Week 6 Flashcards
Chest XR Interpretation
Airway, apices Bones Cardiac Diaphragms Extras Frame
Bronchial Pulmonary Dysplasia
common in premature infants
tachypnea, grunting, increased respiratory effort, retractions, irritability
Pectus Excavatum
congenital
depression over breast bone
Pectus Carinatum
Pigeon chest
opposite of depression- bowing of breast bone
Croup
laryngo-tracheal-bronchitis usually viral generally worse at night inflammation of larynx, subglottic area barking or seal-like cough
Pneumonia in Infants
inflammation of lung tissue usually viral (over 5 yo) crackles or rhonchi a negative CXR does not rule out! very clinical dx
Readiness to quit smoking
o Ask about tobacco use o Advise to quit o Assess willingness to make a quit attempt o Assist in quit attempt o Arrange follow up
fremitus
decreased when voice is higher pitched or soft when transmission of vibrations is impeded
Causes of decreased fremitus
thick chest wall obtructed bronchus COPD pleural effusion fibrosis air (pneumothorax) tumor
Percussion: Flat
soft intensity
high pitched
short duration
ex: thigh
Percussion: Dull
medium intensity
medium pitch
medium duration
ex: liver
Percussion: Resonant
loud intensity
low pitch
long duration
ex: lung
Hyperresonant
very loud intensity
low pitch
long duration
Tympanitic
loud intensity
high pitch
long duration
ex: gastric air bubble
Vesicular sounds
soft
low pitch
heard through inspiration
Bronchovesicular sounds
intermediate intensity
with inspiratory + expiratory
detecting easier during expiration
Bronchial sounds
louder, harsher, higher in pitch
short silence between inspiratory + expiratory
Tracheal sounds
loud, harsh sounds
Crackles- conditions heard in
Pneumonia Interstitial Lung Disease Atelectasis Heart failure Bronchitis Bronchiectasis
Fine late inspiratory crackles
abnormal lung tissue
Pleural rubs- conditions heard in
Pleurisy
pneumonia
pulmonary embolism
Causes of Chest Pain
Angina pectoris MI pericarditis Aortic dissection Pleuritic pain GERD Diffuse esophageal spasm costochondritis Anxiety
Causes of Dyspnea
Left sided heart failure Chronic bronchitis COPD Asthma Interstitial Lung Disease Pneumonia Pneumothorax PE Anxiety with hyperventilation
Laryngitis
dry cough
often with viral rhinosinusitis
Acute Bronchitis
cough, dry or productive
acute, viral without fever
Mycoplasma & Viral Pneumonia
dry hacking cough
may become productive of mucoid sputum
Bacterial Pneumonia
sputum is mucoid, purulent, may be blood-streaked,
Postnasal drip
chronic cough, sputum is mucoid or purulent
associated with allergic rhinitis
bronchiectasis
chronic cough
purulent sputum, may be bloody
recurrent bronchopulmonary infections common
GERD
chronic cough
wheezing
early morning hoarseness, repeated attempts to clear throat
crackles
discontinuous nonmusical sounds
small airways are deflated during expiration, pop open with inspiration
Fine crackles
softer, high pitched
mid to late inspiration
Coarse crackles
lower frequency, longer duration
early inspiration, last through expiration
popping sounds over lobe
COPD, asthma, pna, bronchiectasis
Wheezes
continuous musical sounds
occur during rapid airflow
Rhonchi
variant of wheezes, lower in pitch
may disappear with coughing
Stridor
continuous high pitch, high frequency
musical sound
during airflow through narrowing of tract
Pleural Rub
discontinuous, low frequency , grating sound
d/t inflammation as it slides against pleura
nonmusical sound
biphasic
Mediastinal Crunch
precordial crackles
synchronous with heartbeat
LL position, d/t air in mediastinum
