Thorax/Lungs/Abdomen

Question 1

Barrel Chest

Answer 1

Increased AP diameter of the chest

e.g. Chronic Obstructive Pulmonary Disease

Question 2

Pectus Excavatum

Answer 2

Chest deformity characterized by depression of the lower portion of the sternum (“funnel” chest)
e.g. congenital; Rickets; Marfan’s; Cobbler’s Chest

Question 3

Pectus Carinatum

Answer 3

Chest deformity characterized by the anterior displacement of the sternum (“Pigeon” chest)
e.g. congenital; Rickets; Marfans

Question 4

Tactile Fremitus

Answer 4

palpable vibrations transmitted through the bronchopulmonary tree. Best appreciated by placing the palmer aspect of the metacarpalphalangeal joints against the thorax.
e.g. increased when there is consolidation as with pneumonia; decreased with a bronchial plug or with pleural effusion

Question 5

Percussion Notes

Answer 5

Resonant –over the normal chest
Hyperresonant– in COPD
Dull– over the liver
Flat– over the thigh muscle

Question 6

Vesicular Breath Sounds

Answer 6

Inspiration is longer than expiration (true over most of the thorax)

Question 7

Bronchovesicular Breath Sounds

Answer 7

Inspiration equals expiration in length (between scapulae)

Question 8

Bronchial or Tracheal Breath Sounds

Answer 8

Expiration is longer than inspiration (over suprasternal notch)

Question 9

Crackles

Answer 9

relatively brief, inspiratory non-musical adventitial sounds heard on auscultation of the chest. Come from small airways and can relate to secretions or fibrosis
Fine-Soft, high pitched e.g. CHF
Coarse- louder, lower in pitch e.g pneumonia

Question 10

Rhonchi

Answer 10

low pitched adventitial sounds heard on auscultation of the chest. They are of longer duration than crackles, a snoring-like quality, come from secretions in large airways.
e.g. bronchitis

Question 11

Wheeze

Answer 11

High pitched, musical adventitial sounds heard on auscultation of chest. They are of longer duration than crackles or rhonchi. Caused by air flow through narrowed airways.
e.g. asthma; foreign body in a bronchus.

Question 12

Stridor

Answer 12

an upper airway inspiratory sound caused from airway obstruction in the trachea or larynx. Louder and typically lower pitched than a wheeze. Commonly heard without a stethoscope.
e.g. Croup; foreign body in the trachea

Question 13

Bronchophony

Answer 13

louder than normal and more clearly heard transmitted voice sound.

Question 14

Egophony

Answer 14

the spoken letter “E”” is heard as “A”

Question 15

Whispered pectoriloquy

Answer 15

whispered sounds are heard louder and more clearly

Question 16

Friction Rub

Answer 16

Pleural and cardiac, like pieces of leather rubbed together or a creaking sound. Heard during inspiration and expiration.
e.g. pleuritis; pericarditis

Question 17

Murmurs

Answer 17

relatively prolonged extra heart sounds caused by disruption in blood flow through and out of the heart. Can be pathologic and non.

Question 18

Thrill

Answer 18

palpable vibration over the chest

e.g. may accompany loud murmurs (4/6 or greater)

Question 19

Click

Answer 19

Extra systolic sound of short duration

e.g. mitral valve prolapse

Question 20

Bruit

Answer 20

Basically a murmur over a vessel

e.g. carotid bruit in partially carotid artery occulusion

Question 21

Convex (related to abdomen)

Answer 21

gently rounded

Question 22

Flat (related to abdomen)

Answer 22

not convex or concave

Question 23

Concave or scaphoid (related to abdomen)

Answer 23

concavity

Question 24

Striae

Answer 24

Streaks most often on abdomen . Collagen fiber disrupted.

e.g. stretch marks

Question 25

Bulging Flanks

Answer 25

prominence of flanks

e.g. ascites-free fluid in the abdomen

Question 26

Bowel sounds

Answer 26

borborygmi describes bowel sounds that are frequent and loud peristaltic sounds

Question 27

Ascites signs

Answer 27

1. shifting dullness
2. Fluid wave

Both abnormal findings on abdomen examination

Question 28

Percussion

Answer 28

Dullness over liver and tympanitic with gas in GI tract