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Physiotherapy Competency Exam > Cardiorespiratory Physical Examination > Flashcards

Cardiorespiratory Physical Examination Flashcards

(60 cards)

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1
Q

What are the four components of Cardiorespiratory physical examination (IPPA)?

A
  1. Inspection
  2. Palpation
  3. Percussion
  4. Auscultation
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2
Q

What does “Inspection” require?

A
  1. Vital Signs
  2. Mechanisms of Ventilation
  3. Thoracic Shape
  4. Head, neck and extremities
  5. Speech, cough, sputum
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3
Q

Where should you palpate to check the pulse?

A

Radial artery with index and middle finger DON’T USE THUMB

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4
Q

Bradycardia

A

Slow heart rate < 60BPM

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5
Q

Tachycardia

A

Fast heart rate > 100BPM

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6
Q

Normal resting heart rate range for adults

A

60-100BPM

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7
Q

Normal resting heart rate for children (1-8 years)

A

80-100BPM

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8
Q

Normal resting heart rate for infants (1-12 months)

A

100-120BPM

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9
Q

Normal resting heart rate Neonates (1-28 days)

A

120-160BPM

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10
Q

What is an irregular and inconsistent heart rate associated with?

A

atrial fibrilation

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11
Q

Should you let a patient know when you’re assessing the respiratory rate?

A

No, because then it will cause them to alter their breathing pattern. Assess their resp rate while taking their pulse, and do not tell them that you are checking their respiration rate. Count breaths and beats for 15 seconds and multiply the number by 4.

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12
Q

What are the normal ranges for the respiratory rate in adults?

A

12-20 breaths/min

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13
Q

What are the normal ranges for the respiratory rate in children 1-8?

A

15-30 breaths/min

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14
Q

What are the normal ranges for the respiratory rate in 1 to 12-month-old children?

A

25-50 breaths/min

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15
Q

What are the normal ranges for the respiratory rate in neonates (1-28 days)?

A

40-60 breaths/min

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16
Q

What is tachypnea, eupnea, bradypnea?

A

Fast resp rate, normal resp rate, slow resp rate

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17
Q

Where should blood pressure be taken

A

The left arm at heart level, with the skin exposed, arm relaxed and the cuff placed 1” above the brachial artery

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18
Q

How to take blood pressure

A
  1. Inflate the cuff at the blood pressure site ( L arm 1” above brachial artery)
  2. inflate cuff until pulse disapears and then add an additional 20mmHG
  3. delfate the cuff slowly at 2mmHG/beat
  4. Systolic BP = pressure at which first sound is heard
  5. Diastolic BP = pressure at which sound dissapears
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19
Q

What is normal BP?

A

120/80

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20
Q

What is a hypertensive BP?

A

140/90

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21
Q

What are normal SpO2 ranges?

A

95-100%

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22
Q

What is a normal ratio for inspiration to expiration? What are obstructive and restrictive ratios?

A

1:2 (normal)
1:3 + (obstructive)
1:1 (restrictive)

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23
Q

What are the components of vital signs?

A
  1. Heart rate
  2. Blood pressure
  3. Respiratory rate
  4. Oxygen Saturation/SpO2
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24
Q

What should be considered when looking at mechanisms of ventilation?

