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Bloc B - Respiration > Respiratory Physical Exam > Flashcards

Respiratory Physical Exam Flashcards

1
Q

Key aspects of resp physical (10 letters)

A

ROOCCSPAVT

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2
Q

ROOCCS letters meaning

A 
Resp rate
Observe (resp pattern, distress, chest wall shape and mvmt)
Oximetry
Clubbing
Cyanosis
Surface anatomy (of lobes)
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3
Q

PAVT letters meaning

A

Percussion
Auscultation
Vocal fremitus (egophony and whispered pectoriloquy)
Tactile fremitus

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4
Q

Trick to ID oblique fissure

A

ID vertebra prominens (C7) and T1, count down to T3: posterior origin of oblique fissure

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5
Q

other name for sternal angle

A

Angle of Louis

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6
Q

Trick to ID horizontal fissure

A

Angle of Louis, go laterally to 2nd rib, count down to 4th rib

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7
Q

normal resp rate

A

8-16 breaths per min

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8
Q

tachypnea and bradypnea values

A

over 20 and under 8 breaths per min

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9
Q

Resp rate of 40+ for hours shows what

A

sign of resp failure and is not sustainable

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10
Q

normal inspiratory time vs expiratory time ratio

A

I:E is 1:2

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11
Q

prolonged expiratory phase shows what

A

underlying obstructive impairment

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12
Q

Cheyne-Stokes breathing explan

A

rhythmic auscillation of depth of resp (changes between shallow and deep)

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13
Q

ataxic breathing def

A

completely chaotic resp pattern (short, long, shallow, deep)

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14
Q

Kussmaul breathing def

A

sustained deep breathing for hours

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15
Q

Kussmaul breathing, a condition where it’s seen

A

metabolic acidosis

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16
Q

What is the abdominal paradox

A

when breathing, chest wall goes up and abdoment goes down (inwards)

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17
Q

normal opposite of abdominal breathing + explan

A

synchronous thoraco-abdominal movement: breathe in, chest goes up and abdomen goes up too

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18
Q

why abdominal paradox happens

A

diaphragm problem (becomes a simple piece of tissue, not working), accessory muscles of resp recruited (neck), suck air into airways bc are able to lift chest up. create suction and neg pressure sucks abdominal contents

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19
Q

Abdominal paradox: what portion of diaphragm is not working

A

Two sides are not working (in order to see abdominal paradox)

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20
Q

signs of resp distress that can be seen in the resp pattern on or near chest (3)

A

tachypnea
use of accessory muscles of resp
intercostal indrawing

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21
Q

signs of resp distress that can be seen on face (3)

A

nasal flaring (nostrils open and close)
pursed lip breathing
unable to complete sentence verbally

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22
Q

signs of resp distress that can be seen in periphery (3)

A

cyanosis

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23
Q

goal of pursed lip breathing

A

send back positive pressure in lung as to block the end of expiration to keep alveoli open

24
Q

ataxic breathing shows what

A

sign of CNS problem

25
Q

Cyanosis how to see it

A

Finger nails are blue and hand too

26
Q

Central cyanosis sign

A

mouth mucosa is blue

27
Q

clubbing def

A

angle between nail and finger is lost

28
Q

Clubbing: thing we can ask patient to do to see it + name

A

Shamroth’s sign. Put hands together on exterior surface and see if gap between fingers

29
Q

Nails characteristics in clubbing

A

Are spongier and softer than normal (if were to push on them)

30
Q

clubbing can be sign of what, is seen in what conditions

A

lung cancer, bronchiectasis, indulent (tough) pulm infections (lung abcess, TB, fungal infection of lung)

31
Q

Conditions in which clubbing is NOT seen

A

COPD, emphysema, chronic bronchitis, asthma

32
Q

T-F: if remove cancer, clubbing stays

A

F: clubbing goes away when cancer removed

33
Q

Exam Q T-F: COPD causes clubbing

A

False

34
Q

familial clubbing shows what

A

nothing, it would then be benign

35
Q

clubbing only characteristic of resp conditions: T-F?

A

False. few extra-thoracic conditions where it appears

36
Q

T-F: Clubbing caused by hypoxia

A

False. Has nothing to do with hypoxia

37
Q

Percussion principle and name of surface receiving blow

A

Apply palm of hand and hit third finger. No stethoscope.

Pleximeter

38
Q

Percussion: air-filled structures produced ___ sound

A

tympanitic or resonant sound

39
Q

chest percussion: diff in sound between bone and surface between bone

A

no difference

40
Q

auscultation meaning

A

listening (with steth)

41
Q

auscultation in resp done with that part of steth + exception

A

with diaphragm

exception: bell of apex of the lung

42
Q

breath sounds: bronchial sound def

A

inspiratory and expiratory sounds are equal

43
Q

normal location of a bronchial breath sound

A

over the trachea and central airways (on top of sternum)

44
Q

vesicular breathing sound def

A

expir and inspi sounds are lower but can barely hear exp sound

45
Q

normal location of vesicular breathing

A

periphery. away from central airways (lateral chest wall for ex)

46
Q

broncho-vesicular breathing def

A

mix of bronchial and vesicular. Hear insp well and expiratory barely

47
Q

broncho-vesicular breathing normal location

A

parasternal (side of sternum)

48
Q

added or adventitial sounds indicate what

A

pathology. you normally don’t hear them

49
Q

3 adventitial (added) sounds

A

1) discontinuous crepitations or crackles (rales)
2) continuous wheezes or ronchi
3) discontinuous rubs that are monotonous from breath to breath, dry

50
Q

2 adventitial sounds that are very similar

A

crepitations-crackles-rales and rubs are similar

51
Q

percussion: how to detect pleural effusion or consolidation (as in pneumonia)

A

percussion: dull sound instead of tympanitic sound

52
Q

auscultation: how to detect pleural effusion or consolidation (as in pneumonia)

A

pleural effusion: can’t hear breathing

pneumonia: hear bronchial breathing instead of usual vesicular breathing

53
Q

Egophony test what you do

A

put stethoscope over region of chest and ask patient to say eeeeeeeeeeee.
If effusion, eee still sounds like eee
If pneumonia, eeee becomes aaaa.

54
Q

whispered pectoriloquy: what you do and purpose

A

listen with stethoscope and ask patient to whisper 1,2,3 continuously.
If pneumonia, can hear sound well
If effusion, sound not transmitted

55
Q

tactile fremitus: what you do and purpose

A

put hand on region as if chopping something, ask patient to say 99 loudly (33 in french).
If pneumonia, feel vibration over consolidation
If effusion, won’t feel the vibration

Bloc B - Respiration (36 decks)

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