Practical

Question 1

first step for practical

Answer 1

grab all equipment

wash hands and equipment in front of pt

Question 2

during auscultation of the lungs

which side do you always start

Answer 2

uninvolved side

Question 3

never listen over

Answer 3

bone and breast tissue

Question 4

ausultation locations

Answer 4

upper lobe (A)

middle lobe (A)

lower lobe (A)

upper lobe (P)

middle lobe (P)

lower lobe (P)

lateral

Question 5

upper lobe anterior

Answer 5

above clavicle to 4th rib

Question 6

middle lobe anterior

Answer 6

4th to 6th rib

Question 7

lower lobe anterior

Answer 7

6th rib

Question 8

upper lobe posterior

Answer 8

none

Question 9

middle lobe posterior

Answer 9

5th rib to 10th rib

maybe 12th

Question 10

lower lobe posterior

Answer 10

down to the 8th ribs

Question 11

always ausculate through

Answer 11

2 breath cycles

Question 12

how to measure JVD

Answer 12

supine (30-40 degrees)

pt turns head away and holds breath

mark distal part of vein

measure to angle of louis

Question 13

normal JVD and positive dx

Answer 13

3-5 cm is normal

abnormal indicates R CHF

Question 14

when doing evaluative percussion, where will you hear a dull sound

Answer 14

over solid organs

L 3-5 ICS = heart

R 5-7 ICS = liver

Question 15

when doing evaluative percussion, where will you hear a tympanic sound

Answer 15

over hallow organs

L 6th ICS

Question 16

when doing evaluative percussion, where will you hear a resonate sound

Answer 16

over normal air filled organs

L 6th ICS

Question 17

normal diaphragmatic excursion is

Answer 17

3-5 cm

Question 18

how can you evaluate diaphragmatic excursion with evaluative percussion

Answer 18

percuss from rib 8 down until hear dull (mark)

have pt breathe in and repeat (mark and measure)

Question 19

to assess chest wall pain

Answer 19

palpate different areas of chest wall

if painful –> positive

Question 20

to evaluate chest wall expansion and motion, what sports do you place your hands

Answer 20

5 anterior

2 lateral

6 posterior

Question 21

5 anterior spots –> CWE

Answer 21

traps

sternum

anterior rib cage

Question 22

2 lateral spots –> CWE

Answer 22

lateral rib cage

Question 23

6 posterior spots –> CWE

Answer 23

upper traps

b/w both scaps

below both scaps

Question 24

when asses tactile femitus

Answer 24

start superior and go inferior (then posterior)

Question 25

whatre all the breathing techniques

Answer 25

pursed lip breathing paced breathing inspiratory hold stacked breathing diaphragmatic controlled breathing lateral costal breathing butterfly breathing

Question 26

pursed lip breathing

Answer 26

pucker lips

Question 27

paced breathing

Answer 27

slowing breathing

Question 28

inspiratory hold

Answer 28

2-3 s

Question 29

stacked breathing

Answer 29

build breaths on top of each other

Question 30

lateral costal breathing

Answer 30

SL/arm over head ribs towards ceiling

Question 31

if pt had a MI, HR cant go above

Answer 31

20 beats above resting in 4 weeks

Question 32

if pt had open heart surgery, HR cant go above

Answer 32

30 beats above resting for 4 weeks

Question 33

for tx of MI and open heart surgery

Answer 33

add 10 beats every 4 weeks

Question 34

manually assisted cough techniques

Answer 34

castrophrenic heimlich abdominal thrust anterior chest compression counter rotation

Question 35

whatre the self assisted cough techiniques

Answer 35

prone on elbows long sitting short sitting quadruped

Question 36

for postural drainage, tx which lobe first and for how many minutes each lobe

Answer 36

most affected 5-10 min each lobe

Question 37

anterior segments are

Answer 37

"basal segments"

Question 38

percussion and vibration --> anterior lower lobes

Answer 38

ribs 5-6 midclavicular line to mid-axillary line fingers pointing out

Question 39

percussion and vibration -->right middle lobe

Answer 39

ribs 4-6 fingers pointing out may not be possible on a female

Question 40

percussion and vibration --> left lateral segment

Answer 40

ribs 6-8 spinous process to posterior axillary line fingers out

Question 41

superior segments

Answer 41

ribs 4-7 b/w supine and medial border of scap fingers pointing out