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MD3001 - Respiratory Clinical > Respiratory Examination > Flashcards

Respiratory Examination Flashcards

1
Q

What are the 7 specific areas asked about in a respiratory PC?

A
  1. Chest pain
  2. Dyspnoea
  3. Cough
  4. Sputum
  5. Haemoptysis
  6. Wheeze
  7. Systemic upset
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2
Q

What does flapping tremour indicate?

A

CO2 retention

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3
Q

What does a fine tremor indicate?

A

overuse of salbutamol inhaler

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4
Q

What are the respiratory causes of clubbing?

A
  • bronchial carcinoma
  • Mesothelioma
  • Chronic suppurative (pus-making) lung diease
    • Bronchiectasis
    • lung abscess
    • emphysema
  • Pulmonary fibrosis
  • Cystic fibrosis
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5
Q

What is polycythaemia?

A

high concentration of RBC in blood making it thick and difficult to circulate through vessels and organs. Gives a ‘ruddy’ complexion

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6
Q

What is Horner’s Syndrome?

A

damage to cervical sympathetic nerves

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7
Q

What are the clinical features of Horner’s Syndrome?

A
  • unilateral miosis
  • partial ptosis
  • loss of sweating on the same side
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8
Q

What are prominent veins on the chest wall and indication of?

A

SVC obstruction

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9
Q

What is surgical emphysema?

A

air in the subcutaneous tissue

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10
Q

What conditions are likely to cause tracheal deviation towards the leison?

A
  • lobar collapse
  • pneumonectomy
  • pulmonary fibrosis
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11
Q

What conditions are likely to causes tracheal deviation away from the leison?

A
  • Large pleural effusion
  • tension pneumothorax
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12
Q

causes of a resonant percussion note?

A

normal lung

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13
Q

Causes of a hyperresonant percussion note?

A

**Too much air

  • emphysema
  • large bullae (air filled sac)
  • pneumothorax
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14
Q

Causes of a dull percussion note

A

Fluid/Solid

  • Collapse
  • Consolidation
  • Fibrosis
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15
Q

Causes of a “stony” or very dull percussion note

A
  • pleural effusion
  • haemothorax
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16
Q

What causes increased fremitus/vibration?

A

consolidation or fibrosis

17
Q

What causes decreased fremitus/vibration?

A

pleural effusion, pneumonia or collapse

18
Q

Describe vesicular breathing

A
  • inspiratory sounds last longer than expiration
  • soft intensity
  • relatively low pitch
  • located over most of both lungs
19
Q

When are vesicular breath sounds diminished? and give examples

A

when normal lung is displaced by air

  • obesity
  • pleural effusion
  • pneumothorax
  • collapse
  • hyperinflation - emphysema in COPD
20
Q

Describe bronchial breathing

A
  • expiratory sound lasts longer than inspiratory
  • loud intensity of sound
  • pitch is relatively high
  • heard over the manubrium (larger proximal airways)
  • harsh in nature
  • gap between inspiration and expiration
21
Q

Why does bronchial breathing occur?

A

damage to small airways/alveoli

22
Q

What are crackles and what do they sound like?

A

high pitched, discontinuous sounds

similar to the sound produced by rubbing your hair between your fingers

23
Q

Potential causes of crackles?

A
  • pulmonary oedema
  • pulmonary fibrosis
  • bronchial secretions
  • COPD
  • pneumonia
  • lung abscess
  • TB
  • Bronchiolitis
  • bronchiectasis
24
Q

What is pleural rub?

A
  • associated with pleuritic pain
  • like “creaking leather”
  • low pitched
25
Q

Causes of pleural rub?

A
  • PE
  • pneumonia
  • vasculitis (irritation of the lining of the lung)
26
Q

What is wheeze?

A
  • continuous oscillation of opposing airways
  • Muscial quality, high pitched
  • louder in expiration
  • implies airway narrowing
27
Q

causes of wheeze

A

COPD/ASthma

Localised - lung tumour

28
Q

Polycythaemia =

A

abnormally increase concentration of Hb in the blood (increased haemocrit). Either through reduction in plasma volume or increase in RBC numbers

29
Q

Cyanosis =

A

a bluish discolouration of the skin due to poor circulation or inadequete oxygenation of the blood

30
Q

Horner’s Syndrome

A

An interruption of nerve supply from the brian to the face and eye on one side of the body (sympathetic nerve supply)

  • unequal size of pupil (miosis)
  • Dropping of the eyelid (psosis)
  • Anhydrosis (lack of sweating)
31
Q

What can cause horner’s syndrome?

A

A tumour at the apex of the lung

32
Q

What is pancoast’s tumour?

A

tumour of the pulmonary apex. Defined by location and usually spreads to nearby tissues.

Most are non-small cell cancers

33
Q

Cor pulmonale =

A

abnormal enlargement of the RHS of the heart as a result of lung disease (pulmonary vessels)

34
Q

Surgical emphysema =

A

when air/gas is located in the subcutaneous tissues (between skin and pleura)

35
Q

Vesicular breath sounds =

A

heard across the lung surface. Lower-pitched, resultiing sounds with higher intensity during inspiration

  • during expiration sounds intensity can fade
  • inspiratation = 2-3x the length of expiration
36
Q

Bronchial breath sounds =

A

tubular hollow sounds which are heard over large airways (2nd and 3rd intercostal spaces)

Louder and higher pitched than vesicular breath sounds

MD3001 - Respiratory Clinical (7 decks)

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