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Year 3 CCA > Respiratory Examination > Flashcards

Respiratory Examination Flashcards

1
Q

On inspection of the surrounding are, what are you looking for?

A
  1. Drips
  2. Oxygen
  3. Medication
  4. Sputum pots
  5. Inhalers
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2
Q

On general inspection of the patient, what are you looking for?

A
  1. Body habitus
  2. Well/ unwell
  3. Breathlessness
  4. Pursed lips breathing
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3
Q

What might pursed lips breathing indicate?

A

COPD

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4
Q

On inspection of the nails, what are you looking for?

A
  1. Clubbing

2. Koilonychia

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5
Q

What are respiratory causes of clubbing?

A
  1. Interstitial lung disease
  2. Lung cancer
  3. Bronchiectasis
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6
Q

Why is koilonychia relevant to a respiratory examination?

A

Iron deficiency anaemia causing shortness of breath.

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7
Q

On inspection of the hands, what are you looking for?

A
  1. Temperature
  2. Capillary refill time
  3. Peripheral cyanosis
  4. Tar staining
  5. Flapping tremor
  6. Fine tremor
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8
Q

What might a flapping tremor indicate?

A

Severe CO2 retention.

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9
Q

What might a fine tremor indicate?

A

Excessive use of beta 2 agonist

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10
Q

On inspection of the face in general, what are you looking for?

A

A Cushingoid appearance

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11
Q

On inspection of the eyes, what are you looking for?

A
  1. Horner’s syndrome
  2. Conjunctival pallor
  3. Iritis, conjuctivitis
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12
Q

What signs indicate Horner’s syndrome?

A
  1. Miosis
  2. Ptosis
  3. Anhydrosis
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13
Q

What might Horner’s syndrome indicate in a respiratory examination?

A

Pancoast tumour pressing on sympathetic chain of nerves in chest.

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14
Q

What might conjunctival pallor indicate?

A

Anaemia causing shortness of breath

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15
Q

What may eye problems like iritis, conjunctivitis indicate in a respiratory examination?

A
  1. TB

2. Sarcoidosis

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16
Q

On inspection of the mouth, what are you looking for?

A

Central cyanosis

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17
Q

What might a raised JVP indicate?

A
  1. Right heart failure
  2. Overload
  3. Massive PE
  4. Tension pneumothorax
  5. Cardiac tamponade
  6. SVC obstruction
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18
Q

What is a tracheal tug and what might it indicate?

A

Trachea pulls down on inspiration due to hyperinflation (COPD)

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19
Q

What does a trachea deviate towards?

A
  1. Collapse

2. Pneumonectomy

20
Q

What does a trachea deviate away from?

A
  1. Tension pneumothorax

2. Very big effusion

21
Q

What should the cricosternal distance be and when might it be reduced?

A

2-3 finger breadths, reduced with hyperinflation.

22
Q

What are you looking for on inspection of the chest?

A
  1. Deformity and symmetry
  2. Scars
  3. Respiratory pattern
  4. Intercostal drawing
23
Q

What does a barrel chest indicate?

A

Hyperinflation

24
Q

What does pectus excavatum (funnel chest) indicate?

A

Developmental defect

25
What does pectum carinatum (pigeon chest) indicate?
Increased respiratory effort during development.
26
What does paradoxical movement of the chest and abdomen indicate?
COPD or obstruction
27
What types of scars might you look out for?
1. Thoracotomy 2. Chest drain 3. Radiotherapy tattoo
28
What might a prolonged expiratory phase coupled with pursed lips breathing indicate?
Sign of smoking related lung disease.
29
What does intercostal drawing indicate?
COPD due to hyperinflation
30
What does a parasternal heave indicate?
Cor pulmonale
31
What might a shift in apex beat indicate (respiratory related)?
1. Collapse | 2. Tension pneumothorax
32
What might hyper-resonance on percussion indicate?
1. Pneumothorax | 2. Emphysematous bullae
33
What might dullness on percussion indicate?
1. Consolidation 2. Collapse 3. Alveolar fluid 4. Pleural thickening 5. Neoplasm
34
What might stony dullness on percussion indicate?
Pleural effusion
35
What might a local area of diminished breath sounds indicate?
1. Effusion 2. Tumour 3. Pneumothorax 4. Pneumonia 5. Collapse
36
What might globally diminished breath sounds indicate?
COPD
37
What might bronchial breath sounds indicate?
1. Consolidation | 2. Upper boarder of pleural effusion
38
What might a polyphonic wheeze indicate?
1. Asthma | 2. COPD
39
What might a monophonic wheeze indicate?
1. Carcinoma | 2. Foreign body
40
What might crepitations indicate?
1. Infection 2. Fluid 3. Fibrosis
41
What should you do if you hear crepitations?
Ask patient to cough and listen again - it may clear secretions.
42
What might a rub on auscultation indicate?
1. Pneumonia | 2. PE with infarction
43
What does increased sound when testing vocal resonance indicate?
Consolidation
44
What does decreased sound when testing vocal resonance indicate?
1. Effusion | 2. Pneumothorax
45
Where do lung bases extend to posteriorly?
11th ribs
46
What may sacral and ankle oedema indicate?
Right heart failure

Year 3 CCA (3 decks)

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