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Physical Assessment > Week 3 Respiratory and Breast > Flashcards

Week 3 Respiratory and Breast Flashcards

1
Q

T/F High pitched noise louder during inspiration indicating partial obstruction is called what?

A

stridor

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2
Q

T/F Bronchovesicular sounds are heard in the second and third intercostal space in the interscapular area?

A

True

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3
Q

Breathing pattern of extreme rate and depth assess for DKA

A

Kussmaul

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4
Q

Shape ssociated with COPD

A

Barrel chest

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5
Q

All are normal breath sounds except what?

A

rhonchi

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6
Q

70-year old complaining of fever and confusion can mean what?

A

Pneumonia

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7
Q

Decreased wall expansion on one side means what respiratory disease?

A

pneumothorax

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8
Q

Normal sounds percussion on lung fields

A

Resonance

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9
Q

Decreased oxygenation of blood cells mean what?

A

hypoxemia

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10
Q

Which side of the body has three lobes in the lungs?

A

Right, and the left only has two

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11
Q

What is the order in which the chest is assessed?

A

Inspection, palpation, auscultation

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12
Q

What are you assessing at in the anterior part of the chest?

A

Color, symmetry, clavicles, chest wall itself

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13
Q

What does unlevel shoulders mean?

A

Pneumothorax or collapsed lung

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14
Q

What is the proportion of the diameter of the chest?

A

The lateral diameter is larger than the anteroposterior diameter of the chest

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15
Q

What a normal chest proportion

A

L to A/P 2:1

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16
Q

What kind of chest proportion would a barrel chest patient have?

A

L to A/P 1:1

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17
Q

What is pectus carinatum? Aka? Cures?

A

Pigeon chest is when the sternum protrudes outward and this is congenital and will require surgery to correct.

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18
Q

What is pectus excavatum? Aka?

A

Funnel chest is a congenital deformity where the sternum is going inward and chest compression may interfere with respiration and cause murmurs

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19
Q

What does the respiratory pattern of kussmaul look like?

A

Rapid and deep, so fast and goes up and down. Labored.

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20
Q

How early do you check for scoliosis?

A

11-12 y.o.

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21
Q

What is a lateral curvature and rotation of the thoracic and lumbar spine?

A

scoliosis

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22
Q

What does someone with kyphosis look like?

A

A hunchback because there is a curvature of the thoracic spine

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23
Q

What causes kyphosis? And what complications are there?

A

Old age and causes decreases lung expansion and increase in cardiac problems

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24
Q

What causes lordosis and what is it?

A

Lower back curves forward toward the pelvis too much when the belly is big like in pregnant women and toddlers

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25
Q

At what point does scoliosis affect the lungs?

A

When greater than 45 degrees

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26
Q

A curve in the middle or lumbar area, it can be what?

A

scoliosis

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27
Q

What type of palpation do you use for the chest wall?

A

Indirect palpation to assess for vibrations

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28
Q

What is tactile fremitus?

A

When the back is palpated, the back is felt for vibrations

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29
Q

What is diaphragmatic excursion and how is it performed?

A

You are looking for even expansion of the lungs while you place your hand in a “w” formation at the base of the ribs and feel the patient breathing

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30
Q

Where are tracheal sounds heard? What is the quality?

A

Over the trachea, harsh, high pitched

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31
Q

Where are bronchial sounds heard? What is the quality?

A

Next to the trachea, superior to each clavicle and in the first intercostal space, loud, high pitched

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32
Q

Where are bronchovesicular sounds heard? What is the quality?

A

Over major bronchi in the 2nd and 3rd intercostal spaces between the scapulae, and medium loudness, medium pitch

33
Q

Where are vesicular sounds heard? What is the quality?

A

Remainder of lungs, soft low pitched

34
Q

What breath sounds have inspiration less than expiration?

A

Tracheal and bronchial

35
Q

What lung sound would expiration be greater than inspiration?

A

Tracheal and Bronchial

36
Q

What lung sound would expiration be equal to inspiration?

A

Bronchovesicular

37
Q

What would you hear with atelectasis and what does it indicate?

A

Silence from a collapsed alveoli

38
Q

Where in the airway would cause stridor?

A

Inspiration in the upper airway aka croup

39
Q

What causes rhonchi and when is it heard? Aka

A

Wheezes or sibilant (hissing) is heard upon expiration and inspiration and is high pitched, and continuous and with a blocked airflow in asthma

40
Q

What causes rales and when is it heard? Aka

A

Crackles are ear at the end of inspiration and high pitched, and with collapsed or fluid filled alveoli

41
Q

What might cause a friction rub?

