Week 8 - Lung Thorax Exam Flashcards
What should you inspect on the posterior thorax exam?
Anatomic Abnormalities: Barrel Chest or Kyphosis
Rate and Rhythm: Tachypnea or Hyperpnea?
4 things to assess on palpation of posterior thorax exam?
- Identify areas of tenderness
- Assess expansion
- Assess tactile fremitus: Have patient say “99” while you touch the chest
- Special maneuver: Identification of a rib fracture
How is percussion helpful?
Percussion helps differentiate lungs that are full of air, fluid, or solid masses.
Percussion Note: Dull
Where might you find this sound in a healthy person?
What pathology might it signify?
Location: like over liver
Path: lobar pneumonia
What is the sound of a normal, healthy, air-filled lung?
Resonant
Percussion Note: Hyperresonant
Where might it normally be found in the body?
What pathology might be assoc. with this note in the lung?
Not normally found in the body
Path: emphysema
If auscultating on top of the clothing, how much might sound transmission be diminished?
Never attempt to auscultate through clothes or gown! Transmission of sounds can be diminished by as much as 10 Db.
3 things to take note of while performing anterior thorax exam: inspection
- Signs of labored breathing, use of accessory muscles, sitting forward, exhaling with pursed lips.
- Position of the trachea.
- Anatomic abnormalities, incl: pigeon chest, funnel chest (pectus excavatum), barrel chest.
Anterior Thorax: Palpation - what 3 things will you note?
- Note any tender areas.
- Assess respiratory expansion.
- Assess tactile fremitus.
What area is important not to forget when percussing and/or auscultating the anterior thorax?
Anterior and lateral chest. Don’t forget the right middle lobe (RML)!
What sounds are made using egophony?
“eeee”
“aaayyy” may indicate pathology
What sounds are made using bronchophony?
A-B-C
Should sound muffled - note if/where you hear the letters clearly.
What sounds are made using pectoriloquy?
1-2-3
