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Clinical Med > Chest and thorax > Flashcards

Chest and thorax Flashcards

(60 cards)

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1
Q

What is the normal range for diaphragmatic excursion

A

3-5 cm

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2
Q

True or false: the diaphragm is usually higher on the left side

A

True

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3
Q

What sounds are the highest in pitch and intensity

A

bronchial sounds

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4
Q

What sounds are low-oitched, low intensity sounds of healthy lungs?

A

vesicular sounds

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5
Q

True or false: crackles usually clear with coughing?

A

False

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6
Q

When in the breathing cycle are crackles heard?

A

With inspiration

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7
Q

What are rhonchi?

A

wheezes usually heard with expiration

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8
Q

When in the breathing cycle are wheezes usually heard?

A

continuously

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9
Q

True or false: a higher pitched wheeze usually indicates a less severe obstruction

A

False–higher = worse

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10
Q

What a friction rubs indicative of?

A

Inflammation

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11
Q

How is bronchophony tested?

A

having patient say “99”. this will look for consolidation

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12
Q

When is egophony tested?

A

looking for consolidation

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13
Q

What are the three tests that you can perform for consolidation?

A

egophony
bronchophony
Whispered pectoriloquy

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14
Q

What are cheyne-stokes patterns?

A

alternating period of apnea and hypernea, periodic breathing

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15
Q

What are Kussmaul’s respiration?

A

very deep, gasping and rapid breathing seen in metabolic acidosis

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16
Q

What are grunting respirations?

A

Short and explosive sounds, more common in children but also in adults as a sign of respiratory muscle fatigue

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17
Q

What are adventitous breath sounds?

A

abnormal breath sounds auscultated such as crackles, rhonchi, wheezes, and friction rub

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18
Q

Define: atelectasis?

A

incomplete expansion of the lungs

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19
Q

true or false: patients with a barrel chest also have some degree of kyphosis

A

true

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20
Q

Define: biot respirations

A

irregularly respiration varying in depth an interrupted by intervals of apnea that lacks a repetitive pattern

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21
Q

Define: bronchiectasis

A

chronic dilation of the bronchi or bronchoiles caused by repeated infections or bronchial obstructions

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22
Q

Define: Bronchitis

A

inflammation of the large airways.

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23
Q

Define: Bronchophony

A

tissue (greater clarity and increased loudness of the spoken word)

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24
Q

Define: Bronchiolitis

A

inflammation of the bronchioles

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25
What are the three normal breath sounds?
1. Vesicular 2. Tubular 3. Bronchovesicular
26
What are vesicular breath sounds?
heard over most of the lung fields; low pitch, soft and short expirations
27
What are tubular breath sounds?
heard only over trachea, high pitch; loud and long expirations, sometimes a bit longer than inspiration
28
What are Bronchovesicular breath sounds?
heard over main bronchus area and over upper right posterior lung field; medium pitch; expiration equals inspiration
29
Define: Pectoriloquy
a striking transmission of voice sounds through the pulmonary structures, so that they are clearly audible through the stethoscope; commonly occurs from lung consolidation.
30
Define: Pectus carinatum
forward protrusion of the chest
31
What are the principle muscles used in inspiration?
External intercostals | Diaphragm
32
What part of the chest do you use in quiet respiration?
Passive recoil of the diaphragm
33
What are the muscles used in active, expiration?
Internal intercostals Abdominal muscles Obliques
34
What are the muscles used in activeinspiration?
SCM | Scalenes
35
About what phsycial landmark do the bronchi split?
Sternal angle
36
The lung exists down to which vertebra?
T10
37
How far does the diaphragm move?
4-5 cm
38
What are the four steps of the physical exam?
1. Look 2. Listen 3. Palpate 4. Percuss
39
To get flail chest, what must happen?
Break two portions of three ribs
40
What palpation sounds are characterisitcs of COPD?
Hyperresonant.
41
What are the breath sounds of a COPD patient?
Distant with delayed expiratory phase and scattered expiratory wheezes
42
Will fremitus be increased or decrease in patient with COPD?
Decreased
43
Will the diaphragm move more or less in a patient with COPD?
Less
44
Will there be kyphosis in asthma?
No--flattening of it
45
Will the lungs be resonant in asthma
Yes
46
Will there be bronchophony, egophony, or whispered pectoriloquy in Asthma?
No
47
Will there be diaphragmatic changes in asthma?
No
48
When (in the breath cycle) do wheezes usually occur with asthma?
Expiration
49
What should be the top thing on your differential if you see a patient with asymmetric chest movement?
Pneumothorax
50
Will the lung be more or less resonant in pneumothorax?
More
51
Will breath sounds be decreased or increased in penumothorax?
Decreased throughout
52
Will there be diaphragamatic excursion changes in pneumothorax?
Yes, decreased on the affected side
53
Which breath sounds are continuous?
Wheezes and rhonchi
54
Which breath sounds are discontinuous?
Crackles
55
What do wheezes indicate?
Narrowed airway
56
What do rhonchi indicate?
Secretions in large airways
57
What do crackles indicate?
either abnormalities of the lung, or inspissated secretions (if able to clear)
58
What is the pitch different between wheezes and rhonchi?
Rhonchi are low | Wheezes are high
59
Where is the oblique fissue of the right lung found with inspiration (relative to the ribcage)
Right 5th rib along the sternum, traveling to the 6th rib at the midclavicular line
60
Where is the transverse fissure found in either lung with inspiration (relative to the ribcage)?
4th rib at the midclavicular line

Clinical Med (30 decks)

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