Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MD2 FT > W2L6 Respiratory Exam > Flashcards

W2L6 Respiratory Exam Flashcards

1
Q

PA vs AP x-ray:

A

PA= hug the X-ray film. Small heart.

AP= X-ray film behind (eg: lying in bed and film slipped behind you). Big heart.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is ABPA?

A

Allergic bronchopulmonary aspergillosis= aspergillosis pneumonia

Type III hypersensitivity (antigen- antibody complexes)

Occurs in atopic people eg people with asthma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the signs of hyper inflated lungs on CXR (3)?

A
  1. serrated diaphragm at the intercostal origin of the diaphrag
  2. flat diaphragm (decreased costo-diaphragmatic angle)
  3. Increased retrosternal space on a lateral film
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How does a pleural effusion look different to consolidation on a plane film?

A

pleural effusion has a curved edge, and looks different in different planes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the resp causes of clubbing? (3)

examples/ assF of each

A

Respiratory: suppurative lung disease (bronciectasis, TB, abscess, empyema), NSCLC (malignant hypertrophic pulmonary osteohypertrophy–> will also have tenderness of ulna and radius), pulmonary fibrosis (CF, asbestosis, idiopathoc, mesothelioma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the cardio causes of clubbing (3)?

A

Cardiac: Cyanotic HD, endocarditis, left atrial myxoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the GI causes of clubbing? (3)

A

GI: cirrhosis, IBD, coeliac

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the endo causes of clubbing? (1)

A

endo: thyrotoxicosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the condition combining clubbing and periostitis of the small hand joints, especially the distal interphalangeal joints associated with NSCLC called?

A

malignant hypertrophic pulmonary osteohypertrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How much deoxy Hb do you need to have central cyanosis?

A

> 4g/100ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the 2 types of cyanosis and what are their signs?

What is their relationship?

A

Peripheral= circulatory insufficiency= not enough O2 delivery per extraction rate

Central= respiratory insufficiency= decreased O2 saturation of Hb/ shunt

Peripheral cyanosis will always accompany central cyanosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is asterixis a sign of (in a resp exam)

A

hypercapnea (hold hands out and up and bend elbows a bit, push against hands if they have an altered mental state)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Is it normal to be able to see someone breathing when they are at rest and clothed?

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the surface markings of the lungs?

A

Hila: Costal cartilages 3-4; this is vertebral level T5-7.

Inferior margins of the lung are:
T6 - mid-clavicular line
T8 - mid-axillary line
T10 - posteriorly At each point, the parietal pleural reflections sit inferiorly by approximately 2 ribs.

Oblique fissure: The oblique fissure begins posteriorly at the level of the spine of vertebra TIV, passes inferiorly crossing rib IV, the fourth intercostal space, and rib V. It crosses the fifth intercostal space at the midaxillary line and continues anteriorly along the contour of rib VI.

Horizontal fissure: The horizontal fissure starts at rib V in the midaxillary space and continues anteriorly, crossing the fourth intercostal space and following the contour of rib IV and its costal cartilage to the sternum.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is paradoxical movement of chest and abdomen a sign of?

A

Chest moved in during inspiration and out during expiration. This is a sign of:

  1. traumatic injury to the thorax (flail chest), in which several ribs are fractured in two or more places and are no longer attached by bony cartilage to the rest of the rib cage.
  2. surgical removal of several ribs
  3. paralysis of the diaphragm
  4. secondary to respiratory muscle fatigue in patients with acute ventilatory failure.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is a barrel chest indicative of?

A

Anteroposterior diameter of the chest in increased compared to the lateral diameter. AP diameter/ lateral diameter= thoracic ratio. Beyond 0.9= abnormal.

Sign of hyperinflation associated with severe asthma or emphysema.

17
Q

What is kyphoscoliosis indicative of?

A

exaggerated forward curvature of the spine and lateral bowing of the spine. causes are idiopathic, marfans, polio.
My reduce lung capacity and increase WOB.

18
Q

what is a funnel chest indicative of?

A

Localised depression of the lower end of the sternum. May restrict lung capacity.

19
Q

What is a pigeon chest indicative of?

A

Outward bowing of the sternum and costal cartilages.

Caused by chronic childhood resp disease–> repeated strong contractions of the diaphragm which the thorax is still pliable. ALSO in rickets.

20
Q

Causes of increased percussion note?

A

Pneumothorax, hyperinflation due to COPD/ chronic asthma, lung cyst.

21
Q

Causes of decreased percussion note?

