Week 3.2 and 3.3 Objective Examination and Effects of Anaesthesia Flashcards
When doing observations what should you look at?
- General Appearance
- Position/posture
- Colour - may be indicative of cyanosis
- Clubbing - (in the finger)
- Thoracic shape
- Accessory muscle use
- Breathing pattern
- Attachments
The inspiration to expiration ratio is approximately?
1:2
Associated with O/E of the chest and leads to increase AP diameter associated with increase resting lung volumes (FRC, RV - hyperinflation)
Barrel chest
This is the loss of angle between nail and the nail bed and is typically associated with chronic respiratory conditions.
Digital clubbing (affects the hands)
Accessory muscles shouldn’t be used on quiet breathing. True or false?
True
What is Pectus carinatum?
- pigeon chest
- Associated with hyperinflation
- May be congenital
Happens when a section or part of the ribcage moves in on inspiration. - can be due to #ribs, flail segment. There is a loss of structural integrity of the chest wall.
Local rib cage paradox
What is pectus excavatum?
“funnel chest”
- congenital
A restrictive type of pattern for breathing
O/E - chest shape, this is an increased flexion of the thoracic spine +/- lateral curvature of the spine
Kyphosis/kyphoscoliosis
What do you call when intercostal spaces sucked in during inspiratory due to forceful inspiration?
Costal Indrawing
Happens when abdomen moves in on inspiration. Diaphragm gets fatigue (Really really short of breath)
Abdominal Paradox
What is the normal rate of breathing?
12-16 breaths/min
Part of O/E abnormal breathing patterns. It is adopted spontaneously by some patients and is also used as a treatment by physios. Usually happens in expiration.
Pursed lip breathing
The bottom ribs is drawn in by diaphragm contraction is called?
- Occurs in patients with COPD - hyperinflation causes low flat diaphragm - can’t actively contract and descend.
“Hoovers sign”
Rib indrawing
what are the O/E you can find in an ADULT patient with respiratory distress?
- SOB
- increased RR
- Abnormal breathing pattern eg abdominal paradox
- use of accessory muscles
- leaning forward
- sitting up
- single word sentences
- stridor