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Lung Flashcards

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1
Q

Dyspnea

A

Difficult or labored breathing

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2
Q

SOB

A

Shortness of breath

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3
Q

Hemopytis

A

Coughing up blood

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4
Q

COPD

A

Chronic obstructive pulmonary disease

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5
Q

Emphysema

A

-Alveoli are damaged & rupture leading to fewer and larger sac instead of many tiny ones
-Causes SOB & difficulty getting older air out

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6
Q

Symptoms of lung disease

A

-Cough, sputnum, SOB, vocal cord dysfunction, chest pain

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7
Q

Cough

A

-Mechanical or chemical irritation of the trachea or bronchi

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8
Q

Sputum

A

-Diseases of the air passages

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9
Q

Exam findings of Dyspnea & SOB

A

-Use of accessory muscle use, pursed lips, tripod position

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10
Q

Types of Dyspnea

A

-Activity: Dyspnea at rest, exertional dyspnea
-Position: Orthopnea, Paroxsymal nocturnal dyspnea

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11
Q

Other causes of dyspnea

A

Anemia, CO2 poisoning, metabolic dyspnea

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12
Q

Vocal cord dysfunction

A

-Respiratory disorder can cause vocal cord inflammation
-Causes: Smoking, Cold, post nasal drip, acid reflux

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13
Q

Wheezing

A

-High pitched sound, whistling

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14
Q

Pain of the chest

A

-Pain from lung conditions do not originate from lung
-Can be the result of msk issues, pleura, esophageal issues…

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15
Q

Causes of pain in thorax region

A

-Pain from msk issues: Local pain, costochondritis, intercostal sprain/strain, rib fx, cancer of the ribs, vertebrogenic,
-Pain from the pleura: Local catch when moving the pleura, cause is early pleural effusion in pleurisy, common cause of locaal pain in thorax
-Pain from esophalgeal
-Pain from dissecting thoracic aneurysm
-Pain from the heart

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16
Q

Inspection of lungs

A

Fingernails and lips, trachea, chest (thorax) structure, respiration pattern

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17
Q

Cyanosis may suggest

A

interstitial lung disease

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18
Q

Clubbing of nails

A

-Bulbous enlargement of the ends of one or more fingers
-Associated with cardiopulmonary disease

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19
Q

Yellow nails

A

May be result from lung issues, lympodema etc.

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20
Q

Trachea

A

-Static: Positioning
-Abdnormal: Deviates to one side
(IL-atelectasis, CL-mediastinal mass..)

