Week 3.2 and 3.3 Objective Examination and Effects of Anaesthesia Flashcards

1
Q

When doing observations what should you look at?

A
  • General Appearance
  • Position/posture
  • Colour - may be indicative of cyanosis
  • Clubbing - (in the finger)
  • Thoracic shape
  • Accessory muscle use
  • Breathing pattern
  • Attachments
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

The inspiration to expiration ratio is approximately?

A

1:2

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

Associated with O/E of the chest and leads to increase AP diameter associated with increase resting lung volumes (FRC, RV - hyperinflation)

A

Barrel chest

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

This is the loss of angle between nail and the nail bed and is typically associated with chronic respiratory conditions.

A

Digital clubbing (affects the hands)

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

Accessory muscles shouldn’t be used on quiet breathing. True or false?

A

True

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

What is Pectus carinatum?

A
  • pigeon chest
  • Associated with hyperinflation
  • May be congenital
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

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.

A

Local rib cage paradox

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

What is pectus excavatum?

A

“funnel chest”
- congenital
A restrictive type of pattern for breathing

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

O/E - chest shape, this is an increased flexion of the thoracic spine +/- lateral curvature of the spine

A

Kyphosis/kyphoscoliosis

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

What do you call when intercostal spaces sucked in during inspiratory due to forceful inspiration?

A

Costal Indrawing

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

Happens when abdomen moves in on inspiration. Diaphragm gets fatigue (Really really short of breath)

A

Abdominal Paradox

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

What is the normal rate of breathing?

A

12-16 breaths/min

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

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.

A

Pursed lip breathing

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

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”

A

Rib indrawing

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

what are the O/E you can find in an ADULT patient with respiratory distress?

A
  • SOB
  • increased RR
  • Abnormal breathing pattern eg abdominal paradox
  • use of accessory muscles
  • leaning forward
  • sitting up
  • single word sentences
  • stridor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the O/E you can find in a CHILD patient with respiratory distress?

A
  • indrawing of sternum, intercostal spaces, abdomen
  • Nasal flaring
  • Grunting
  • Stridor
17
Q

Puts the underlying structures in motion and results in resonance
- can help localise a pathology in the thorax

A

Percussion Note

18
Q

This is the transmission of sound through the chest wall
- Vibration felt on the chest wall as the patient speaks - a buzzing sensation

A

Vocal (Tactile) Fremitus

19
Q

When palpating and there is air under the skin what do you call this? it may also be palpated as a popping or crackling sensation.

A

Subcutaneous emphysema (SCE)

20
Q

“A drug-induced reversible depression of the CNS that results in the loss of physiologic response and perception to all external stimuli.”

A

General Anaesthesia

21
Q

A component of General Anaesthesia which reduces stress and anxiety, and increases sedation. Eg midazolam

A

Premed

22
Q

What is induction? (component of General anaesthesia)

A
  • its aim is to quickly initiate anaesthesia.
  • IV short acting coma-inducing drug (Eg Propofol, barbiturates)
  • can be induced via intubation and mechanical ventilation (or laryngeal mask airway in some cases)
23
Q

A component of General Anaesthesia were the anaesthesia is maintained for the duration of the surgical process.
- a combination of inhaled anaesthetic agents, neuromuscular blockade, and analgesics

A

Maintenance

24
Q

A component of general anaesthesia were the concentration of anaesthetic agents are reduced, patient is given drugs that reverse muscle blockade.

A

Reversal

25
Q

A regional anaesthesia where a catheter is inserted into subarachnoid or epidural space.
- Blocks motor, sensory, pain and spymathetic

A

Spina/epidural anaesthesia

26
Q

What is local anaesthesia?

A
  • can be used for peripheral procedures
  • for short term procedures of extremities
    may block a bundle of nerves
27
Q

A surgical complication wherein the wound ruptures due to failure proper wound healing

A

Dehiscence

28
Q

Is a significant cause of mortality and morbidity. Prolongs stay in the hospital and affects 20-30% of patients after a major UAS (upper abdominal surgery) and CT (cardiothoracic) surgery.

A

PPC (Postoperative Pulmonary Complication)

29
Q

What is a clinically significant PPC?

A
  • respiratory failure
  • pneumonia
  • collapse/consolidation
  • secretion retention
30
Q

An Intraop factor that affects the respiratory system by reducing the FRC by 30-40% when induced by ________.

A

Anaesthesia

31
Q

Is always assumed to be the major factor in post op pulmonary dysfunction.
It reduces the ability to increase tidal volume and take deep breath - it may also change the breathing pattern and may reduce one’s ability to cough

A

Pain