Test & Measures and Breath Sounds

Question 1

What are the values on the Angina Scale?

Answer 1

(1 good, 4 bad)

1 - Mild, barely noticeable
2 - Mod, bothersome
3 - Mod severe, very uncomfortable
4 - Most severe or intense pain ever experienced

Question 2

What is “normal” on the Ankle Brachial Index (ABI)?

Answer 2

1.0-1.30 = Normal, no blockage

Question 3

What does a high # on the Ankle Brachial Index (ABI) indicate?

Answer 3

> or = 1.30 indicates rigid arteries

Question 4

What does a low # on the Ankle Brachial Index (ABI) indicate?

Answer 4

< 1.0 indicates blockage

lower # = more severe (ex: <0.4 in severe block)

Question 5

Where do you auscultate the Aortic Area?

Answer 5

2nd intercostal space at the RIGHT sternal border

*A before P

Question 6

Where do you auscultate the Pulmonic Area?

Answer 6

2nd intercostal space at the LEFT sternal border

*A before P

Question 7

Where do you auscultate the Mitral Area (bicuspid valve)?

Answer 7

Apex of the heart
(5th intercostal space, medial to the left midclavicular line)
*Tri before your Bi

Question 8

Where do you auscultate the Tricuspid Area?

Answer 8

4th intercostal space at level of the sternal border

*Tri before your Bi

Question 9

When does an S3 heart sound occur in the cardiac cycle?

Answer 9

• Diastole (passive ventricle filling)

“Ventricular gallop”

Question 10

What CAN an S3 heart sound indicate in adults?

Answer 10

• Key for Chronic Heart Failure (CHF)

Question 11

When does an S4 heart sound occur in the cardiac cycle?

Answer 11

• 2nd phase of diastole due to atrial contraction

“Atrial gallop”

Question 12

What CAN an S4 heart sound indicate in adults?

Answer 12

• Previous MI or CABG
• HTN
• CAD
• Pulmonary Disease

Question 13

What are normal breath sounds heard over the Trachea?

Answer 13

Tracheal and Bronchial sounds

- loud, tubular

Question 14

What are normal breath sounds heard over the Distal Airways?

Answer 14

Vesicular

- high pitched, breezy

Question 15

What are abnormal breath sounds?

Answer 15

Sounds heard outside of their normal location or phase

Question 16

What are adventitious breath sounds?

Answer 16

Never normal

- continuous and discontinuous odd breath sounds

Question 17

What do Crackles sound like?

Answer 17

Discontiuous, high-pitched

Base of lungs

Question 18

What pathology causes Crackles?

Answer 18

Fluid or secretions

• Atelectasis
• Fibrosis
• Pulmonary Edema
• Pleural Effusion

Question 19

What does Pleural Friction Rub sound like?

Answer 19

Dry, crackling

Question 20

What pathology causes Pleural Friction Rub?

Answer 20

Inflammed visceral and parietal pleurae rubbing together

Question 21

What does Rhonchi sound like?

Answer 21

Continuous, low-pitched

Question 22

What pathology causes Rhonchi?

Answer 22

Secretions, bronchial spasm, neoplasm

Question 23

What does Stridor sound like?

Answer 23

Continuous, high-pitched wheeze

Question 24

What pathology causes Stridor?

Answer 24

Upper airway obstruction

Question 25

What does Wheezing sound like?

Answer 25

Continuous "musical" or whislting

Question 26

What pathology causes Wheezing?

Answer 26

Narrowing of airways | - bronchospasms, edema, collapse, secretions, neoplasms

Question 27

What sounds will you hear with pneumonia?

Answer 27

bronchial breath sounds where vesicular should be

Question 28

When will you hear Decreased breath sounds?

Answer 28

severe congestion emphysema hypoventilation

Question 29

What sounds will you hear with pneumothorax?

Answer 29

Absent breath sounds

Question 30

What is bronchophony?

Answer 30

Increased vocal resonance - greater clarity and loudness (ex: 99)

Question 31

What is Egophony?

Answer 31

E to A change

Question 32

What is Whispered Pectoriloquy?

Answer 32

Recognition of whispered words "1,2,3"

Question 33

What is "normal" on the BMI?

Answer 33

18.5 - 24.9

Question 34

What is normal capillary refill time?

Answer 34

Full color in < 2 seconds

Question 35

What is abnormal capillary refill time?

Answer 35

> 2 seconds | capillary blood flow compromised

Question 36

What in the range and major classifications for the Borg Dyspnea scale?

Answer 36

``` Range: 0-10 0 - No breathlessness 3 - Moderate 5 - Severe 10 - Max ```

Question 37

What does a positive stress indicate?

Answer 37

High probability of coronary artery disease

Question 38

What are the absolute indications for terminating a stress test?

Answer 38

- Drop in SBP > 10 mm Hg - Moderately severe angina (3/4) - Inc nervous system symptoms (ataxia, dizziness) - Cyanosis, pallor - Sustained v-tach

Question 39

What is the number that describes a normal amplitude or volume of the pulse?

Answer 39

2+ 3+ bounding 1 small or reduced 0 absent

Question 40

What is the normal adult respiratory rate?

Answer 40

12 - 20 breaths/min

Question 41

What is Apnea?

Answer 41

absence of spontaneous breathing

Question 42

What is Biot's breathing pattern?

Answer 42

Irregular breathing | - vary in depth and rate

Question 43

What is Bradypnea?

Answer 43

< 12 breaths/min

Question 44

What is Tachypnea?

Answer 44

> 20 breaths/min

Question 45

What is Cheyne-Stokes (periodic) breathing?

Answer 45

dec rate and depth of breathing with periods of apnea | **CNS damage**

Question 46

What is Eupnea?

Answer 46

Normal rate and depth of breathing

Question 47

What is Hyperpnea?

Answer 47

Inc rate and depth of breathing

Question 48

What is Hypopnea?

Answer 48

Dec rate and depth of breathing

Question 49

What are Kussmaul's respirations?

Answer 49

Deep and fast breathing | **Metabolic acidosis**

Question 50

What is Paradoxical breathing?

Answer 50

Chest wall moves in with inhalation and out with exhalation | **chest trauma or paralysis of diaphragm**

Question 51

If a patient post-op lung resection has audible crackles, what do you do?

Answer 51

Initiate bronchopulmonary hygiene - Postural drainage - Vibration - Shaking - Suctioning