Pedia 3B - Applied Pulmonary Flashcards Preview

Pediatrics 3B > Pedia 3B - Applied Pulmonary > Flashcards

Flashcards in Pedia 3B - Applied Pulmonary Deck (117):
1

Cough - Dry

Pleurisy
Hacking - LTB

2

Cough - Productive (2)

Pneumonia
TB

3

Sputum - Purulent (2)

Lung abscess (also very bad smell; copious)
Cystic Fibrosis

4

Sputum - Frothy

Heart Disease

5

Sputum - Copious

Lung Abscess (also very bad smell)

6

Sputum - Blood tinged

Mitral stenosis

7

Sputum - Greenish

Cystic Fibrosis

8

Sputum - Frank blood

Hemoptysis

9

Sputum - Very bad smell

Lung abscess (purulent; copious)

10

Cough - Worse on lying down

Postnasal drip (also when sleeping/awakening)

11

Cough - w/pain on chest

Pleurisy

12

Cough - hoarse

laryngotracheobronchitis

13

Cough - Whoop

Pertussis

14

Cough - Aphonic

Vocal cord paralysis

15

Cough - All day but only while awake

Habit

16

Cough - Worse when asleep/awakening

Postnasal drip (also on lying down)

17

Stridor (6)

Harsh
High Pitch
During or end of INspiration
Narrowing of upper air passages
LTB, Foreign bodies, Epiglottitis, Diphtheria, Vocal cord paralysis
Snoring

18

Snoring

stridor while asleep

19

Noise at start of expiration

Grunt

20

Rapid succession of short, sharp sounds
Usu. moribund/dying
D/t air going in/out thru pooled saliva

Rattle

21

Harsh
High Pitch
During or end of INspiration
Narrowing of upper air passages
LTB, Foreign bodies, Epiglottitis, Diphtheria, Vocal cord paralysis
Snoring

Stridor (6)

22

Musical sound
Asthma
Heard w/o stethoscope

Wheeze

23

Cyanosis - Definition

Bluish discoloration of skin & mucus membranes

24

Rattle

Rapid succession of short, sharp sounds
Usu. moribund/dying
D/t air going in/out thru pooled saliva

25

Cough - Definition

Paroxysmal expiratory movements

26

Central Cyanosis - Definition

Generalized (inc. tongue)
Ward extremities

27

Wheeze

Musical sound
Asthma
Heard w/o stethoscope

28

Absence of Clavicle

Cleido-cranial dysostosis

29

Pre-sternal edema

Mumps

30

Unilaterally prominent anterior chest

Cardiac Problems
Rib Abnormalities
Scoliosis

31

Hypo-plastic nipples

Down's
Turner's

32

Super-numerary nipples

Renal abnormality

33

Shield chest

Turner's

34

Pectus excavatum

Congenital anomaly,
Chronic nasal obstruction
- adenoidal hypertrophy

35

Pigeon Breast

Normal
Pectus carinatum
Rickets
Osteomalacia

36

Costo-condral swelling

Rickets
(Rachitic)

37

Deep groove along lower ribs

Normal (esp in premature)

Harrison's Sulcus (if late)
- Rickets
- COPD

38

(-) Pectoralis major
- Unilateral Flattened Chest

(-) Nipple
(-) Breast
Pleural herniation

39

Sprengel's Deformity

HIGH Scapula
Lower angle to the spine

40

Paroxysmal
- Dx Test
- Abd on INSP
- Abd on EXP
- Dse

- Requires fluoroscopy
- Abd flattens on INSP
- Abd bulges on EXP

- Diaphragmatic Paralysis (Congen, Poliomyelitis)
- Pneumothorax

41

Non-Paroxysmal
- Dx Test
- Abd on INSP
- Abd on EXP
- Dse

Chest and Abd move
Abd more visible
- Abd bulges on INSP
= Thorax moves up and out (chest exp)

