Respiratory Examination Flashcards
What is the structure of doing a respiratory examination?
- introduction and explanation
- inspection
- palpation
- percussion
- auscultation
When inspecting legs what are we looking out for?
Erythema nodosum
When inspecting the face what are we looking for?
- signs of central cyanosis
- signs of polycythaemia
- signs of Horner’s Syndrome
When inspecting the hands what are we looking for?
- tar staining
- nail clubbing
- tremors
What are the clinical features of Horner’s Syndrome?
- unilateral miosis
- partial ptosis
- facial anhydrosis
What are the different types of tremor?
- fine (excessive use of B-agonists)
- flapping (CO2 retention)
What does resonant percussion mean?
normal lung
What can hyper resonant percussion mean?
- emphysema
- large bullae (fluid filled sac or lesion)
- pneumothroax
What can dull percussion mean?
- lung collapse
- lung consolidation (exudate in airways and alveoli)
- fibrosis
What can stony or very dull percussion mean?
- pleural effusion (build up of fluid between the layers of pleura)
- haemothorax
Describe how you would do tactile vocal fremitus?
- use palm/ulnar border of hand
- tell patient to say 99 and feel for vibration
- increased fremitus: lung consolidation/fibrosis
- decreased fremitus: pleural effusion/pneumothorax/lung collapse
Describe vesicular breath sounds
- inspiration longer than expiration
- low pitched, quiet
- heard over most of lung fields
- no gap between inspiration and expiration
What can cause diminished vesicular breath sounds?
- obesity
- pleural effusion
- pneumothorax
- collapse
- hyperinflation
Describe bronchial breath sounds
- harsh in nature, loud
- gap between inspiration and expiration
- expiratory component dominates
What is the difference between bronchial and vesicular breath sounds?
- bronchial breath sounds originate from larger airways
- bronchial breath sounds are caused by damage to small airways/alveoli
