Week 1 - Assessment skills and problem lists

Question 1

During your Objective Ax, what might you observe?

Answer 1

General appearance
Position
Chest
Skin colour
Abdomen
Use of accessory muscles
Nasal flaring
Lines, drains
O2 therapy
Quality of voice

Question 2

During your Objective Ax, what might you observe about a persons’ general appearance?

Answer 2

Eyes - anaemia, high Hb, jaundice, drooping, oedema
Hands - tremor (flapping/fine), wastage, clubbing, nicotine, cyanosis, temp
Mouth - dry/ dehydrated, cyanosis, purse lip breathing
Oedema - peripheral, pitting

Question 3

During you Objective Ax, what might you observe about a person’s chest?

Answer 3

Shape - Scoliosis, kyphosis, kyphscoliosis, hyperinflated
WOB/ SOB
Movement - pump handle/ bucket handle
Indrawing/ recession of intercostal spaces
Paradoxical/ Hoovers’ sign/ flail ribs
Tracheal tug

Question 4

What are the muscles of inspiration?

Answer 4

Diaphragm
External IC
Accessory - Scalenes, SCM, pec major/ minor, serratus anterior, lats

Question 5

What are the accessory muscles of expiration?

Answer 5

Rectus Abdominus
Obliques
Transversus Abdominus
Iliocostalis
Longissimus
Serratus Posterior Inferior
QL

Question 6

Describe normal breath sounds

Answer 6

Sounds heard over entire lung fields
Muffled in quality
Quieter further away from trachea
Inspiration louder and longer than expiration
No pause between inspiration and expiration

Question 7

Describe increased/ bronchial breath sounds

Answer 7

Inspiration and expiration are equal pitch, intensity and duration
Definite pause between inspiration and expiration

Question 8

What might cause decreased breath sounds?

Answer 8

Decreased ventilation/ air entry
Decreased mechanics of breathing or chest wall movement
Decreased transmission of sound to the chest wall

Question 9

Give three types of added sounds

Answer 9

Crackles - coarse/ fine
Wheeze - monophonic/ polyphonic
Rub