- Abd Flattens on EXP
= Thorax resting

Dse: Normal

42

DEC Fremitus

FACE P
- FBO (Bronchus)
- Atelectasis
- Collapsed lung
- Effusion
- Pneumothorax

43

INC Fremitus

CPC
- Consolidation
- Pneumonia
- Cavity (large)

44

Breaths/Minute (Tachycardia)

0-2m 30-50 (60)
2-12m 20-30 (50)
1-5y 20-30 (40)
6-12y 15-20 (30)
12-18y 12-16 (24)

45

INSP
Upper Obstruction

Croup
Diptheria

46

EXP
Airway Obstruction

Bronchial Asthma

47

Tracheal Deviation
Right -
Ipsilateral -
Contralateral -

Tracheal Deviation
EXCLUDE SCOLIOSIS FIRST
R - Normal
Ipsi- Fibrosis & Collapse
Contra - Pneumothorax & Effusion

48

Tracheal Notch
- Shallow, Supra-sternal -
- Deep, supra-sternal -

Tracheal Notch
- Shallow, Supra-sternal - Ant displacement, Mediastinitis
- Deep, supra-sternal - MASS

49

Tracheal Movement
- Pendular

Tracheal Movement
- Pendular
= Obstruction of large bronchus
= Large pneumothorax

50

Tracheal Movement
- Rhonchus/Thud

Tracheal or Laryngeal Obstruction

51

Asymmetry of chest excursion

Effusion
Collapse
Consolidation

52

Normal Chest Circumference

Birth 33 +/-3
1 year 48 +/-3
3 Years 52 (50-56)

53

Head>Chest:

Chest

Head>Chest: first 9-12 months (or 6 months, depending on chapter)

Chest

54

Persistent infantile head:chest proportion

Hydrocephalus

55

Small thoracic Cage

Ellis Van Crivald

56

Oval Chest seen after _____ year

After 2 years

57

Breathing Movement
- After 4-5 years

Intercostal

58

Breathing - Splinting

INC ICP
Pleural irritation
CNS irritation

59

Breathing - Short Grunt on EXP

Painful condition

60

Breath Sounds - INCREASED

Broncho-pneumonia
Collapse of lung
FBO
(Anything that DEC air entry)

61

Breath Sounds - DECREASED

Fibrosis
Thickened Pleura
Pleural Effusion
Pneumothorax

62

Crunching sound over chest, near pericardium

Pneumothorax

63

INSP Wheeze

Croup

64

EXP Wheeze

Asthma

65

End INSP crackles

Profuse
Best heard when sitting
Restrictive lung disease

66

EARLY INSP Crackles

Lower chest
Any position
Airway Obstruction

67

Wheeze - HIGH pitch
Whistling

Asthma (also expiratory)

68

Wheeze - LOW pitch
Snoring

Emphysema

69

Discontinuous, interrupted

Rales
Crepitations
Crackles

70

Adventitious
- Continuous
- UN-interrupted

Wheeze
Rhonchus

71

Vocal Resonance - INC

PCPC
Consolidation
Lobar Pneumonia
Cavity (Large, TB)
Pleural effusion

72

Vocal Resonance - DECREASED

FBO
Emphysema
Pleural Effusion
Pleural Thickening
Pneumothorax

73

Tugging Sound in Trachea

FB

74

Percussion - DULL

Heart
Lung

Effusion
Consolidation
Fibrosis
Collapse
Pleural Thickening

75

Percussion - Resonant

Lungs

76

Percussion - HYPER-resonant

Lung of infants
Thin chest wall

Emphysema (asthmatic)
Pneumothorax

77

Percussion - Tympanic

Stomach

78

Resonance - INC

Whispered Pectorilloquy
Bronchophony

79

Sternal Tenderness -

Leukemia?

