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Physical Dx > Exam 2: Pulmonary > Flashcards

Exam 2: Pulmonary Flashcards

(72 cards)

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1
Q

How many lobes are in the right lung?

A

3

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2
Q

How many lobes are in the left lung?

A

2

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3
Q

Where is lung apices located?

A

2-4cm above the clavicle

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4
Q

Where does the trachea bifurcate into R and L bronci?

A

Anteriorly- sternal angle

Posteriorly- T4

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5
Q

What is the normal respiration rate?

A

14-20 breaths/min

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6
Q

What is it called when the diaphragm contracts, chest wall expands, and negative intrathoracic pressure draws
air into lungs?

A

Inspiration

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7
Q

What is it called when the diaphragm relaxes, chest wall contracts, intrathoracic pressure normalizes, air leaves lungs?

A

Expiration

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8
Q

What is the order of techniques?

A 
IPPA
Inspection
Palpation
Percussion
Auscultation
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9
Q

What are common causes of tracheal deviation?

A

Large pleural effusion, large pneumothorax, mass/tumor

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10
Q

What is pectus carinatum?

A

Convex anterior chest

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11
Q

What is pactus excavatum?

A

Concave anterior chest

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12
Q

What is barrel chest?

A

Increased A-P diameter

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13
Q

What is flail chest?

A

Rib fractures cause paradoxical movement of chest wall

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14
Q

What is kyphosis?

A

Abnormal forward curvature of spine

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15
Q

What is scoliosis?

A

Abnormal lateral curvature of the spine

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16
Q

What is bradypnea? What are some causes?

A

Slow respirations
<12 breaths/min

-Diabetic coma, drug induced respiratory depression

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17
Q

What is tachypnea? What are some causes?

A

Rapid respirations
>20 breaths/min

-Restrictive lung disease, elevated diaphragm, pain

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18
Q

What is hyperventilation?

A

Faster, deeper respiration

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19
Q

What is sighing?

A

Periodic deeper breaths

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20
Q

What is obstructive breathing?

A

Prolonged expiration

2/2 increased airway resistance

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21
Q

What would you call rapid and deep respiration

caused by metabolic acidosis?

A

Kassmaul breathing

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22
Q

What would you call irregular, unpredictable, shallow or deep, with intermittent apnea?

A

Biot’s breathing

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23
Q

What would you call periods of gradually increasing and decreasing depth of respirations
with periods of apnea?

A

Cheyne-Strokes breathing

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24
Q

What would you call the absence of spontaneous respiration?

