exam 3 Flashcards by britt rank

Adventitious Breath Sound that

low-pitched bubbling and gurgling sounds
start in early inspiration and may be present in expiration
may decrease somewhat by suctioning or coughing but reappear shortly
sounds like opening a Velcro fastener

Crackles——Coarse (coarse rales)

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occurs with obstructed bronchus, pleural effusion or thickening, pneumothorax, or emphysema. Any barrier that comes between the sound and your palpating

Decreased fremitus

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objective data method of thorax and lungs that is used for

tactile fremitus

Palpation

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Arterial insufficiency: Palpation

 Absent or weak pulse
 Cool temperature
 No edema

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objective data method of the heart and neck vessels that is used for

hands & fingers, chest

Inspection

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Normal breath sound that is

Over major bronchi I=E. Pitch- moderate. Qual- mixed

Bronchovesicular:

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Supply oxygenated blood to the head and neck

- Located between the trachea & SCM

Carotid arteries

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Transport deoxygenated blood from capillaries to the right side of the heart

Veins:

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voice souds technique where

-Auscultate the chest while the person phonates a long “ee-ee-ee-ee” sound

Egophony

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A ______ indicates turbulence from a local vascular cause and is a marker for atherosclerotic disease

bruit

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Adventitious Breath Sound that

superficial sound
pieces of leather are being rubbed together;
sounds louder if you push the stethoscope harder onto the chest wall;
sound is inspiratory and expiratory

Pleural friction rub

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difficulty breathing

Dyspnea:

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voice souds technique where

-Ask the person to whisper a phrase such as “one-two-three” as you auscultate

Whispered Pectoriloquy

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objective data method of thorax and lungs that is used for

Resp. rate & effort to breathe (nasal flaring, accessory muscles, positioning)

Inspection

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Adventitious Breath Sound that

Low-pitched musical snoring, moaning
more prominent on expiration; may clear somewhat by coughing

Wheeze—Low-pitched (sonorous rhonchi

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how to calculate pack years

Multiple the number of cigarettes smoked per day by the number of years smoked
Divide by 20

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Increase in both rate and depth. Normally occurs with extreme exertion, fear, or anxiety. Also occurs with diabetic ketoacidosis (Kussmaul respirations), hepatic coma, salicylate overdose (producing a respiratory alkalosis to compensate for the metabolic acidosis), lesions of the midbrain, and alteration in blood gas concentration (either an increase in CO2 or a decrease in oxygen). Hyperventilation blows off CO2, causing a decreased level in the blood (alkalosis).

Hyperventilation:

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Have one way valves that allow blood to flow against gravity and return to the heart

Veins:

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collapse or closure of a lung

Atelectasis:

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Adventitious Breath Sound that

Sound like fine crackles
do not last and are not pathologic;
disappear after the first few breaths;

Atelectatic crackles (atelectatic rales)

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Have a smooth muscle layer that contracts and relaxes in response to changes in blood volume

Arteries

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“LUB” heard loudest at apex - listen at tricuspid & mitral points

S1: Closure of AV valves

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objective data method of thorax and lungs that is used for

respiratory expansion

(hands on back, equal bilaeraly)

Palpation

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objective data method of the heart and neck vessels that is used for

apical impulse

Palpation

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is awakening from sleep with SOB and needing to be upright to achieve comfort.

Paroxysmal nocturnal dyspnea

Four heart valves facilitate __________ movement of blood through the heart to prevent backflow

unidirectional

sputum that is White or clear mucoid—

colds, bronchitis, viral infections;

The right side of the heart transports__________ blood to the lungs

unoxygenated

Transport O2 and blood via the heart to the organs and tissue capillaries (perfusion)

Arteries

objective data method of thorax and lungs that is used for Tenderness, lumps

Palpation

objective data method of thorax and lungs that is used for skin color, nails, configuration of chest (chest deformities)

Inspection

occurs with compression or consolidation of lung tissue (e.g., lobar pneumonia). This is present only when the bronchus is patent and the consolidation extends to the lung surface.

