Assessment of the Respiratory System

Question 1

5 most common abnormal breath sounds

Answer 1

Wheezing
Rhonchi (Course Crackles)
Rales
Stridor
Pleural Rub

Question 2

identify which of the 5 most common abnormal breath sounds is being described
- caused by airway obstruction
- occur during asthma
- occur during COPD
- occur during interstitial lung disease
- occur during infections
- occur during pulmonary embolism
- occur during aspiration

Answer 2

Wheezing

Question 3

identify which of the 5 most common abnormal breath sounds is being described
- continuous high pitched sound
- whistling sound
- worse on expiration

Answer 3

Wheezing

Question 4

identify which of the 5 most common abnormal breath sounds is being described
- caused by
COPD
Bronchitis
Bronchiectasis
Pneumonia
Chronic Bronchitis
Cystic Fibrosis

Answer 4

Rhonchi or Course Crackles

Question 5

identify which of the 5 most common abnormal breath sounds is being described
- makes low pitched bubbling or rattling sound during inspiration and expiration
- occur in the bronchi

Answer 5

Rhonchi or Course Crackles

Question 6

identify which of the 5 most common abnormal breath sounds is being described
- caused by
Pulmonary edema
Pneumonia
Atelectasis
- occur in alveoli

Answer 6

Rales or Fine Crackles

Question 7

identify which of the 5 most common abnormal breath sounds is being described
- Brief discontinuous popping or cracking sound
- sounds like fire crackling, hair between fingers, and cellophane being crumpled

Answer 7

Rales or Fine Crackles

Question 8

identify which of the 5 most common abnormal breath sounds is being described
- caused by
upper airway narrowing

Obstruction of airway like
Epiglottis, Pertussis, Aspiration, Croup

Answer 8

Stridor

Question 9

identify which of the 5 most common abnormal breath sounds is being described
- loud high pitched whistling or crowing sound
- occurs usually on inspiration

Answer 9

Stridor

Question 10

identify which of the 5 most common abnormal breath sounds is being described
- caused by
inflammation in the pleura
Pleural Effusions
Empyema
Hemothorax

Answer 10

Pleural Rub

Question 11

identify which of the 5 most common abnormal breath sounds is being described
- symmetrical continuous leather creaking localized sound
- Does not change location when a person’s cough

Answer 11

Pleural Rub

Question 12

Where does do they insert needle for tension pneumothorax?

Answer 12

2nd ICS

Question 13

Where do they insert a chest tube

Answer 13

4th ICS

Question 14

large air collection in the pleural space compromises respiration and cardiac function

Answer 14

tension pneumothorax

Question 15

most important examination technique for assessing air flow through the tracheobronchial tree

Answer 15

Auscultation

Question 16

3 Voice sounds

Answer 16

Bronchophony
egophony
Whisper Pectoriloquy

Question 17

Identify which of the 3 breath sounds is being described
- ask the client to repeat the letter “E”
- present when e sound changes to A sound

Answer 17

Egophony

Question 18

Identify which of the 3 breath sounds is being described
- ask the client to repeat the phrase “ninety-nine”
- loud voice heard clearly

Answer 18

Bronchophony

Question 19

Identify which of the 3 breath sounds is being described
- ask the client to whisper the phrase “one-two-three” or “ninety-nine”
- present when whispered sounds are loud and clear

Answer 19

Whispered Pectoriloquy

Question 20

Characteristics of Percussion sounds: Flat

Answer 20

Intensity: Soft
Pitch: High
Duration: Short
Example Location: Thigh

Question 21

Characteristics of Percussion sounds: Dull

Answer 21

Intensity: Medium
Pitch: Medium
Duration: Medium
Example Location: Liver

Question 22

Characteristics of Percussion sounds: Resonant

Answer 22

Intensity: Loud
Pitch: Low
Duration: Long
Example Location: Healthy Lung

Question 23

Characteristics of Percussion sounds: Hyper resonant

Answer 23

Intensity: Very Loud
Pitch: Lower
Duration: Longer
Example Location: Usually None

Question 24

Characteristics of Percussion sounds: Tympanic

Answer 24

Intensity: Loud
Pitch: High
Duration: Longer
Example Location: Gastric Air bubble or puffed out cheek

Question 25

ratio of anteroposterior diameter to transverse diameter

Answer 25

1:2

Question 26

What to note when inspecting

Answer 26

Tracheal deviation Chest wall deformities Kyphosis – curvature of the spine (anterior/posterior) Scoliosis – curvature of the spine (lateral) Barrel Chest – increased anterior/posterior chest wall Pectus excavatum Pectus carinatum

Question 27

Signs of Respiratory Distress

Answer 27

Tachypneic (>25/bpm) Cyanosis (hypoxia) or pallor (heart failure) Pursed-lip breathing Accessory muscle use Diaphragmatic paradox Intercostal indrawing Emphysema Dominant Bronchitis Dominant Paradoxical Breathing

Question 28

Accessory muscles of ventilation

Answer 28

1. scalene 2. sternocleidomastoid 3. pectoralis major 4. trapezius 5. external intercostals.

Question 29

Characteristics of Breath Sounds

Answer 29

Vesicular Broncho Vesicular Bronchial Tracheal

Question 30

Identify Characteristics of Breath Sounds - inspiratory sound longer than expiratory - Intensity: soft - Pitch Low - Location: over most lungs

Answer 30

Vesicular

Question 31

Identify Characteristics of Breath Sounds - Inspiratory and Expiratory almost equal - Intensity: Intermediate - Pitch: Intermediate - Location: 1st and 2nd ICS

Answer 31

Broncho Vesicular

Question 32

Identify Characteristics of Breath Sounds - expiratory lasts longer than inspiratory - Intensity: Loud - Pitch: High - Location: over manubrium

Answer 32

Bronchial

Question 33

Identify Characteristics of Breath Sounds - inspiratory and expiratory sounds almost equal - Intensity: Very Loud - Location: over trachea in the neck

Answer 33

tracheal

Question 34

Continuous Adventitious Breath sounds

Answer 34

Wheezing Rhonchi Stridor

Question 35

Identify Continuous Adventitious Breath sounds - high pitched with snoring quality

Answer 35

Wheezing

Question 36

Identify Continuous Adventitious Breath sounds - Low pitched with snoring quality

Answer 36

Rhonchi

Question 37

Identify Continuous Adventitious Breath sounds - continuous high-frequency high pitch musical sound - best heard over neck during inspiration - caused by airway obstruction

Answer 37

Stridor

Question 38

Discontinuous Adventitious Breath sounds

Answer 38

Fine Crackles Coarse Crackles Pleural Rub

Question 39

Identify Discontinuous Adventitious Breath sounds - soft high pitched sound - very breif

Answer 39

Fine Crackles

Question 40

Identify Discontinuous Adventitious Breath sounds - loud low pitched sound

Answer 40

Coarse Crackles

Question 41

Identify Discontinuous Adventitious Breath sounds - low frequency grating sound - results from inflammation and roughening of visceral pleura

Answer 41

Pleural Rub