wk 1: PE part 2

Question 1

¬ Auscultation

* Breath Sounds

Answer 1

o [BS] Breath sounds (Normal, Vesicular, Pleural Effusion)
♣ Localised BS intensity > local airway obstruction
♣ Generalised BS intensity > large air spaces (e.g. emphysema)

Question 2

¬ Auscultation

o BB] Bronchial breath sounds

Answer 2

♣ Bronchial breathing > Consolidation (‘solid’ lung) > dec. no. of interfaces > dec attenuation > inc. BS

Question 3

¬ Auscultation
o [AS] Added/Adventitious Sounds
WHEEZE

Answer 3

Wheeze : INTRAthoracic vibration or flutter of (almost) touching sides of the airway
o Expiration : airways narrower, wheeze more likely/more intense
o Synchronous when airways obstruct at the same time (e.g. late in normal forced expiration)
o Asynchronous and Multiple: arise from different airways obstructing at different phases of the respiratory cycle

Question 4

¬ Auscultation
o [AS] Added/Adventitious Sounds
STRIDOR

Answer 4

• Stridor: EXTRAthoracic heard at mouth and over the trachea rather than over the chest - NECK
o Inspiration: diameter of airway is decreased on inspiration

Question 5

¬ Auscultation
o [AS] Added/Adventitious Sounds
CRACKLES

Answer 5

o Coarse Crackles indicate secretions, or diffuse small airways disease
o Fine End-Inspiratory atelectasis = sudden opening of distal airways
o Fine Crackles: Diffuse Interstitial Pulmonary Fibrosis, Left Heart Failure

Question 6

¬ Cough

Answer 6

o	Strength (Weak, Fair, Strong)
o	Dry/Moist
o	Effective/ineffective
o	Productive/Non-productive
o	Sputum (quality/quantity)

Question 7

¬ Neural] Lower Limbs

Answer 7

o Oedema
o Deep Vein Thrombosis (Colour, Temperature, Palpation, Homan’s sign)
o Circulation (Dorsalis Pedis, Posterior Tibial)
o Peripheral Perfusion (Capillary refill)
o Musculoskeletal (ROM, Strength)
o Neurological (Sensation, Tone)

Question 8

MOBILITY

Answer 8

¬ Mobility
o Bed Mobility (Rolling, Getting out of bed, Sit to stand, Transfers)
o Gait
o Balance (Sitting, Standing, *Higher level as appropriate)

Question 9

¬ Specific Assessment

Answer 9

o Pulse Oximetry (SpO2, HR, At rest/exertion, Supplemental O2)
o **Epidural (P/I, Sensation, Muscle Strength)
o Exercise Capacity (6MWT, Shuttle walk
o Quality of Life Questionnaires (St. George Respiratory Disease, Cystic Fibrosis Questionnaire)
o Dyspnoea scales/questionnaire (BORG, Medical Research Council)
o Other Measures (Lifespan, Neurological, Musculoskeletal)