A

Breathing pattern, ratio of inspiration and expiration, depth of breathing

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25
Funnel chest
pectus excavatum
26
Pigeon chest
pectus carinatum
27
What should be assessed when looking at a cough?
1. Effective (strength) 2. Productive (sputum) 3. Persistent (frequency) 4. Wet or dry
28
Pulmonary edema sputum is what colour and consistency?
Pink and frothy
29
What colour is normal or asthma sputum?
White
30
What to perform during palpation?
1. chest wall expansion 2. diaphragmatic excurssion 3. edema 4. pain and crepitus 5. tracheal positioning 6. tactile fremitus
31
What are the two methods when assessing chest wall expansion, and what are they used for?
1. Manual method = used for diagnosing, looking for movement and symmetry, upper lobes, middle lobe, lower lobes 2. Circumferential method = uses tape measure and looks at the difference between full inhalation and exhalation, taken at axila or 10th rib, take 3 measurements and best of 3, used for assessing progress
32
Diaphragmatic excursion uses mthe anual method and or the circumferential method explain these
The manual method involves placing the hand on the belly during inspiration The circumferential method involves placing tape at the apex of the belly and instructing the patient first to exhale and then maximally inhale
33
What are some conditions that cause edema?
1. R-sided heart failure 2. Pregnancy (some women) 3. Lymphedema 4. Systemic diseases
34
What is a key trait of edema
Edema moves distally and is gravity-dependent
35
What could R sided heart failure lead to?
Edema
36
What is important to note for palpation when thinking about pain?
Palpation can be used to help differentiate between angina and MSK-related pain, as during palpation, it should not cause angina
37
What is crepitus, and what does it signify?
Crepitus is a crunchy sound. If CREPITUS PRESENT ON SKIN, it can be a sign of subcutaneous emphysema (air under skin) - the possible causes of this could be air leak from a chest tube, trauma, or PNEUMOTHORAX
38
What should be considered when assessing tracheal positioning?
1. Trachea should be between the sternocostal joints 2. Increase in volume or pressure pushes the mediastinum away (pneumothorax, pleural effusion, tumour) 3. Decrease in volume or pressure pulls the mediastinum ipsilaterally (atelectasis, pneumonectomy)
39
What are the tactile fremitus considerations?
1. Therapist palpates with palm for vibrations from sound transmission as patient loudly repeats "99" 2. Increase sound transmission = more consolidation or dense tissue (pneumonia, interstitial pulmonary fibrosis, pulmonary oedema, tumour) 3. Decrease sound transmission = hyperinflated lungs or increased space between lungs and chest wall (emphysema, pneumothorax, pleural effusion)
40
Percussion considerations
Percussion can be used to support diagnosis = to determine the density of underlying tissue
41
How is percussion technique performed?
1. DIP directly on chest wall 2. Strike DIP on chest wall with tip of middle finger 3. 2-3 taps 4. Best performed on exposed skin
42
Percussion sounds
1. Resonant = normal aerated lung 2. Dull = non-aerated lung tissue (atelactasis, pneumonia, tumor) 3. Hyperresonant = hyperinflated lung (COPD, pneumothorax)
43
Can diaphragmatic excursion be measured with percussion?
Yes. (study how to do this shi)
44
Which nerves innervate the diaphragm?
C3, 4, and 5 keep the phrenic nerve's ass alive
45
What do we auscultate for?
1. Breath sounds 2. Voice sounds 3. Heart sounds
46
Should the stethoscope be used on skin, clothing or both?
Skin, fools who use it on clothers are trick ass *******
47
When auscultating the lungs how should the patient breathe?
1. In and out through their mouth 2. Auscultate the entire lung space before moving on 3. 1 whole breath before moving on
48
What is the shape format for auscultation
Like a "2" written with tron format
49
Whats the difference between stethoscope bell and diaphragm
Bell = low freq sounds (arteries) Diaphragm = high freq sounds (lungs)
50
Is there a middle lobe on the L lung?
Hell nah, but it does have the Lingula which separates the upper and lower
51
What are the three normal breath sounds?
1. Vesicular = I:E = 1:3, soft and low pitch, heard over peripheral lung tissue, indicates normal lung 2. Broncho vesicular = I:E = 1:1, inspiration soft and expiration loud, heard over main stem bronchi in 1st and 2nd intercostal space 3. Bronchial = I:E = 1:1 or 1:2, louder on exhalation, loud high pitched, hollow quality, distinct pause between insp and expire, heard over trachea and manubrium
52
What are Bronchial normal breath sounds?
I:E = 1:1 or 1:2, louder on exhalation, loud high pitched, hollow quality, distinct pause between insp and expire, heard over trachea and manubrium
53
What are Broncho vesicular normal breath sounds?
I:E = 1:1, inspiration soft and expiration loud, heard over main stem bronchi in 1st and 2nd intercostal space
54
What are Vesicular normal breath sounds?
1:3, soft and low pitch, heard over peripheral lung tissue, indicates normal lung
55
What are abnormal breath sounds?
1. Crackles (rales) 2. Wheezes (rhonchi) 3. Pleural friction 4. Stridor
56
Course crackles identifiers
Wet, inspiration and or expiration, any area of lung, etiology = air moving retained secretions causing intermittent opening and closing of airway
57
Fine crackles identifiers
Dry, inspiration, typically basal lung, Etiology = sudden opening of collapsed alveoli
58
What causes pleural friction rub?
Produced by frictional resistance between layers, pain may be associated, may be confused with pericardial rub (to differentiate ask patient to HOLD BREATH, if RUB PERSISTS = PERICARDIAL RUB and if RUB DISAPPEARS = PLEURAL FRICTION RUB)
59
Stidor
audible without stethoscope due to airway obstruction or narrowed airway loud, musical, high constant pitch Most prominent during inspiration
60

Physiotherapy Competency Exam (4 decks)

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