A 
Consolidation (pneumonia, tumour), 
fluid (pulm oedema, pleural effusion), 
atelectasis, 
dense fibrosis, 
elevated hemidiaphragm (pulled up, pushed up or paralysed)
22
Q

Describe bronchial breathing?

What can cause bronchial breathing?

A

Louder and lower pitched breath sounds.

Expiration as long as inspiration

PAUSE between expiration and inspiration

Causes: consolidation without proximal obstruction, can sometimes also be caused by collapse or pleural effusion.

23
Q

What is the term for normal breathing? What are its features?

A

Vesicular breathing. No pause, expiration sounds shorter than inspiration.

24
Q

What causes decreased breath sounds?

A

airflow obstruction, hyperinflation, pleural effusion or pneumothorax, thick chest wall, lung collapse (may be caused by a proximal consolidation)

25
Q

What are rhonchi and what causes them?

A

Snoring, gurgling. Rhonchi are often a low-pitched moan that is more prominent on exhalation. It differs from wheezes in that wheezes are high and squeaky while these are low and dull.

Rhonchi are caused by partial blockages to the main airways by mucous, lesions, or foreign bodies. Pneumonia, chronic bronchitis, and cystic fibrosis are patient populations that commonly present with rhonchi.

Coughing can sometimes clear this breath sound and make it change to a different sound.

26
Q

What are wheezes and what causes them?

A

Musical sounds caused by partial bronchial obstruction.

Can be caused by asthma,chronic bronchitis,pulmonary
oedema, foreign body, lung tumour

27
Q

What do crepitations sound like and what causes them? 2 kinds.

A

Short explosive non musical sounds
– High or low pitched
– Inspiratory or expiratory

Mechanism
1. Bubbling of air through secretions: caused by pulmonary oedema (eg heart failure, ARDS, sepsis), bronchopneumonia. Will occur throughout inspiration and expiration.

  1. Sudden opening of small airways and alveoli with rapid equalisation of pressures. On expiration alveoli collapse, and then when you breathe in they pop open. Caused by pulmonary fibrosis. Occur 1/2 way through or towards the end of inspiration. Higher pitched and have a ‘metallic’ or ‘velcro’ sound.
28
Q

What is pleural rub? Sound, mechanism, causes.

A

Non musical sound, usually longer and lower pitch than crepitations, inspiratory with mirror image in expiration, not cleared by coughing, may be may be palpable and often associated with pleuritic pain (pain fibres are in the pleura, not the lung).

• Mechanism - sliding of roughed pleural surfaces (without intervening pleural fluid)

• Causes
– Inflammation (infective and non infective)–> may cause with increased inflammation due to increased fluid.
– Tumour

29
Q

How do you elicit forced expiratory time, what does it test and what is an abnormal result?

A

Bedside test of lung function. Breath sounds stop at about the VC therefore shouldn’t hear them for more that 3 secs. Listen over the trachea (with steth)

  • Usually less than 3 seconds.
  • More than 6 seconds indicates significant airflow obstruction
30
Q

What do you look for in the abdomen in a resp exam?

A

features of right heart failure, liver metastases

31
Q

What do you look for in the legs in a resp exam?

A

features of right heart failure, venous thrombosis

32
Q

What are the spirometry signs of obstruction?

A

low FEV1, normal FVC, low FER (FEV1/FVC)

33
Q

What is a normal FEV1?

A

80%

34
Q

What are the spirometry signs of restriction?

A

low FEV1, low FVC, normal FER.

35
Q

What are the signs of consolidation on exam?

A

Usually no shift in trachea and small change in chest movement
• decreased percussion note
•  increased breath sounds (bronchial, +/-
crepitations)
• increased vocal resonance

36
Q

What are the signs of pleural effusion on exam?

A

Mediastinal shift and decreased movement only if very large
• decreased percussion note
• decreased breath sounds
• decreased vocal resonance

37
Q

What are the signs of pneumothorax effusion on exam?

A
  • Shift of mediastinum (depending on size)
  • decreased movement (sometimes)
  • increased percussion note
  •  decreased breath sounds
  •  decreased vocal resonance

(if small cant detect)

38
Q

What are the signs of pulmonary ht?

A

– Palpable RV heave
– Loud P2
– S4 present
– increased a wave of JVP

39
Q

What are the signs of RHF?

A

– Elevated JV pressure
– 3rd heart sound
– Peripheraloedema, ascites, pleural effusions

MD2 FT (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions