasis trauma TB
76
how do you distinguish betwen effusion and raised hemidiaphragm?
examination findings identical | CXR to differentiate
77
what are the cause of raised hemidiaphragm?
phrenic nerve palsy | caused by thoracic surgery, trauma, malignancy
78
what are the signs of hyperinflation?
``` reduced cricosternal distance +/- tracheal tug increased A-P diameter intercostal indrawing (Hoover's sign) apex beat not palpable hyper-resonant percussion note ```
79
what are the features of bronchial breathing?
loud and blowing inspiration length= expiration audible gap between inspiration and expiration reproducible by placing stethoscope over trachea
80
what are the types of pleural effusion?
transudate and exudate
81
what are the differences between transudate and exudate pleural effusion
transudate protein <30g/l | exudate protein >30 g/l
82
what are the causes of transudate pleural effusion?
LVF volume overload hypoalbuminemia meig's syndrome
83
what are the causes of exudate pleural effusion?
infection- pneumonia, TB infarction- PE inflammation- rheumatoid arthritis, SLE malignancy- bronchogenic, mesothelioma
84
what are the types of breathing
bronchial and vesicular
85
where are vesicular breath sounds heard?
normally over most of lung

1 Medicine (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions