Thorax and lungs Flashcards
What are environmental asthma triggers?
Higher risk in inner city because of more pollution
Pet dander, dust, pollen, smoking around children
Who is at higher risk for tuberculosis?
Those in prisons, extended care facilities
Older adults
Smokers
What conditions can cause a barrel chest?
COPD
emphysema
When are Cheyne-stokes respirations seen?
Can be seen in overdoses, heart failure
Most often associated with being close to death
When do you usually see Biot’s respirations?
When there is trauma
What are the signs of early hypoxia?
RAT- restlessness, anxiety, tachycardia/tachypnea
What are the signs of late hypoxia?
BED- bradycardia, extreme restlessness, severe dyspnea
How does hypoxia present in pediatrics?
F- feeding difficulty
I- inspiratory stridor
N- nares flare
E- expiratory grunting
S- sternal retractions
What are the lung sound fields from high to low?
Bronchial
Bronchio-vesicular
Vesicular
What are atelectacic breath sounds?
Heard after surgery sometimes or when on bed rest
Similar in sound to crackles but if pt takes a deep breath and coughs and crackles go away, it’s atelectacic
How do you test egophony?
pt says eee
How do you test bronchophony?
99; it should sound muffled
How do you test whispered pectoriloquy?
123; should be almost not audible
What conditions cause wheezing?
Asthma
Acute bronchitis
COPD
Heard during expiration
What conditions cause stridor?
Croup
Foreign body obstruction
What conditions cause fine crackles and what does it sound like?
Where is it best heard?
Sounds like hair rubbing near the ear
Congestive heart failure
Pulmonary fibrosis
Base of the lungs during inspiration
What conditions cause coarse crackles and what does it sound like?
Where are they best heard?
Low pitched and moist
Pulmonary edema
Bronchitis
Base of the lungs during inspiration
What does pleural friction rub sound like and what conditions cause it?
Where is it best heard?
Harsh grating or creaking
TB
pneumonia
Best heard in the lower anterior lungs and lateral chest
What is sibilant wheezing?
When air is passing through a narrowed airway
What is a sonorous wheeze?
Deep, low-pitched rumbling or coarse sound
What percussion sound is caused by bronchitis?
Resonance
Loud, low-pitched and has long duration
What percussion sound is caused by pneumonia?
Dullness
What percussion sound is caused by pneumothorax?
Tympany
What percussion sound is caused by pleural effusion?
Flatness
What does capillary of more than 3 seconds indicate?
Arterial insufficiency to the extremities
What are manifestations of pulmonary tuberculosis?
Night sweats
Low-grade fever
Blood in the sputum
Weight loss
What is an expected finding of a toddler having heart failure?
Orthopnea- difficulty breathing while lying down
What is a manifestation of atelectasis?
Hypoxemia- decreased oxygenation of the red blood cells and cyanosis due to poor oxygen exchange
What is an expected finding for atelectasis for someone who is postoperative?
Increasing dyspnea
What area of the body is the most reliable indicator of central cyanosis?
Oral mucosa
What does rhonchi sound like and what causes it?
Rumbling, snoring or rattling sound resulting from fluid or mucous
What is a sign of DVT?
Dull, aching calf pain
Edema, warmth, and redness in the calf
What finding is expected for a newborn who has a large patent ductus arteriosus?
Systolic murmur
What is an expected finding for right sided heart failure?
Elevated central venous pressure (CVP)
What are manifestations of PAD?
Skin that is cool or cold to the touch
Pale and cyanotic when the extremity is elevated above the heart, and dark red when it is dangling normally
Leg pain at rest
Thickened toenails
What does an S3 sound represent specifically?
Ventricular gallop- cussed by a rush of blood into a ventricle that is stiff or dilated
Can be found in heart failure and hypertension
