Thorax and Lungs

Question 1

Orthopnew

Answer 1

Difficulty breathing when supine

Question 2

Paroxysmal Nocturnal Dyspnea

Answer 2

Awakening from sleep with SOB and needing to be upright to achieve comfort.

Question 3

Crepitus

Answer 3

a grating sound or sensation produced by friction between bone and cartilage or the fractured parts of a bone.

Question 4

Pneumothorax

Answer 4

presence of air or gas in the cavity between the lung and chest wall causing lung atelectasis

Question 5

Bronchophony Test

Answer 5

Ask the patient to repeat the words “ninety nine”. If clear, you can suspect increased lung density as with Pneumonia, edema, or pulmonary fibrosis. The lungs are being pushed on.

Question 6

Egophony

Answer 6

Ask the patient to say “eee” as you listen to the lungs. “eee” becomes an “aaaa” in the compressed of consolidated lung and indicated pathology.

Question 7

Whisper Pectoriloquy

Answer 7

Ask the patient to whisper “1,2,3” if you can clearly hear the words, this indicated even slight compression or consolidation.

Question 8

Forced Expiratory Time

Answer 8

The number of second that it takes for ta person to exhale from total lung capacity to residual volume

Question 9

Forced vital capacity

Answer 9

Measure with spirometer. The total volume of air exhaled

Question 10

FEV1

Answer 10

The forced expiratory volume in 1 second.

Question 11

Ratio between FVC and FEV1

Answer 11

75% or better for healthy

Question 12

Pulse Oximetry

Answer 12

noninvasive method to assess arterial oxygen saturation (SpO2) The healthy persons SpO2 is usually around 99-100% Need to be evaluated in the context of the persons hemoglobin level, acid base balance, and ventilatory status.

Question 13

6-minute walk test

Answer 13

6 MWT, safer, simple, inexpensive, clinically significant, Aging adult. This is to see how far the person can go in 6 minutes. If they can walk 300 meters or more they are more likely to engage in activities of daily living.

Question 14

AP-transverse diameter ratios (child/adult)

Answer 14

Child: Increased until about 6yo (after indicated chronic asthma or cyctic fibrosis)
Adult: 1:2 ratio

Question 15

Infantile Breathing

Answer 15

Obligate nose breathers. Primary Muscle of inspiration is the diaphragm, intercostal muscles are not developed yet. There will be abdominal expansion
Little to no thoracic expansion.
30-40 breaths/minute

Question 16

Stridor

Answer 16

High pitched, inspiratory, crowing sound. Indication of foreign body obstruction, croupe, and epiglottitis

Question 17

Aging Adult Respiratory considerations

Answer 17

AP-T ratio increases = more barrel chested appearance
May tier easily. Dizziness,
Kyphosis may lead to extending and tilting the head back.
Tripod position indicates that the person is trying to get more air. This usually indicates COPD)