Lung and Thoracic Exam II Flashcards Preview

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Flashcards in Lung and Thoracic Exam II Deck (40):
1

what questions should you ask during the lung health history?

chest pain
dyspnea (SOB)
wheezing
cough
hemoptysis (spitting up blood)

2

what extrathoracic structures may also cause chest pain

neck
gallbladder
stomach
pancreas (pancreatitis)

3

what thoracic structure is not innervated with sensory nerves?

lung parenchyma

4

dyspnea

abnormal or uncomfortable breathing in the context of that person's "normal"
unpleasant sensation or difficulty in breathing

5

wheezing

musical respiratory sounds that may be audible
-indicates airway obstruction (secretions, tissue inflammation)
-does not always mean asthma

6

cough

common symptom (trivial-ominous)
reflex response to stimulae that irritate receptors in the larynx, trachea, or large bronchi
typically respiratory but may be cardiac or GI

7

what is often the last symptom to go when a person has an URI

cough

8

why does the cough persist even after the disease is over with?

reactive inflammation of the airway

9

how can GERD cause a cough

acid in esophagus can cause bronchospasm in the airway

10

what should you differentiate in a cough?

dry or moist
productive or non productive
-may be moist but non productive if they can not expectorate any sputum

11

what should you consider with sputum?

volume
color
odor
consistency

12

orthopnea

difficulty breathing while lying down
-described by how many pillows it takes to breathe comfortably

13

mucoid sputum

translucent, white, grey

14

purulent sputum

yellowish, green

15

mycoplasma pneumonia typically has a

dry hacking cough
-atypical pneumonia

16

bronchitis (viral), viral/bacterial pneumonia typically has a

sputum producing cough

17

anaerobic lung abscess typically has

foul smelling sputum

18

cystic fibrosis typically has

tenacious, sticky sputum

19

bronchiectasis or lung abscess typically has

large volumes of sputum

20

where can blood come from that comes out of the mouth?

oral mucosa (lesions)
nose
lungs
GI

21

characteristics of hemoptysis

blood streaked
frank blood (glob of blood)-what size? (quarter, half dollar, dime)

22

hemoptysis

blood that is expectorated from somewhere below the vocal cords (trachea, bronchi)

23

what are the 4 A's for smoking cessation?

Ask
Advise
Assist
Arrange

24

Steps of the exam

initial survey (breathing, color, accessory muscle use, posture)
exam of posterior chest (sitting)
exam of anterior chest (supine)
special techniques

25

what to observe on palpation

tenderness? abnormalities?
test chest expansion
tactile fremitus (vibration on palpation)

26

tactile fremitus

transmitted through bronchopulomary tree to the chest wall
-use ball or ulnar surface of hand
-say "ninety nine" if faint, speak louder or deeper
-have to have a baseline

27

what does decreased fremitus mean?

obstructed bronchus
COPD
pleural effusion
fibrosis
pneumothorax
some tumors
thick chest wall (obese)

28

when is a good time to do tactile fremitus?

if someone has aspirated something or has some problem that would be only on one side, you would be able to note a decrease in vibration on one side only

29

what does increased fremitus mean?

increased density of tissue (consolidation)
-almost impossible to tell the difference

30

what does percussion do?

produces audible sound and palpable vibration
establishes content of underlying fluid
penetrates 5-7 cm

31

elevated hemidiaphragm

when one side of the diaphragm is higher than the other

32

what is the normal amount of diaphragmatic excursion

5-6 cm

33

bronchophony

say "ninety nine"
normal: sounds should be muffled or indistinct
abnormal: louder, clearer sounds (something is helping sound to transmit more readily through the chest wall)
-while auscultating

34

egophony

say "ee"
normal: hear a long e sound
abnormal: "ee" sounds like "ay"
-while auscultating

35

whispered pectoriloquy

whisper "ninety nine"
normal: sounds heard faintly, if at all
abnormal: loud, clear sounds

36

a percussed lung that gives a flat sound could indicated

large pleural effusion

37

a percussed lung that gives a dull sound could indicate

a lobar pneumonia

38

a percussed lung that gives a normal resonant sound could indicate

simple chronic bronchitis

39

a percussed lung that gives a hyperresonant sound could indicate

emphysema, pneumothorax

40

a percussed lung that gives a tympany sound could indicate

large pneumothorax

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