Vitals and Heart/Lung Examination Flashcards
average temp
98.6 or 37
radial pulse
60-100 bpm
- less than 60=bradycardia
- greater than 100= tachycardia
respirations
normal = 14-20
- tachypnea = fast breathing
- bradypnea = slow breathing
- apnea = no breathing
cheyne-stokes breathing
decreased rates and periods of apnea
kussmaul’s respirations
hyperventalition from metabolic acidosis
blood pressure normal
120/80
pre-hypertension
120-139/ 80-89
stage 1 hypertension
140-159/90-99
stage 2 hypertension
> 160 / >100
orthostatic BP
- if the systolic BP drops 20 or more, or the diastolic pressure drops 10 or more upon standing
- heart rate increases 15 beats per minute or more
- this can be due to volume depletion… normally the BP and heart rate will rise slightly as a nartural response to a change in position from supine to sitting to standing
bell vs diaphragm
bell = low frequency diaphragm = high frequency
systolic vs diastolic
systolic = when first hear sounds, diastolic when sounds disappear
hemoptysis
coughing up blood from lungs
- most ocmmonly caused by infections
hemoptysis
coughing up blood from lungs
- most ocmmonly caused by infections
dyspnea
shortness of breath
dyspnea
shortness of breath
orthopnea
difficulty breathing when lying flat
orthopnea
difficulty breathing when lying flat
wheezing
high pitched sound due to partially obstructed airway
wheezing
high pitched sound due to partially obstructed airway
pleuritic pain
chest wall pain associated with breathing
pleuritic pain
chest wall pain associated with breathing
respiratory examination
- inspection, palpation, percussion, auscultation
respiratory examination
- inspection, palpation, percussion, auscultation
dull, resonant, tympanic, flat
- dull = percussion over solid organ (liver)
- resonant = structure containing air (lung)
- tympanic = percussion over hollow/air structure (stomach)
- flat = percussion over large muscle mass
tracheal sound
very loud, high pitched, harsh, heard over trachea and neck
bronchial
loud, high pitched - tubular sounding, heard over maubrium
bronchovesicular
moderate loud, moderate pitch, tubular rustling sound, heard over mainstem bronchi
vesicular
- soft, low pitch, gentle rustling, heard over most of the lungs
rales/crackles
result of opening and closing of alveoli - i.e. pulmonary edema where aleveoli are filled with fluid
5 auscultation points
- Aortic: right sternal 2nd ICS- RSB
- Pulmonic: left 2nd ICS - LSB
- Erb’s point (location of S2 heard); left 3rd ICS - LSB
- Tricuspid: left 4th ICS - LSB
- Mitral (PMI): left 5th ICS - MCL
rhonchi
low pitched sound arising from turbulent airflow and vibrations of the walls of larger airways being partially abstructed - i.e. bronchitis
SA node
= pacemaker - makes AP wave that stimulates the AV node (Bundle of His). AV node spreads electrical impulse through the rest of the heart
P wave, QRS complex, T wave
P = atrial contraction, QRS= ventricular contraction, Twave = ventricular repolarization
PMI
The PMI – Point of Maximal Impulse or
Apical Impulse
Location: -fifth intercostal space (5ICS)
-mid-clavicular line (MCL)
Thrills and heaves
Thrill – a palpable vibration felt over the precordium.
Heave – a palpable impulse or displacement of the sternum and/or precordium.
5 auscultation points
- Aortic: right sternal 2nd ICS- RSB
- Pulmonic: left 2nd ICS - LSB
- Erb’s point (location of S2 heard); left 3rd ICS - LSB
- Tricuspid: left 4th ICS - LSB
- Mitral (PMI): left 5th ICS - MCL
S1
s1–>S2 = systole “lub”
- closure of tricuspid and mitral valves
S2
dub
- closure of aortic and pulmonic valves
abdomen examination
inspection, auscultation, percussion, palpation
RLQ = best place to listen - secum: small bowel goes to large bowel
borborygmi
increased bowel sounds, low pitched rumbling
abdominal bruits
soft sound made by disrupted arterial flow through narrowed artery
tympany
- most common abdominal percussion notes - due to presence of gas in stomach and small bowel
percussion of liver
- right mid-clavicular line: should hear resonant (lungs) to dull (liver) to tympanic (intestine)
- liver is on RUQ (spleen is LUQ)