A

Inhalation/exhalation and pleural inflammation

42
Q

What would you hear with consolidation?

A

Muffled sounds in the lower lobes normally, but with consolidation, the sound in lower lobes are louder than normal

43
Q

What is consolidation caused by?

A

Fluid filled lungs tissue, usually filled with air

44
Q

What is normal bronchophony?

A

Sound from the top is less muffled because of the bigger airway

45
Q

What is abnormal bronchophony?

A

“99” Sound sounds the same in upper and lower lobes because there is fluid in the lungs

46
Q

What is normal egophony? What sound do you use?

A

Use “eee” and it would be more distinct on the top than the bottom because the sound gets more muffled toward the bottom

47
Q

What is abnormal egophony? What sound do you use?

A

Patient says “eee”, but it sounds like “aahh” so there might be consolidation

48
Q

What is whispered pectoriloquy? What sound do you use?

A

Whispered “99” and the sound up top sounds more clear than the bottom

49
Q

What is abnormal whispered pectoriloquy?

A

Sounds the same throughout all lung fields, which might mean consolidation throughout

50
Q

What is the normal sound for indirect percussion of the chest?

A

resonance

51
Q

What might an elderly patient with respiratory distress have?

A

ALOC

52
Q

If a patient has a hemothorax, what might the patient have and what do you do with it?

A

Chest tube, and don’t empty it, but just measure it.

53
Q

What is a hemothorax

A

Blood in the lungs

54
Q

What does the breast area consist of?

A

Areola, adipose tissue, nipple, Montgomery glands, and tail of spence (goes under the axillae)

55
Q

Where do tumors usually like to hang out?

A

Upper outside in the tail of spence

56
Q

How are the breasts divided?

A

In four quadrants

57
Q

How would the patient be positioned for a breast exam?

A

Hands over head
Hands on hips
Leaning forward

58
Q

What do you look for in an initial breast assessment?

A

Color, symmetry, similar, uncracked, no discharge nipples, dimpling

59
Q

Breast assessment cancer assessment

A

Lumps- inspect and palpate for lumps, and masses
Mammary changes- inspect and palpate for dimpling, tenderness, abnormal contours
Nipple changes- inspect and palpate for retraction, lesions, and discharge
Other symptoms- check size, symmetry, appearance of skin, direction of pointing rashes, and ulceration
Patient risk factors- family history

60
Q

What is the order of assessment techniques?

A

Inspect and palpate

61
Q

In what direction should you exam the breast

A

Start at the axillary and move toward the nipple

62
Q

When is the best time to do a self- breast exam?

A

5-7 days after menses in the shower

63
Q

What should an abnormal breast lump feel like?

A

Hard and fixed, and initially not painful

64
Q

What might the skin look like with cancer?

A

Dimpling

65
Q

What kind of discharge might be present with breast cancer?

A

bloody

66
Q

What is the benign breast problem called and what does it feel like?

A

After the menses, the breasts are tender and the lump is moveable and can be taken care of with compresses and low sodium diet

67
Q

What causes gynecomastia?

A

Males with extra breast tissues and an excess of hormones

68
Q

What is it called if someone has an extra nipple?

A

Supernumerary nipple

69
Q

What can cause peau d’ orange?

A

Inflamed blocked mammary nipple

70
Q

What causes Paget’s disease and what does it look like?

A

Nipple’s areola is deformed and the areola have irregular borders and causes by condition associated with breast cancer

71
Q

What is Stage one of breast development?

A

Preadolescent- only the nipple raised above the level of the breast

72
Q

What is the budding stage?

A

Stage two where the areola increased in diameter and surrounding area slightly elevated

73
Q

When would the breast and areola be enlarged, No contour separation.

A

stage three

74
Q

What stage do you have an areola that forms a secondary elevation above that of the breast in half of girls?

A

Stage four

75
Q

What Tanner stage would you find the areola usually part of the general breast contour and is strongly pigmented?

A

Stage five

76
Q

What breath sound has inspiration less than expiration?

A

Tracheal and bronchial

77
Q

Which breath sound has inspiration equal to expiration?

A

Bronchovesicular

78
Q

Which breath sound has expiration greater than inspiration?

A

Bronchial and tracheal

Physical Assessment (4 decks)

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