A

Apnea

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25
What would you call crackling/grating feeling or sound?
Crepitus
26
A patient presents with air from lung/chest tracts along tissue planes, swelling of eyelids, cheeks, lips, neck, and chest. What do you suspect?
Subcutaneous Emphysema
27
What can cause decreased fremitus?
``` Obstructed bronchus COPD Pleural effusion Lung fibrosis Pneumothorax ```
28
What can cause increased fremitus?
Pneumonia/consolidation
29
How many levels of percussion and auscultation should you do anteriorly, posteriorly, and laterally?
Anterior- 3 Posterior- 4 Lateral- 1
30
What is the purpose of percussion?
Determine if underlying tissue are air-filled, fluid-filled, or solid (7cm deep) Detect areas of tenderness
31
What type of sound would you hear when percussing over air areas (lungs)?
Resonant
32
What type of sound would you hear when percussing over solid areas (liver)?
Dull
33
What type of sound would you hear when percussing over fluid-filled areas (bone/muscle)?
Flat
34
What type of sound would you hear when percussing over hollow areas (stomach)?
Tympani
35
What type of lung issue would produce a hyper-resonant tone, very loud intensity, low pitch, and long duration?
COPD or pneumothorax
36
What type of lung issue would produce a resonant tone, loud intensity, low pitch, and long duration?
Chronic bronchitis
37
What type of lung issue would produce a tympanic tone, loud intensity, high pitch, and moderate duration?
Large pneumothorax
38
What type of lung issue would produce a dull tone, medium intensity, moderate pitch, and moderate duration?
Pneumonia or pleural effusion
39
What type of lung issue would produce a flat tone, soft intensity, high pitch, and short duration?
Pleural effusion
40
What is the purpose of auscultation?
Determine whether there is normal air-flow, airway obstruction, or abnormal air or fluid within the chest or lungs
41
What location of breath sounds has equal inspiration and expiration durations, a very loud intensity, and high pitch?
Tracheal
42
What location of breath sounds has expiration longer than inspiration?
Bronchial (over manubrium)
43
What location of breath sounds has equal inspiration and expiration durations, a moderate intensity, and moderate pitch?
Broncho-vascular Ant: 1st & 2nd interspaces Post: interscapular
44
What location of breath sounds has inspiration longer than expiration?
Vesicular (most of peripheral lung)
45
Patient says “99” during auscultation and you are listening for a louder sound. What test is this?
Bronchophony
46
Patient says “EE” during auscultation and you are listening for an "AAY" sound. What test is this?
Egophony
47
What is it called when sounds are superimposed on usual breath sounds?
Adventitious | Ex: Crackles, rhonchi, wheezes
48
During auscultation you hear intermittent, nonmusical, brief, velcro-like sounds. What is this called?
Crackles
49
During auscultation you hear intermittent, nonmusical, brief, velcro-like sounds. They are soft, high pitched and very brief. What is this called?
Fine crackles
50
During auscultation you hear intermittent, nonmusical, brief, velcro-like sounds. They are louder, lower pitched and brief. What is this called?
Coarse crackles
51
During auscultation you hear musical low pitched, snoring wheeze that clears with cough. What is this called?
Rhonchi
52
During auscultation you hear high pitched, hissing, shrill, whistling. What is this called?
Wheeze
53
What is stridor?
Inspiratory wheeze (larynx/tracheal obstruction)
54
Crackle sounds are indicative of what?
Bronchitis, pulmonary fibrosis, CHF
55
Ronchi sounds are indicative of what?
Large airway secretions, chronic bronchitis
56
Wheeze sounds are indicative of what?
Asthma, COPD, chronic bronchitis, bronchus obstruction
57
What does pleural friction rub sound like and what causes it?
Crackle-like creaking sounds from inflamed pleural surfaces rubbing together. Recent URI, pneuomia
58
What does mediastinal crunch (hamman's sign) sound like and what causes it?
Precordial crackles in sync with heartbeat, not respiration | Mediastinal emphysema
59
At what level of the ribs should you place your thumbs to test respiratory expansion?
10th ribs
60
What are palpable vibrations transmitted through bronchiopulmonary tree to chest wall with patient verbalization?
Fremitus
61
What is fluid collection within the chest but outside | the lung, causing lung compression?
Pleural effusion
62
What is air collection within the chest but outside the | lung, causing lung compression?
Pneumothorax
63
What is overdistention of distal airspaces, resulting in limited expiratory flow and lung hyperinflation?
COPD | Chronic Obstructive Pulmonary Disease
64
What is alveoli filled with fluid/blood/pus increasing the density and opacity of the lung tissue?
Consolidation/infiltrate
65
Patient presents with dull percussion, bronchial and crackle breath sounds, increased transmitted voice sounds, and increased tactile fremitus. What do you suspect?
Consolidation- Pneumonia
66
Patient presents with dull to flat percussion, decreased breath sounds, decreased transmitted voice sounds, and decreased tactile fremitus. What do you suspect?
Pleural effusion
67
Patient presents with hyperresonant or tympanic percussion, decreased breath sounds, decreased transmitted voice sounds, and decreased tactile fremitus. What do you suspect?
Pneumothorax
68
Patient presents with diffusely hyperresonant percussion, decreased breath sounds, decreased transmitted voice sounds, and decreased tactile fremitus, and increaed AP diameter of chest. What do you suspect?
COPD
69
Patient presents with resonant percussion, obscured breath sounds due to high pitched wheezes, decreased transmitted voice sounds, and decreased tactile fremitus. What do you suspect?
Asthma
70
Patient presents with resonant percussion, vesicular breath sounds with some crackles, wheezes or rhonchi, normal transmitted voice sounds, and normal tactile fremitus. What do you suspect?
Chronic bronchitis
71
What is the sternal angle or angle of Louis?
The bony ridge that joins the manubrium and sternal body
72
Are the intercostal spaces above or below their correspondent ribs?
Below

Physical Dx (14 decks)

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