week 5 module 14 resp. exam Flashcards
evaluate respirations for the following
rate quality rhythm pattern note any audible sounds with respiration abnormalities
patterns of respiration
tachypnea bradypnea hyperpnea kussmaul hypopnea cheyne-stokes biot
cheyne stokes
regular breathing with apneic episodes
biot
irregular breathing with apnic episodes
abnormalities when observing respirations
use of accessory muscles
retractions
paradoxic breathing
anterior landmarks
midsternal
midclavicular
lateral landmarks
axillary
posterior landmarks
vertebral
scapular
spinous process
palpation of thoracic muscles/skeleton
tenderness bulges depression masses thoracic expansion elasticity of rib cage
tactile fremitus
parasternally at 2nd ICS
palpable vibration of the chest wall that results from speech or other verbalizations
crepitus
crackly or crinkly sensation
- indicates air in the subcutaneous tissue
- rupture somewhere in the resp. system
- infection with gas-producing organism
friction rub
palpable
coarse
grating vibration
percussion tone indicators for lungs
resonance: normal
hyperresonance: hyperinflation
dullness: diminished air exchange
- fluid-filled or tissue filled
reasons for hyperresonance/hyperinflation
COPD
emphysema
pneumothorax
asthma
reasons for dull: diminished air exchange
pneumonia
atelectasis
pleural effusion
asthma
vesicular breath sounds
low pitched low intensity heard over healthy lung tissue - normal throughout the periphery soft and short expirations
bronchovesicular breath sounds
heard over the major bronchi
typically moderate in pitch and intensity
expiration equals inspiration
bronchial breath sounds
highest in pitch and intensity
heard over the trachea
loud long expirations
crackles
also called rales heard more during inspiration fine: high pitched, relatively short in duration coarse: low pitched, longer in duration - fluid in alveoli -- HF, edema
Ronchi
also called sonorous wheezes
deeper, more rumbling, more pronounced during expiration
caused by passage of air through a partial obstruction
- secretions
– bronchitis, pneumonia
wheezes
continuous, high-pitched sound heard during inspiration or expiration
- high velocity of air through narrow airway
friction rub
occurs outside the respiratory tree dry, crackly, grating, low-pitched usually heard over lower lateral anterior surface - inflammed pleura -- hold breath --- rub disappears: respiratory issue --- rub still there: cardiac issue
bronchophony
greater clarity and increased loudness of spoken sounds
pectoriloquy
extreme bronchophony where even a whisper can be heard clearly through the stethoscope
egophony
intensity of the spoken voice is increased and there is a nasal quality
e becomes a
dec. or absent fremitus
excess air in the lungs
epmphysema
pleural thickening or effusion
bronchial obstruction
inc. fremitus
presence of fluids or solid mass in the lungs
lung consolidation
compressed lung
platypnea
dyspnea increases in the upright posture
