PDCI 3 Chest Exam Flashcards by Lu Chen

2 layers of pleura

Parietal pleura - lines inner rib cage and upper diaphragm

Visceral pleura - covers lungs

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Ribs protect

Liver

Spleen

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Sternal angle marks which rib

2nd rib

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How do you name intercostal spaces

Named after rib above it

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Prominent spine in back

C7 (or C7 and T1)

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Where do they do thorocentesis / pleural effusion?

Between 7th and 8th ribs

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Squeezing pain

Angina

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Tearing pain

Aortic aneurism

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Pain when inhale

Pleuritic pain

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Inflammation of rib is called

Costochondritis

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Right lower chest pain suggests possible

Gall stone

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Pathology of shingles

Skin or muscle tingling 1 to 2 days after rash with vesicles

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Dyspnea suggests what types or problems

Cardiac

Pulmonary

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Causes of wheezing

Secretions
Inflammation
Foreign body

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Cough is a reflex to irritation of

Larynx
Trachea
Bronchi

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A cough that’s cardiovascular in origin suggests

Left heart failure

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Dry hacking cough suggests

Mycoplasma pneumoniae

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Productive cough suggests

Bronchitis

Viral or bacterial pneumonia

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Cough and orthopnea suggest

Heart problem

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A lot of volume from productive cough suggests

Pulmonary abscess

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Foul smelling cough suggests

Anaerobic abscess

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Translucent, white, or gray sputum is described as

Mucoid

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Yellow/green sputum is described as

Purulent

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A lot of blood is called

Frank blood

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Blood streaked cough suggests

``` Bronchitis Bronchiectasis Pneumonia TB Tumor ```

Cough up pinkish blood suggests

Heart failure

Aspects of physical exam

Inspect (see) Palpate (feel) Percuss (beat) Auscultate (listen)

Accessory breathing muscles of neck

Scalene | SCM

What to inspect

Accessory muscles Breathing Color

Tachypnea

Rapid shallow breathing

Hyperpnea

Rapid deep breathing

Cheyne stokes breathing

Deep breathing then apnea

Causes of Cheyne-Stokes breathing

Heart failure Uremia Drug induced respiratory depression Brain damage

What is stridor

Larynx or tracheal obstruction | * emergency!!!!

What is clubbing and what is it associated with

Spoon shaped nails Chronic respiratory distress like.. COPD Congenital heart disease

Traumatic flail chest is caused by

Multiple rib fractures

Barrel chest is caused by

COPD

Pigeon chest is characterized by

Anterior sternum | More of a cosmetic issue

Funnel chest is characterized by

Posterior sternum | Might cause heart murmur or displaced heart

Inspection of posterior chest

Deformities Retraction during inspiration Impairment of movement

Lag in movement on one side suggests

Problem with pleura

Palpation of posterior chest

Tenderness Abnormalities Test chest expansion

Tactile fremitus

Palpable vibrations to chest wall with speaking

Palpate with what part of hand

Median or upper palm

Increased tactile fremitus suggests

Lung consolidation (like lobar pneumonia)

Decreased tactile fremitus associated with

``` Obstructed bronchus COPD Pleural effusion Pleural thickening Pneumothorax Thick chest wall ```

Dull sound when percuss suggests

Lobar pneumonia

Hyperresonant percussion suggests

Pneumothorax

Dull or flat percussion suggests

Pleural effusion

2 hands in percussion called

Pleximeter | Plexor/percussor

Tympanic percussion suggests

Large pneumothorax

What is diaphragmatic excursion

Estimate diaphragm movement with respiration Usually 5-6 cm Distance between levels of dullness on full inspiration and expiration

Large diaphragmatic excursion suggests

Pleural effusion Paralysis of diaphragm Partial atelectasis (collapse) of lung

Normal breathing sounds

Vesicular Bronchovesicular Bronchial Tracheal

What are the two types of adventitious discontinuous sounds

Fine (higher pitched, very brief) | Coarse (lower pitched, not as brief)

What are the two types of adventitious continuous sounds

Wheezes (high pitched) | Rhonchi (low pitched)

Transmitted sounds suggests

Lobar pneumonia

Louder and clearer voice spuds than normal are called

Bronchophony

E to A changes (egophony) suggests

Pneumonia

What is whisper pectoriloquy

Whisper more clearly heard on side with pneumonia

What does consolidation mean

Lungs filled with fluid

What is pleural effusion

Excess fluid between pleural layers

What is pneumothorax

Air in pleural space

What to check in a chest x ray

``` Airway Bones Cardiac Diaphragm Everything else ```

No costophrenic angle in cxr suggests

Pleural effusion

Can double check pleural effusion on cxr by...

Having patient lie on side - pleural effusion will be horizontal always

Collapsed lung also called

Pneumothorax

How can tell pneumothorax on cxr

Look for pulmonary vascular markings

PDCI 3 Chest Exam Flashcards

(68 cards)