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H&P EXAM 2 > Pulmonary > Flashcards

Pulmonary Flashcards

(50 cards)

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1
Q

Hemoptysis

A

Coughing up blood

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2
Q

Dyspnea

A

Shortness of breath

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3
Q

Pleuritic

A

Pain with breathing

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4
Q

What is the 7th rib location?

A

at same level as inferior angle/tip of scapula

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5
Q

What are the boundaries of the lungs? (apex and base)

A

-Apex~2-4cm above clavicle

-Lower border
6th rib midclavicular line (MCL)
8th rib midaxillary line
T10 posterior

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6
Q

Describe the location of the Major and Minor lung fissures

A
  • Major (Oblique) fissure divides each lung in half
  • From T3 spinous process obliquely around to chest to 6th rib at midclavicular line.
  • Minor (Horizontal) fissure (right lung only)
  • Runs close to 4th rib.
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7
Q

Describe Lung fields versus lobes

A
  • The lung fields are subdivided into 6 regions

- Auscultate lung fields to try to determine affected lobe

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8
Q

Trachea bifurcates at _____?

A

the level of the sternal angle anteriorly or T4 posteriorly

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9
Q

Describe Stridor

A
  • A wheeze that is high pitched & largely inspiratory; usually louder in the neck
  • Results from turbulent airflow in upper airway
  • Indicates laryngeal/upper airway obstruction (can be assoc. with epiglottitis, foreign body aspiration)
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10
Q

What are some Possible signs of COPD?

A

1) Clubbing of the fingers: fingertips spread out and become rounder than normal, is often linked to heart or lung conditions
2) Pursed-lip breathing: Reduces respiratory rate from 20 breaths/min to 12/15 breaths/min, increases tidal volume, ↓PaCO2, ↑PaO2

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11
Q

Describe the Tone, Intensity, and Pitch of Emphysematous lungs (diffuse); pneumothorax (local)

A

Tone: Hyper-resonant
Intensity: Very loud
Pitch: Low

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12
Q

Describe the Tone, Intensity, and Pitch of Healthy lungs

A

Tone: Resonant
Intensity: loud
Pitch: Low

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13
Q

Describe the Tone, Intensity, and Pitch of Gastric bubble (or puffed out cheek)

A

Tone: Tympanic
Intensity: loud
Pitch: High

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14
Q

Describe the Tone, Intensity, and Pitch of Liver

Eg. consolidation (pneumonia); pleural effusion

A

Tone: Dull
Intensity: Soft-moderate
Pitch: Moderate-high

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15
Q

Describe the Tone, Intensity, and Pitch of Muscle

Eg. consolidation (pneumonia); pleural effusion

A

Tone: Flat
Intensity: Soft
Pitch: High

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16
Q

Describe the Characteristic sounds of breathing at the Trachea

A

Intensity: Very loud
Pitch: Very High
I:E ratio: 1:1
Description: Harsh

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17
Q

Describe the Characteristic sounds of breathing at the bronchial

A 
Intensity: Loud
Pitch: High
I:E ratio: 1:3
Description: Tubular 
Normal location: Manubrium
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18
Q

Describe the Characteristic sounds of breathing at the bronco-vesicular

A 
Intensity: Moderate 
Pitch: Moderate
I:E ratio: 1:1
Description: Rustling but tubular 
Normal location: Over mainstem bronchi (1st & 2nd interspaces anteriorly & between scapula posteriorly)
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19
Q

Describe the Characteristic sounds of breathing at the vesicular

A 
Intensity: Soft 
Pitch: Low
I:E ratio: 3:1
Description: Gentle rustling 
Normal location: Most of peripheral lung
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20
Q

Describe Crackles (rales)

A

Crackles (rales) – discontinuous sound
Caused by “popping open”of small airways & alveoli that have collapsed. Fluid in the lung can cause this (E.g. pneumonia, congestive heart failure).

