Pulmonary Eval

Question 1

Normal FEV1/ FVC ratio

Answer 1

0.75 to 0.8

Question 2

FEV1/ FVC value for RLD

Answer 2

more than >0.8

Question 3

FEV1/ FVC value for obstructive lung disease

Answer 3

< 0.7

Question 4

Forced midexpiratory flow value range

Answer 4

25 to 75
is the volume of air exhaled in middle 1/2 of FVC

Question 5

clubbed fingers are the enlargement of —– ——. The body doesn’t get enough O2 and compensates with swelling

Answer 5

capillary beds

Question 6

This postural impairment makes it difficult for the lungs to expand

Answer 6

kyphosis

Question 7

Facial signs of pulmonary distress are nasal flaring, sweating, —– ( skin), enlarged —–

Answer 7

paleness
focused or enlarged pupils

Question 8

JVD is associated with ——-

Answer 8

Cor pulmonale

Question 9

hyperinflated chest ratio

AP diameter ( xiphoid process to vertebrae) to transverse diameter

Answer 9

1:1
barrel chest

Question 10

rib angles should measure at —– *
rib angles attach to vertebrae at about —-

Answer 10

90 * rib angle
45* degree vertebrae attachment

Question 11

larger rib and vertebral angles leads to ——-

Answer 11

**air trapping **
this stretches diaphragm causing it to be flatter and less efficient

Question 12

—- SCM and/or adaptive —- of the SCM muscles may indicate a —- pulmonary condition

Answer 12

hypertrophy
shortening
chronic

Question 13

RR for infants

Answer 13

30 - 60 breaths/ min.

Question 14

12 to 18 year olds RR

Answer 14

12 to 20 breaths / min

Question 15

Eupnea: rate, depth, rhythm

Answer 15

normal for all

Question 16

Bradypnea: rate, depth, and rhythm

Answer 16

slow rate
shallow or normal depth
regular rhythm

Question 17

Tachypnea: rate and depth

Answer 17

fast rate
shallow depth

Question 18

Hyperpnea: rate, depth, and rhythm

Answer 18

normal rate,
increased depth, and
regular rhythm

Question 19

Hyperventilation: rate, depth, and rhythm
results in decreased ——

Answer 19

fast rate
increased depth
regular rhythm
decreased arterial carbon dioxide

Question 20

This is when speech is interrupted for a breath. It identifies how many words can be said before next breath

Answer 20

dyspnea of phonation

Question 21

These are abnormal noises that can only be heard with a stethoscope

Answer 21

adventitious breath sounds

Question 22

This lung sound is continous but high pithched

Answer 22

wheeze

Question 23

This lung sound is a subtype of a wheeze. It has a low pitch and implies an obstruction of the airway

Answer 23

Rhochi

Question 24

This adventitious lung sound is discontinous and sound like brief burst of popping bubbles

Answer 24

Crackles

Question 25

This lung sound is heard on the inhale and exhale. It sounds like 2 pieces of leather or sandpaper

Answer 25

pleural rub

Question 26

A productive cough is common with ----- A nonproductive cough is common with ------

Answer 26

productive cough: infection nonproductive cough: lung neoplasm

Question 27

This type of breathing is not coordinated and is not efficient.

Answer 27

**Paradoxical breathing**

Question 28

during paradoxical breathing the chest moves ---- instead of ----- during inhalation

Answer 28

moves inward instead of outward

Question 29

The trachea moves ---- the collapsed side in Atelectasis

Answer 29

towards | partially collapsed area, NOT a collapsed lung

Question 30

T or F: pneuthorax the trachea will deviate away from the collapse side

Answer 30

True

Question 31

Tachypnea, ipsilateral crackles and wheezes, decreased tactile femitus, distant or absent breath sounds all indicate -------

Answer 31

pneumothorax

Question 32

In crepitus the hallmark sign is increasing edema from in the ---- > ---- to ---- with rice cripsy feeing and crackling skin is palpated

Answer 32

chest > scapula > neck to face

Question 33

The PT places their hands on patient and feel for vibrations in the chest from the words. This is called

Answer 33

Tactile Fremitus

Question 34

tactile fremitus provides info on ---- lungs and thoracic cavity

Answer 34

density

Question 35

In tactile fremitus for pneumothroax and pleural effusion are increased or decreased

Answer 35

decreased this prevents lung expansion --> creates more space in the lung prevents sound transmission

Question 36

Mediate Percussion: striking an air filled surface ( lung) will produce what kind of sound? striking a fluid or tissue filled cavity will produce what kind of sound?

Answer 36

air filled - Reasonant sound fluid filled - dull sound

Question 37

What sound would be associated with thoracic air increases ( air trapping)? This is associated with emphysema and pneumothroax?

Answer 37

hyper-reasonant or tympanic

Question 38

What conditions are associated with decreased thoracic air?

Answer 38

atelectasis pleural effusion mucus

Question 39

Pronounced and prolonged expiration would associated with what pathology

Answer 39

obstructive airway disease

Question 40

what elicited sound test involves increased reasonance of voice sounds ?

Answer 40

Egophony say "eeeee"

Question 41

normal and abnormal finding with egophony

Answer 41

Healthy: hear "eeeee" Unhealthy: nasal A or "goat call" sound ausculation

Question 42

what elicited sound test looks at abnormal transmission from lungs to bronchi

Answer 42

Bronchophony say "99"

Question 43

Increased loudness upon whispering

Answer 43

Whispered Pectoriloquy whisper 1,2,3

Question 44

healthy test for Whispered Pectoriloquy

Answer 44

not understood

Question 45

abnormal/ unhealthy test for Whispered Pectoriloquy

Answer 45

understood 1,2,3

Question 46

where are Vesicular breath sounds heard are? are they abnormal or normal? ## Footnote Now from the pulmonary exam lab

Answer 46

Normal heard over most of **peripheral** lung fields

Question 47

reduction in vesicular sound volume indicates

Answer 47

reduced ventilation

Question 48

prolonged **exhale** sound indicates

Answer 48

airway obstruction

Question 49

bronchial sounds are found where?

Answer 49

over / close to the trachea | aka tracheal sounds

Question 50

Broncho-vestibular sounds are found where? what do they represent?

Answer 50

lateral to trachea interscapular region ( L) represent **conituum** of sounds from** larger airways**

Question 51

Narrowing of airways ( aka bronchospasms, bronchial edema, adherent secretions...) produce what type of adventitious lung sound

Answer 51

High pitched **wheeze**

Question 52

Fluid (mucous) in the larger or conducting airways produce what type of adventitious lung sound

Answer 52

Rhonchi ( low pitch/ coarse)