Increased fremitus

Auscultation: 5 listening points of the heart

``` Aortic: 2ICS/RSB Pulmonic: 2ICS/LSB Erb’s: 3ICS/LSB Tricuspid: 4ICS/LSB Mitral: 5ICS/LMCL ```

abnormal finding of a voice sounds where clear “ninety-nine” where the words are more distinct and sound close to your ear

Bronchophony

normal finding of a voice sounds where Normally you should hear “eeeeeeee” through your stethoscope

Egophony

objective data method of the heart and neck vessels that is used for pulse deficit

Auscultation:

Thinner walls makes veins more distensible; can accumulate large amounts of fluid

Veins:

normal finding of a voice sounds where -soft, muffled, and indistinct

Bronchophony

Normal breath sound that is Over trachea & larynx E>I. Pitch- high. Qual- hollow

Bronchial (Tracheal):

objective data method of the heart and neck vessels that is used for General appearance

Inspection

Adventitious Breath Sound that - Discontinuous - crackling, popping during inspiration - not cleared by coughing - rolling a strand of hair between your fingers

Crackles—Fine (formerly called rales

-Return un-oxygenated blood to heart

Jugular veins

The right and left _______ pump blood out of the heart.

ventricles

objective data method of the heart and neck vessels that is used for Heart sounds & Apical heart rate

Auscultation:

sputum that is -rust colored—

TB, pneumococcal pneumonia;

Feel this hollow U-shaped depression just above the sternum, between the clavicles.

Suprasternal Notch:

objective data method of thorax and lungs that is used for measurement of pulmonary function:

Auscultation

This estimates the level of the diaphragm separating the lungs from the abdominal viscera. It may be somewhat higher on the right side

diaphragmatic excursion

is a sustained forceful thrusting of the ventricle during systole. It occurs with ventricular hypertrophy as a result of increased workload.

A heave or lift

Arterial insufficiency: insepection

 Skin is pale & shiny  Hair loss distribution  Distal, dry ulcer

objective data method of thorax and lungs that is used for Resonance, hyper-resonance, dull

Percussion

A cycle in which respirations gradually wax and wane in a regular pattern, increasing in rate and depth and then decreasing. The breathing periods last 30 to 45 seconds, with periods of apnea (20 seconds) alternating the cycle. The most common cause is severe heart failure; other causes are renal failure, meningitis, drug overdose, and increased intracranial pressure. Occurs normally in infants and aging persons during sleep.

Cheyne-Stokes:

Slow breathing. A decreased but regular rate (<10 per minute), as in drug-induced depression of the respiratory center in the medulla, increased intracranial pressure, and diabetic coma.

Bradypnea:

objective data method of the heart and neck vessels that is used for Cardiac border

Percussion

“DUB” heard loudest at base - listen at Pulmonic and Aortic points.

S2: Closure of semilunar valves

Arterial pulse reflects the pumping of the heart during _______

systole

Venous insufficiency: palation

 Moderate to severe pitting edema  Palpable pulse (depending on edema)  Hard skin, normal temperature

abnormal finding of a voice sounds where -spoken “eeee” sound changes to a bleating long “aaaaa” sound

Egophony

after one minute is consistent with radial pulse. Both match with a regular heart rate (60-100 bpm). Rhythm is regular

Apical heart rate

voice souds technique where -Ask the person to repeat “ninety-nine” while you listen with the stethoscope over the chest wall; listen especially if you suspect pathology

Bronchophony

The left side of the heart transports __________ blood to the systemic circulation

oxygenated

sputum that is -pink, frothy—

pulmonary edema, some sympathomimetic medications have a side effect of pink-tinged mucus.

objective data method of the heart and neck vessels that is used for carotid pulses

Palpation

Venous insufficiency: inspection

 Swollen leg  Darkened hyperpigmentation at ankle  Ulcers on leg and ankle

palpable vibration. Sounds generated from the larynx are transmitted through patent bronchi and the lung parenchyma to the chest wall, where you feel them as vibrations.

Fremitus:

abnormal finding of a voice sounds where -whispered voice is transmitted very clearly and distinctly, although still somewhat faint; it sounds as if the person is whispering right into your stethoscope, “one-two-three”

Whispered Pectoriloquy

Rapid, shallow breathing. Increased rate, >24 per minute. This is a normal response to fever, fear, or exercise. Rate also increases with respiratory insufficiency, pneumonia, alkalosis, pleurisy, and lesions in the pons.

Tachypnea:

Neck muscles are ________ in COPD from aiding in forced respirations across the obstructed airways.

hypertrophied

objective data method of thorax and lungs that is used for crepitus

Palpation

objective data method of the heart and neck vessels that is used for jugular veins, carotid arteries

Inspection

objective data method of the heart and neck vessels that is used for Pulsation or heave

Palpation

: crackling sensation palpable over the skin surface

Crepitus

sputum that is -yellow or green—;

bacterial infections

provides information about the right side of the heart

Jugular vein distention (JVD)

Adventitious Breath Sound that - High-pitched, musical squeaking sounds - predominate in expiration but may occur in both expiration and inspiration - sound is similar to that of a vibrating reed

Wheeze—High-pitched (sibilant

normal finding of a voice sounds where The normal response is faint, muffled, and almost inaudible

Whispered Pectoriloquy

objective data method of thorax and lungs that is used for diaphragmatic excursion

Percussion

Circulation, Motion, and Sensation 5 Ps

1. Pain, 2. Pulse, 3. Pallor, 4. Parasthesia, 5. Paralysis poikiothermia

: An irregular shallow pattern caused by an overdose of narcotics or anesthetics. May also occur with prolonged bed rest or conscious splinting of the chest to avoid respiratory pain.

Hypoventilation

Normal breath sound that is Over peripheral lung fields I>E. Pitch- low. Qual- rustling

Vesicular:

The right and left _____ are the receiving chambers.

atrium

objective data method of thorax and lungs that is used for adventitious, voice sounds

Auscultation

Adventitious Breath Sound that - High-pitched, inspiratory, crowing sound; - louder in neck than over chest wall

Stridor

: Flex your head and feel for the most prominent bony spur protruding at the base of the neck. This is the spinous process of C7. If two bumps seem equally prominent, the upper one is C7, and the lower one is T1.

Vertebra Prominence

exam 3 Flashcards

(84 cards)