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21
Q

Describe Rhonchi

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A

Snoring quality
Caused by airway secretions & narrowing / partial obstruction (E.g. bronchitis, COPD)
Low-pitched, continuous sound

22
Q

Describe Wheeze

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A

High-pitched, whistle

Caused by airway obstruction (E.g. asthma)

23
Q

Describe Sighing

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A

periodic deeper breaths

24
Q

Describe Apnea

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A

Absence of breathing caused by Cardiac arrest

25
Describe Biot's
Irregular breaths with long periods of apnea caused by Increased intracranial pressure, Drug induced respiratory depression, Brain damage
26
Describe Cheyne-Stokes
Irregular breaths with intermittent periods of increased and decreased rates and depths of breath alternating with periods of apnea caused by Drug induced respiratory depression, cognitive heart failure, Brain damage
27
Describe Kussmaul's
Fast and deep breaths caused by Metabolic acidosis
28
Describe Hyperventilation
Deeper, usually faster breathing
29
Describe Pectus carinatum
"Pigeon chest'
30
Describe Pectus excavatum
"sunken chest"
31
Describe Kyphosis
Hunch back
32
Describe Kyphoscoliosis
abnormal curvature of the vertebral column in two planes (coronal and sagittal). It is a combination of kyphosis and scoliosis.
33
Describe Atelectasis
- Loss of air from lung or collapse of lung tissue with reduced lung volume - Can result from blockage of air passages with mucus or from pleural effusion
34
Describe Tension Pneumothorax
Large amount of air entering the chest when a one-way valve (air in) is formed by an area of damaged tissue
35
Describe Pneumonia
Pneumonia refers to pneumonitis (inflammation of the lung), usually due to infection but sometimes has noninfectious cause; has the additional feature of pulmonary infiltrates / consolidation
36
Describe Consolidation
-Condition in which lung tissue becomes firm and solid rather than elastic and air-filled because usu. due to accumulated fluids & tissue debris - Lung/pulmonary infiltrate is filling of the air spaces with fluid - Infiltrates can cause consolidation
37
Describe a Pleural Effusion
Collection of fluid in the pleural space – the space between the visceral pleura (lining over the lungs) and the parietal pleura (lining over the thoracic wall)
38
Describe a Hemothorax
Blood in pleural space
39
Describe Empyema
Pus in pleural space Usu. results from infection that spreads from the lungs (e.g. pneumonia, abscess)
40
Describe Pleurisy/Pleuritis
Inflammation of the pleura
41
Describe Acute Bronchitis
Inflammation of the bronchi (not involving the lungs) | Bronchi are considered part of the upper airway
42
Describe Obstructive lung diseases
1) Asthma - Bronchial tubes (airways) are hyper-responsive (extra sensitive) --> Airways become inflamed & produce excess mucus --> Muscles around the airways tighten making the airways narrower --> Narrower airways obstruct breathing - Reversible 2) COPD (e.g. emphysema) - Assoc. with airway resistance & residual volume of air even after full expiration - Can result in hyperinflated lungs (barrel chest) - Considered (at least to some degree) irreversible
43
Describe Pleural friction rub
- Squeaking or grating sound of the pleural linings rubbing together - Assoc. with pleurisy - Heard on inspiration and expiration
44
Describe Crepitus
Palpable grating or crunching, can occur with: | E.g. rib movement due to fracture (bone crepitus)
45
Describe Tactile fremitus (a special test)
- looking for consolidation - Vibrations transmitted through the bronchopulmonary tree - Use ulnar surface of the hand to appreciate the palpable vibrations
46
Mediastinal crunch (Hamman sign)
- Loud crackles, clicks, and gurgling sounds - Due to pneumo-mediastinum (mediastinal emphysema) - Synchronous with heart beat
47
Describe the transmission of sound in Consolidation vs. Air + effusion
- Consolidation increases transmission | - Air + effusions decrease transmission
48
Discuss Tactile Fremitus, Percussion, Breath sounds, Voice sounds, Adventitious sounds for Pneumonia (Consolidation)
``` Tactile Fremitus: Increase Percussion: Dull Breath sounds: Bronchial Voice sounds: Increase Adventitious sounds: Crackles ```
49
Discuss Tactile Fremitus, | Percussion, Breath sounds, Voice sounds, Adventitious sounds for COPD/emphysema (Obstructive)
``` Tactile Fremitus: Decrease Percussion: Hyperresonant Breath sounds: Diminished Voice sounds: Decrease Adventitious sounds: May hear wheeze, rhonchi (if bronchitis) ```
50
Discuss Tactile Fremitus, | Percussion, Breath sounds, Voice sounds, Adventitious sounds for effusion
``` Tactile Fremitus: Decrease Percussion: Dull or flat Breath sounds: Diminished Voice sounds: Decrease Adventitious sounds: Possible pleural rub ```

H&P EXAM 2 (5 decks)

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