80

Cold - Clear

Viral
Allergy
LATE bacterial

81

Cold - Green (hilog)

Bacterial
LATE Viral

82

Cold - Unilateral, foul, persistent

FB
Polyp

83

Cold - Blood tinged

Nose picking
Allergic rhinitis w epistaxis
Pliable Kesselbach's

84

Upon waking =

Allergic usually

85

Cold - Immunizations to ask

HiB
Flu
Pneumococcal
BCG
DPT
Influenza

86

Cough - Dry

Pleursy
Dry Hacking - LTB

87

Cough - Paroxysmal
Pertussoid

Cough Cough Cough Whoop
High Pitch
Loud Insp
Pale
Cyanosis
NO Inhalation between

88

Cough - (Pertussoid or Staccato)
Cough Cough Cough Whoop
High Pitch
Loud Insp
Pale
Cyanosis
NO Inhalation between

Pertussoid

89

Cough - Staccato

inspiration in between cough
--> cough-inspiration-cough-inspiration •

Heard in atypical pneumonia (Chlamydia, Mycoplasma, Adenovirus

90

Cough
Inspiration in between cough
--> cough-inspiration-cough-inspiration •

Heard in atypical pneumonia (Chlamydia, Mycoplasma, Adenovirus

Paroxysmal Staccato

91

Rickets
Scurvy

• Costochondral swelling
• Scorbutic: sharp angle
• Rickets: obtuse angle

Rosary Beads

92

Rosary Beads description

Rickets
Scurvy

• Costochondral swelling
• Scorbutic: sharp angle
• Rickets: obtuse angle

93

Crackles - Late INSP

ILD
Pneumonia

94

Crackles - Early INSP

Asthma
Bronchitis

95

Crackles - Mid-INSP

Bronchiectasis

96

Crackles - Implications (4)

Inflammation
Edema
Infection
CHF

97

Wheeze - HIGH Pitch

Asthma (also expiratory)

98

Wheeze - Low Pitch

Emphysema

99

Wheeze - Expiratory

Asthma (also HIGH pitch)

Most wheezes are expiratory

100

Wheeze - Late INSP

Croup

101

Wheeze - Implications (5)

- Obstructive airway disease
- Occlusion of bronchus
- CHF

Diff by tapping/physiotherapy
- if clears wheeze – likely infectious
- If localized – Mass

102

• Vary a lot, difficult to identify
• Coarser, lower pitch, snoring or moaning quality, continuous, usu superimposed on a vesicular breath sound
• Also d/t narrowing

• Bronchial secretions in the large airways
• Occult neoplasm (esp localized)
• Clear when you cough/tap

Rhonchi

103

Rhonchi

• Vary a lot, difficult to identify
• Coarser,
- Lower pitch,
- Snoring or moaning quality,
- Continuous,
- Usu superimposed on a vesicular breath sound
• Also d/t narrowing

• Bronchial secretions in the large airways
• Occult neoplasm (esp localized)
• Clear when you cough/tap

104

• Rubbery, grating sound produced by friction of pleural surface • Palpable, bilateral, do not clear w/cough
- INSP and EXP
-

Pleural Rub

105

Physiologic PEEP,
Raises functional residual capacity by closing glottis at the end of expiration
- Pulm Pathology
- Mod-Severe Resp. distress (Very ominous)

Grunt

106

Mono: Usually I
- INSP - Usu obstruction above glottis
- EXP - usu obstruction intrathoracic
- Bi: - obstruction in area btwn glottis and subglottis

Stridor

107

Vomit after coughing

Post-tussive

108

Vomit after eating

Non-respiratory

109

Cough - Barking

Croup
Epiglottitis

110

Laryngomalacia is physiologic up to

18 months

111

MC sign of DOB

Tachypnea

112

Alar flaring is (early/late?) sign of Resp. distress

LATE

113

Cessation of normal breathing > 10 sec
w/o cyanosis and
w/o any sign and symptoms

Periodic breathing

114

Head _______ is synchronous with respiration

Head _______ is synchronous with cardiac rate

Bobbing

Nodding

115

Intercostal retractions best seen in the _______ portion

Posterior

116

Rosary + Obtuse angle

Rickets

117

Rosary + Sharp angle

Scorbutic