Thorax and lungs Flashcards

1
Q

Define Adventitious breath sounds

A

abnormal auscultated breath sounds like crackles, rhonchi, wheezes and friction rub

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2
Q

Define Atelectasis

A

incomplete expansion of the lung

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3
Q

Define Barrel chest

A

increased AP diameter, often with some degree of kyphosis - COPD

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4
Q

Define Biot respirations

A

irregular respirations varying in depth and intermittent apnea intervals, no repetitive pattern

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5
Q

Define Bronchiectasis

A

chronic dilation of the bronchi or bronchioles, caused by repeated infections of bronchial obstructions

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6
Q

Define Bronchophony

A

exaggeration of vocal resonance emanating from a bronchus surround by consolidated lung tissue

  • greater clarity and increased loudness of spoken word
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7
Q

Define COPD

A

nonspecific diagnosis of decreased ability of lungs to ventilate - includes chronic bronchitis and emphysema

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8
Q

Define Egophony

A

consolidated lung tissue, e’s turn to a’s

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9
Q

Define Vesicular

A

normal breath sounds:

low pitch, soft, short expirations

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10
Q

Define Tubular

A

normal breath sounds: heard only over trachea, high pitch; loud and long expirations, longer than inspiration

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11
Q

Define Bronchovesicular

A

normal breath sounds:

heard over main bronchus area and over upper right posterior lung field; medium pitch; expiration equals inspiration

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12
Q

Define Othopnea

A

SOB, lying down

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13
Q

Define Pectoriloquy

A

striking transmission of voice sounds through pulmonary structures so they are clearly audible through stethoscope - lung consolidation

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14
Q

Define Pectus carinatum

A

Pigeon chest:

forward protrusion of sterum

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15
Q

Define Pectus excavatum

A

Funnel chest:

depression of sternum

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16
Q

Define Tactile fremitus

A

tremor or vibration in any body part detected on palpation

17
Q

Define Whispered pectoriloquy

A

whisper heard same way as normal speech when lung is consolidated by pneumonia

18
Q

Most sensitive place in chest to look for fluid?

A

Sulcuses where diaphragm meets chest wall

19
Q

Boundaries of horizontal fissure

A

with inhalation = 4th rib at sternum, 5th rib at midaxillary line

20
Q

Boundaries of oblique fissure

A

with inhalation = 6th rib at midaxillary line

21
Q

Basic ausculatation vs. detailed

A

6 points vs 12

22
Q

Normal diaphragm movement height

23
Q

What’s important about right mainstem bronchus?

A

Runs straighter than the left. Aspirated object will more likely be here.
Bifurcation of right and left occurs at sternal angle (2nd rib)

24
Q

Thorax and lungs physical exam - order?

A
  1. LOOK: assess for stability
  2. Listen
  3. Palpate
  4. Percuss
25
Things to LOOK for in PE:
Shape, movement, posture (walking), acting*, accessory muscles Cyanosis, clubbing, edema, bad odor to breath, needle marks *Accessory muscle use is another form of acting ill
26
Tripoding
maximize air space, COPD, epiglottitis
27
Bell use
light touch, just seal skin heart sounds *must be on skin
28
Diaphragm use
dimpling skin is ok | lungs
29
Where to percuss middle lobe?
in front
30
Pulmonary embolism on palpation
localized collapse so ribs don't move over area with embolism
31
Pneumonia on palpation
feel fremitus with consolidation
32
COPD PE
thorax symmetric with moderate kyphosis and increased AP diameter, decreased expansion, hyperresonant lungs, distant breath sounds, delayed expiratory phase, scattered exp. wheezes, diaphragm descent 2 cm bilaterally. fremitus decreased; no bronchophony/egophony or whispered pectoriloquy.
33
Asthma PE
thorax symmetric with flattened kyphosis and normal AP diameter (use secondary muscles of respiration), lungs are resonant (unless bronchial plug), broncho-vesicular breath sounds and scattered expiratory wheezes bilaterally (stronger with forced expiration) No bronchophony, egophony, or whispered pectoriloquy. Diaphragms descend 4cm bilat.
34
Pneumothorax PE
thorax asymmetry, decreased movement on one side, hyperresonant lung on that side, BS decreased on that side in all lobes, diaphragms descend 4 cm on the opposite side only