Examination: Respiratory Flashcards Preview

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Flashcards in Examination: Respiratory Deck (16):
1

(R) Step 1:

Prepare the Patient:

2

(R) Step 2:

Hand Hygiene

3

(R) Step 3:

General Inspection:
- mental state, alertness, respiratory effort, coughing, wheezing, stridor, oxygen, sputum in a cup etc.

4

(R) Step 4:

Inspection of the hands:
- clubbing (spongey nail bed, diamond in fingers caused by chronic CO2 buildup or malignancy)

5

(R) Step 5:

Measurement of the pulse and Respiratory Rate

6

(R) Step 6:

Examination of the Head and Neck:
- conjunctivae
- lips and tongue (Put your tongue back in now, thank you)
- position of trachea (deviated?)

7

(R) Step 7:

Inspection of Ant. and Lat. Chest walls:
- shape of chest
- scars
- pattern of respiration
- use of accessory muscles?

8

(R) Step 8:

Measurement of Chest Expansion:
- Lower rib cage (5cm)
- upper anterior chest wall (2cm)

9

(R) Step 9:

Percussion of Ant. Lat. Chest wall:
- compare R and L
- Clavicle
- Mid-Clav Line every 2 intercostal spaces
- 2 positions on mid-axillary line

10

(R) Step 10:

Auscultation of Ant. Lat. chest wall:
- open mouth by patient
- listen for normal vesicular breath sounds
- same positions as percussion and above scapula for lung apex
- Then say 99 or every position as well

11

(R) Step 11:

Examination of the posterior chest:
- Look
- Expansion
- Percuss (two positions in the upper zone b/t scapula and spine and then two positions between lateral chest wall and spine in the lower zone)
- Auscultate
- 99

12

(R) Step 12:

Measurement of Peak flow:
- indicator faces upwards
- set to zero to begin with
- deepest breath possible
- place lips tightly around mouthpeice
- blow as hard & fast as you can
- best out of three

13

(R) Step 13:

Conclude Examination

14

Where is the trachea located?

- lies behind the manubrium and bifurcates at the level of the manubriosternal junction.

15

Where are the apex of the lungs located?

- 2.5 cm above the medial 3rd of the clavicles

16

Where are the oblique fissure and horizontal fissure of the lungs situated?

Oblique: join the spinous process of T2 to the 6th costal cartilage Anteriorly. --> coincides with the medial border of the scapula when hands are behind the head

Horizontal: extends from the 4th costal cartilage back to intersect with the oblique fissure (on the right lung)