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21
Q

Abnormal chest structures

A

-Thorax: congenital or developed
-Bumps

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22
Q

Chest/thorax shape deformities

A

Congenital: Pectus carianatum, pectus excavatum,
-Developed: Barrel chest

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23
Q

Pectus carinatum

A

Pigeon chest

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24
Q

Pectus excavatum

A

Inward bend

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25
Bumps on ribs
Metastasis, fracture callus, benign growths, rachitic rosary
26
Rachitic rosary
Row of beading at the costochondral junction
27
Normal respiration
Eupnea
28
Eupnea
12-20 rpm, unlaboured
29
Apnea
Absence of breathing
30
Kussmaul breathing
-“air hunger” -Rapid rate, deep depth…
31
Chyene-Stokes
-Alternating rate, rhythm, depth, alternating deep breathing
32
Hippocratic respiration
<10 breaths/minute Referred to as fish mouth breathing Death is imminent
33
Anxiety attack
-May be hyperpnea -Extremity or oral tingling may be experienced -Patients or observers may not notice …
34
Thoracic Retraction
-Intercostal muscles are sucked in on inspiration
35
Tracheal palpation and tracheal tug
-If the trachea is not in midline, doing the tracheal tug can confirm observations -Normal: Trachea is midline, no movement or tugging -Abnormal: Trachea not midline, IL deviation…
36
Lateral chest expansion
-Posterior: Place hands along 10th intercostal space; thumbs touching mid spine and fingers along rib angle -Anterior: Place thumbs together at midline of chest at subcostal margins, keep off chest so the patient can breathe freely
37
Lateral chest expansion findings
-Normal: Symmetrical/>2.5 inches excursion -Abnormal: Asymmetrical/<2.5 inches excursion, restrictive lung disease…
38
Tactile fremitis
Vibrations on the chest wall, comparing side to side -Posterior: Place ulnar edge of hand or MP joints along mid scapular line lung area bilaterally -Anterior: Place ulnar edge of hand or MP joints along mid-clavicular line Patient is saying: “99,99,99”/Feel for vibrations
39
Percussion of posterior lungs
-Percuss in the intercostal spaces in ladder formation; make sure to percussion lateral aspects -Listen for normal dull and tympanic sounds
40
Percussion Tones
Resonant, Flat, Dull, Tympanic, Hyper resonant
41
Resonant
Hollow; Loud intensity, low pitch, long duration
42
Flat
Extremely Dull; Soft intensity, high pitch, short duration
43
Dull
Thud Like; Medium intensity, medium/high pitch, medium duration
44
Hyper resonant
Booming; Very loud, very low, longer
45
Tympanic
Drum like; Loud intensity, high pitch, medium duration
46
Auscultation of posterior lung
Listen for normal bronchial, bronchovesicular & vesicular sounds -Determine if adventitius sounds are present/absent -Perform in ladder format
47
Auscultation of anterior lung
-Use bell for apex (exception), everything else diaphragm -Listen for one full breath cycle at each spot
48
Normal breathing sounds
-Bronchial: High pitched tubular or hollow (trachea & bifurcation of disection of louis?) -Bronchovesicular: Medium intensity and pitch (closer to upper 1/2 chest near sternum) -Vesicular: Soft and airy, low pitched (most of the lungs)
49
Adventitious lung sounds
Fine crackling, coarse crackling, wheezes, rhonchi, stidor, pleural friction rub, mediastinal crunch
50
Fine Crackles
High pitched cracking ike a fire place (Inspiration/Expiration)
51
Coarse Crackling
Low pitched popping sound like a bubbling or moist quality
52
Wheezes
High pitched whistling sound/squeaking, more pronounced on the expiration d/t narrow pathways -Asthma, chronic bronchitis, COPD, CHF
53
Rhonchi
Lower pitched, sounds like a moaning, gurgling or snoring -COPD, Pneumonia, Chronic bursitis, cystic fibrosis
54
Stridor
-Loud, high pitched wheezing/whistling or crowing like sound -Croup, Epiglossitis
55
Pleural friction rub
Cracking or grating sound, low pitched, sounds like walking on fresh snow -Pleurisy, pneumonia
56
Mediastinal Crunch “Hanman’s sign”
-Precordial crackles synchronous with heart beat -Mediastinal emphysema
57
Vocal Fermitus Tests
-Bronchophony: Patient says 99 several times -Egophony: Patient repeats saying the letter “e” -Whispered pectoriloguy: Patient whispers repeatedly blue moon -Abnormal: If the word is muffled, it suggests consolidation
58
Respiratory Syncytial Virus (RSV)
Most common lung and airway infection of infants and small children Can also be seen in adults -Caused by airborne pathogen -Inspection: dyspnea, thoracic retraction -Auscultation: Wheeze crackles -Special: Cotton swag of the nose, CBC
59
Influenza
RNA virus that infects the respiratory tract -Symptoms: Fever, fatigue, cough, headache, sore throat, nausea -Inspection: Dynpnea -Auscultation: Wheezing -Special tests: Nasal swab, CBC
60
Croup
Difficulty breathing with stridor (crowing sounds) -Typically worse at night -Lasts 5-6 days -Inspection: Cyanosis, retractions, tachpnea -Auscultation: Decreased breath sounds, wheezing -Special tests: Nasal swab, CBC, neck and chest x-ray
61
Reactive airway disease (RAD)
-Bronchi overreact to irritant & spasms -Irritants: like pollen, exercise, stress -Describes a set of sx to indicate pe…
62
Asthma
-A reactive airway disease -Inspection: Accessory muscle use, tachypnea, prolonged expiration -Palpation: Decreased respiratory movements, decreased tactile fremitus -Percussion: Normal -Auscultation: Wheezing, possible crackles
63
Bronchitis
Upper respiratory tract infection -Sx include: Cough w/ mucus, GREEN sputum is classic -Inspection: Normal to rapid breathing, coughing, prolonged expiration -Palpation: Possible wheezing vibration or tactile fremitius -Percussion: Normal -Auscultation: crackles, wheezing, rhonchi
64
COPD
-Group of progressive lung diseases -Inhaled toxins causes inflammatory response -Patient cannot breathe out air fully
65
Exam Findings for COPD
-Inspection: Barrel chest, accessory muscle use -Palpation: Decreased respiratory movements -Percussion: Hyperresonance -Auscultation: none, or the crackles, wheezes & rhonchi associated with chronic bronchitis
66
Blue bloaters
Person looks blue and overweight -Sx: SOB, chronic cough -Coexsisting cardiovascular conditions -Now recognized as chronic bronchitis
67
Pink puffers
Person looks pink, is thin and breathing fast -Sx: pursed lips, barrel chested, SOB -Now recognized as severe emphysema
68
Pneumothorax
-Presence of air or gas in pleural cavity -May occur spontaneously -May occur with penetrating trauma -May accompany other lung pathology
69
Pneumothorax exam findings
-Inspection: Trachea shifts to opposite side, dyspnea -Palpation: Tracheal deviation, decreased tactile fremitus -Percussion: Hyperresonant on the involved side -Auscultation: Absence of normal sounds over the collapsed area
70
Pneumonia
-Inflammation of the lung parenchyma -Most cases are due to infection by bacteria or viruses -Distribution may be lobar, segmental or lobular -Can be partial/complete
71
Partial consolidation
-Inspection: Tachypnea, cough -Palpation: normal or minor asymmetry of motion -Percussion: Hyperesonant to dull over the consolidated area -Auscultation: Crackles over the vesicular areas, rhonchi over the tubes
72
Complete consolidation: Lung Findings
-Inspection: Tachypnea, cough -Palpation: Symmetry of motion, increased tactile fremitus over the consolidated area -Percussion: Dullness in the area involved -Auscultation: Loss of vesicular sounds, increased vocal fremitus
73
Pleural effusion
-Excess fluid in the pleural cavity due to another condition -Causes: congestive heart failure, pneumonia -Common sx: Chest pain and dypnea
74
Pleural effusion exam findings
-Inspection: Accessory muscle use, dyspnea, prolonged expiration, trachea deviation -Palpation: Trachea deviation, opposite side of effusion, asymmetry of chest motion, decreased tactile fremitus -Percussion: Dullness -Auscultation: Pleural rub, loss of vesicular sounds, increased vocal fremitus
75
Lung cancer
-Asymptomatic to a variety of symptoms -A chronic cough is common -May cough up blood (hemoptysis)
76
Lung Cancer exam findings
-Inspection: Deviated trachea, retraction signs -Palpation: Deviated trachea -Percussion: Dullness in areas -Auscultation: Altered sounds-may include crackles, wheezes

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