Respiratory Examination Flashcards
What are the 7 specific areas asked about in a respiratory PC?
- Chest pain
- Dyspnoea
- Cough
- Sputum
- Haemoptysis
- Wheeze
- Systemic upset
What does flapping tremour indicate?
CO2 retention
What does a fine tremor indicate?
overuse of salbutamol inhaler
What are the respiratory causes of clubbing?
- bronchial carcinoma
- Mesothelioma
- Chronic suppurative (pus-making) lung diease
- Bronchiectasis
- lung abscess
- emphysema
- Pulmonary fibrosis
- Cystic fibrosis
What is polycythaemia?
high concentration of RBC in blood making it thick and difficult to circulate through vessels and organs. Gives a ‘ruddy’ complexion
What is Horner’s Syndrome?
damage to cervical sympathetic nerves
What are the clinical features of Horner’s Syndrome?
- unilateral miosis
- partial ptosis
- loss of sweating on the same side
What are prominent veins on the chest wall and indication of?
SVC obstruction
What is surgical emphysema?
air in the subcutaneous tissue
What conditions are likely to cause tracheal deviation towards the leison?
- lobar collapse
- pneumonectomy
- pulmonary fibrosis
What conditions are likely to causes tracheal deviation away from the leison?
- Large pleural effusion
- tension pneumothorax
causes of a resonant percussion note?
normal lung
Causes of a hyperresonant percussion note?
**Too much air
- emphysema
- large bullae (air filled sac)
- pneumothorax
Causes of a dull percussion note
Fluid/Solid
- Collapse
- Consolidation
- Fibrosis
Causes of a “stony” or very dull percussion note
- pleural effusion
- haemothorax
What causes increased fremitus/vibration?
consolidation or fibrosis
What causes decreased fremitus/vibration?
pleural effusion, pneumonia or collapse
Describe vesicular breathing
- inspiratory sounds last longer than expiration
- soft intensity
- relatively low pitch
- located over most of both lungs
When are vesicular breath sounds diminished? and give examples
when normal lung is displaced by air
- obesity
- pleural effusion
- pneumothorax
- collapse
- hyperinflation - emphysema in COPD
Describe bronchial breathing
- 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
Why does bronchial breathing occur?
damage to small airways/alveoli
What are crackles and what do they sound like?
high pitched, discontinuous sounds
similar to the sound produced by rubbing your hair between your fingers
Potential causes of crackles?
- pulmonary oedema
- pulmonary fibrosis
- bronchial secretions
- COPD
- pneumonia
- lung abscess
- TB
- Bronchiolitis
- bronchiectasis
What is pleural rub?
- associated with pleuritic pain
- like “creaking leather”
- low pitched
