S1_L5_Obj - 9-10 Flashcards
DIAPHRAGMATIC EXCURSION/CHEST EXPANSION also can be
documented under:
anthropometric measurements
DIAPHRAGMATIC EXCURSION/CHEST EXPANSION. measured at the
ff levels (frownfelter):
axilla
xiphoid
DIAPHRAGMATIC EXCURSION/CHEST EXPANSION. measured at the
ff levels (hillegass):
axilla
xiphoid
subcostal
DIAPHRAGMATIC EXCURSION/CHEST EXPANSION. measured at the
ff levels (others):
Supramammary
Mammary
Inframammmary
Instructions for diaphragmatic excursion:
Maximal Inspiration to Maximal Expiration
what will we follow in diaphragmatic excursion
hillegass in CM
hillegass measurement:
2-3 inches
others measurement:
3-5 cm
frownfelter measurement:
3-5 cm
1 inches is equal to _
2.54 cm
palpation and cardiopulmo ax:
mediastinal shift
mediate percussion
vocal/tactile fremitus
IPSI mediastinal shift
atelectasis, lobectomy, pneumonectomy
CONTRA mediastinal shift
pleural effusion, abdominal organ herniation
There was an increase causing the shift in what mediastinal shift
contralateral mediastinal shift
There was a decrease causing the shift in what mediastinal shift
Ipsilateral mediastinal shift
Done on the middle phalanx or the fingernails tapping and
make sure you are listening for it
MEDIATE PERCUSSION
mediate percussion done on the _ or the _ tapping
middle phalanx, fingernails
Resonant mediate percussion:
low pitched and hollow (normal)
Hyperresonant / Tympanic mediate percussion:
too much air
Hyporesonant / Dull mediate percussion:
liquid or solid (normally heard over liver
& other dense tissues); “thud-like”
too much air
Hyperresonant / Tympanic
liquid or solid (normally heard over liver
& other dense tissues); “thud-like”
Hyporesonant / Dull
low pitched and hollow (normal)
resonant
VOCAL / TACTILE FREMITUS: what part of hand to use
Use ulnar border of the hand or the palm
Ask the patient to say _ or _ in vocal or tactile fremitus
Ask the patient to say “ninety-nine” or “tres-tres”
● Check if vibration is symmetrical or asymmetrical in the fremitus t or f
t
Increased vibration for fremitus means
lung consolidation
Decreased vibration for fremitus means
pleural effusion, pneumothorax, atelectasis
Check strength of diaphragm, and secondary muscles of respiration t or f
t
Observe precautionary measures for post-chest surgeries or CTTs t or f
t
secondary muscles of respi:
scalene, scm
Always start with an _ because it will show their level of
difficulties as well as show you the main problems that you will
need to check
OMT
Check the following for OMT:
Level of Independence
Speed / Timing
Quality of Movement / Compensatory Movements
Balance
CV Endurance
Tolerance in Upright Position
New York Heart Association (NYHA) Functional Classification:
Slight limitation of physical activity. Comfortable at rest.
Ordinary physical activity results in fatigue, palpitation, dyspnea (SOB).
Class II
New York Heart Association (NYHA) Functional Classification:
No limitation of physical activity. Ordinary physical activity does
not cause undue fatigue, palpitation, dyspnea (SOB)
Class I
New York Heart Association (NYHA) Functional Classification:
Unable to carry on any physical activity without discomfort.
Symptoms of heart failure at rest. If any physical activity is
undertaken, discomfort increases.
Class IV
New York Heart Association (NYHA) Functional Classification:
Marked limitation of physical activity. Comfortable at rest.
Less than ordinary activity causes fatigue, palpitation, or dyspnea.
Class III
OBJECTIVE ASSESSMENT (FOR HEART FAILURE):
No objective evidence of CVD. No symptoms and
no limitation in ordinary physical activity.
Class A
OBJECTIVE ASSESSMENT (FOR HEART FAILURE):
Objective evidence of moderately severe CVD.
Marked limitation in activity due to symptoms, even
during less-than-ordinary activity. Comfortable only at rest.
Class C
OBJECTIVE ASSESSMENT (FOR HEART FAILURE):
Objective evidence of severe CVD. Severe limitations.
Experiences symptoms even while at rest.
Class D
OBJECTIVE ASSESSMENT (FOR HEART FAILURE):
Objective evidence of minimal CVD. Mild symptoms and
slight limitation during ordinary activity. Comfortable at rest
Class B
New York Heart Association (NYHA) Therapeutic Classification:
Physical activity need not be restricted in any way
Class A
New York Heart Association (NYHA) Therapeutic Classification:
Should be at complete rest, confined to bed or chair
Class E
New York Heart Association (NYHA) Therapeutic Classification:
Ordinary activity should be moderately restricted
and whose more strenuous efforts should be discontinued
Class C
New York Heart Association (NYHA) Therapeutic Classification:
Ordinary activity should be markedly restricted
Class D
New York Heart Association (NYHA) Therapeutic Classification:
Ordinary physical activity need not be restricted but
who should be advised against severe or competitive sports
Class B
General Wellbeing Scales, Questionnaires
● Short Form 36 (SF 36)
● Sickness Impact Scale (SIP)
● Quality of Well-being Scale
● Quality of Life Systemic Inventory
● Nottingham Health Profile
● Dartmouth Primary Care Cooperative
Information
● Multidimentional Health Locus of
Control Inventory
● Symptoms Questionnaire
Heart Disease Questionnaire
MacNew Heart Disease Quality of Life Questionnaire (MacNew)
Cardiac-specific Scales & Questionnaires
● Minnesota Living with Heart Failure Questionnaire
● Outcomes Institute Angina Type Specification
● Quality of Life after Myocardial Infarction
Pulmonary- specific scales & Questionnaires
● Chronic Respiratory Disease Questionnaire
● St. George’s Respiratory Questionnaire
● Pulmonary Functional Status Scale and Dyspnea Questionnaire
● Living with Asthma Questionnaire
Cardiac Rehabilitation Questionnaire
● EuroQol Questionnaire
