Overview of Heart/Lung/Abdomen Exam

Question 1

sputum

Answer 1

substance expelled by lung (coughed up)

color, consistency, quantity, frequency, presence or absence of blood

Question 2

hemoptysis

Answer 2

coughing up blood from lungs
-could be sign of serious condition

clot - cancer, cavitary lesion, cardiac disease, PE
tinged - smoking, infections

Question 3

dyspnea

Answer 3

shortness of breath (subjective)

-objective finding - tachypnea

Question 4

paroxysmal nocturnal dyspnea

Answer 4

SOB that occurs during sleeping

Question 5

orthopnea

Answer 5

difficulty breathing while lying flat

Question 6

wheezing

Answer 6

high pitched sound resulting from partially obstructed airway
-bronchospasm, mucosal edema, foreign body aspiration, tumor, CHF

all that wheezes is not asthma

Question 7

cyanosis

Answer 7

bluish discoloration of skin

-decreased oxygen

Question 8

central cyanosis

Answer 8

inadequate gas exchange at level of lungs

Question 9

peripheral cyanosis

Answer 9

excessive extraction of inadequate supply of oxygen at periphery

Question 10

pleuritic pain

Answer 10

chest wall pain associated with breathing

-inflammation of pleuras

Question 11

skills for respiratory exam?

Answer 11

inspection, palpation, percussion, auscultation

Question 12

inspection of chest

Answer 12

shape of chest and how it moves when breathing

• deformity and asymmetry
• abnormal retraction of muscles
• impaired respiratory movements

anterior, posterior, and lateral aspects

Question 13

tactile fremitus

Answer 13

say 99

Question 14

symmetry of chest excursion

Answer 14

anterior and posterior

hands on back at 10th rib

Question 15

dull

Answer 15

percussion of solid organ

Question 16

resonant

Answer 16

percussion over structure containing air (lung)

Question 17

tympanic

Answer 17

over hollow or air containing structure or organ (stomach)

Question 18

flat

Answer 18

percussion over large muscle mass

Question 19

auscultation

Answer 19

NEVER listen through clothes

Question 20

types of normal breath sounds

Answer 20

tracheal, bronchial, bronchovesicular, vesicular

Question 21

tracheal breath sounds

Answer 21

very loud/high pitched
-harsh sounding
-heard over trachea and neck
I:E ratio 1:1

Question 22

brachial breath sounds

Answer 22

-loud and high pitched
I:E ratio 1:3
tubular sounding
heard over manubrium

Question 23

bronchovesicular breath sounds

Answer 23

moderate to intermediate
I:E ratio 1:1

tubular rustling sound
over mainstem bronchi between scapula

Question 24

vesicular breath sounds

Answer 24

soft, low pitch
I:E ration 3:1
gentle rustling
heard over most of lung fields

Question 25

abnormal lung sounds

Answer 25

rales/crackles wheezes rhonchi

Question 26

rales/crackles

Answer 26

result from opening and closing of alveoli and small airways during respiration

Question 27

wheezes

Answer 27

high itched sound from partial obstruction of smaller airway

Question 28

rhonchi

Answer 28

low pitched sound from larger airways partially obstructed

Question 29

p wave

Answer 29

atrial contraction

Question 30

QRS complex

Answer 30

ventricular contraction

Question 31

T wave

Answer 31

ventricular polarization

Question 32

PMI

Answer 32

point of maximal impulse 5th intercostal space mid-clavicular line

Question 33

thrill

Answer 33

palpable vibration felt over precordium

Question 34

heave

Answer 34

palpable impulse or displacement of sternum

Question 35

aortic area?

Answer 35

right sternal borde 2nd ICS

Question 36

tricuspid area?

Answer 36

left sternal border 4th ICS

Question 37

pulmonic area?

Answer 37

left sternal border 2nd ICS

Question 38

Erb's Point?

Answer 38

left sternal border 3rd ICS

Question 39

mitral area?

Answer 39

apex of heart 5th ICS

Question 40

normal heart sounds?

Answer 40

S1 and S2

Question 41

S1

Answer 41

first heat sound (lub) closure of tricuspid and mitral valves -at tricuspid and mitral valves

Question 42

S2

Answer 42

second heart sound (dub) closure of aortic and pulmonic valves -at aortic and pulmonic valves

Question 43

physiologic splitting

Answer 43

of second heart sound | -best over pulmonic valve

Question 44

exam of abdomen?

Answer 44

inspect, auscultate, percuss, palpate, rectal, special technique

Question 45

best place to listen to abdomen

Answer 45

RLQ

Question 46

normal bowel sounds

Answer 46

high pitched tinkle 3-5 seconds

Question 47

borborygmi

Answer 47

increased hyperactive bowel sounds lower pitched rumbling hyperperistalsis

Question 48

abdominal bruits

Answer 48

soft sound made by disrupted arterial flow through a narrowed artery

Question 49

best way to percuss abdomen?

Answer 49

patient supine

Question 50

tympany in abdomen?

Answer 50

presence of gas in stomach and small bowel

Question 51

dull sound?

Answer 51

liver

Question 52

resonant sound?

Answer 52

lung

Question 53

hepatomegaly?

Answer 53

greater than 10cm

Question 54

palpation of abdomen?

Answer 54

light, deep, liver, spleen, kidney

Question 55

rebound tenderness

Answer 55

slowly, gently, deeply palpate | -quick release

Question 56

inferior approach

Answer 56

liver palpation | -11th 12th rib in RUQ

Question 57

hooking technique

Answer 57

also for liver palpation

Question 58

spleen palpation

Answer 58

11th 12th rib LUQ

Question 59

sandwich method

Answer 59

palpate kidneys

Question 60

5 listening posts

Answer 60

aortic, pulmonic, Erbs, tricuspid, mitral