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CardioPulm > Pulmonary Evaluation > Flashcards

Pulmonary Evaluation Flashcards

1
Q

tidal volume

A

normal breath

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2
Q

inspiratory reserve volume

A

extra after breathing in

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3
Q

expiratory reserve volume

A

extra after breathing out

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4
Q

vital capacity

A

max amount of air you can breath in and out

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5
Q

residual volume

A

amount of air in lungs after max breath

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6
Q

What does a residual volume of 0 mean?

A

collapsed lung

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7
Q

What is FEV1/FVC?

A

ratio of total of air out during 1 sec over time

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8
Q

normal FEV1/FVC

A

0.75-0.8

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9
Q

high FEV1/FVC means what

A

> 0.8
- restrictive lung disease

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10
Q

low FEV1/FVC means what

A

< 0.7
- obstructive lung disease

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11
Q

What does an increased rib angle indicate? What does this do to the diaphragm?

A

rib angle > 90 deg
- indicates chronic hyperinflation that places an increased stretch on the diaphragm causing it to become flatter and less effective

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12
Q

Eupnea
- rate, depth, and rhythm

A

normal rate, normal depth, regular rhythm

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13
Q

bradypnea
- rate, depth, and rhythm

A

slow rate, shallow or normal depth, regular rhythm

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14
Q

tachypnea
- rate, depth, and rhythm

A

fast rate, shallow deep

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15
Q

hyperpnea
- rate, depth, and rhythm

A

normal rate, increased depth, regular rhythm

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16
Q

hyperventilation
- rate, depth, and rhythm
- What does this result in?

A

fast rate, increased depth, regular rhythm
- results in decreased arterial carbon dioxide

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17
Q

an increase in lung tissue density causes _______ sound transmission

A

increased

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18
Q

a decrease in lung density (emphysema) would cause _________ sound transmission

A

decreased

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19
Q

adventitious breath sounds

A

the abnormal noises heard only with a stethoscope

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20
Q

Wheeze sound What does this indicate?

A

continuous but high pitched
- inflamed lung (asthma)

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21
Q

Rhonchi sound What does this indicate?

A

wheeze, low pitch like a snore
- implies obstruction of larger airway

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22
Q

crackles What does this indicate?

A

discontinuous adventitious lung sounds that sound like brief bursts of popping bubbles
- indicates fluid in lungs

23
Q

pleural rub What does this indicate?

A

sounds like 2 pieces of leather or sandpaper rubbing together
- indicates infection in pleural space

24
Q

What is paradoxical breathing?

A

chest moves inward instead of outward during inhalation

25
Q

What conditions cause tracheal deviation?

A

atelectasis and pneumothorax

26
Q

Atelectasis. Which way does the trachea move?

A

complete or partial collapse of a lung (alveolar collapse)
- trachea moves toward the collapsed side

27
Q

Pneumothorax Which way does the trachea move?

A

abnormal collection of air in the pleural space that causes an uncoupling of the lung from the chest wall
- creates restrictive lung disease
- trachea moves away from involved lung

28
Q

S&S of pneuothorax

A
  • tachypnea
  • asymmetric lung expansion
  • distant or absent breath sounds
  • decreased tactile fremitus
  • adventitious lungs sounds

ED referral is you see these in a patient

29
Q

What is tactile fremitus?

A

vibrations created while talking and listening to lungs

30
Q

How much vibration will be felt if a patient has more air trapped (emphysema)? fluid trapped (pneumonia)? Air outside lung (pneumothorax)?

A

air trapped - less vibration

fluid - increased vibration

air outside lung - decreased

31
Q

sound from mediate percussion as thoracic air increases? - emphysema and pneumothorax

A

tympanic sound

32
Q

sound from mediate percussion as thoracic air decreases? - atelectasis, mucus, pleural effusion

A

hyporesonant/dull sound

33
Q

egophony. How is it tested and what are normal and abnormal results?

A

increased resonance of voice sounds
- say “Eeeeeee”
normal results = hear Eeeee
abnormal results = nasal A or goat call heard

34
Q

Brinchophony How is it tested and what are normal and abnormal results?

A

abnormal transmission from lungs or bronchi
- say “99” repeatedly
normal = not understandable
abnormal = 99 understood

35
Q

Whispered pectoriloquy How is it tested and what are normal and abnormal results?

A

increased loudness heard upon whispering
- whisper “1-2-3”
normal = not understood
abnormal = understood 1-2-3

36
Q

What type of breathing would be done with post-op pts, dyspena at rest, or pts who have inefficiency with breathing?

A

diaphragmatic breathing training

37
Q

What type of breathing would be done with tachypnea and dyspnea pts?

A

pursed lip breathing

38
Q

What type of breathing would be done with pts with decreased lung volumes, decreased chest wall compliance, and V-Q mismatch?

A

segmental breathing
- provide quick stretch over external intercostals as pt reaches full exhalation

39
Q

What breathing technique is good for patients who you don’t want to hit or vibrate due to precautions/contraindications?

A

active cycle of breathing techniques

40
Q

How to perform active cycle of breathing technique

A

1) Normal diaphragmatic breathing
2) 3-4 deep breaths
3) Hold breath 1-3 sec
4) Relaxed exhale and cough/huff as needed
5) repeat

41
Q

How to perform autogenic drainage?

A

1) Blow out all air
2) Small breaths in and out for 10-20 breaths
3) Medium breaths in and out
4) Large breaths in and out
5) Cough
6) repeat

42
Q

anterior upper segment position (upper lobes)

A

sitting w/ head of bead raised w/ pillow under kness
- used for anterior upper lobes

43
Q

posterior apical segment

A

sitting with flexed trunk forward w/ pillow under knees
- posterior upper lobes

44
Q

anterior segments

A

supine with pillow under knees
- anterior middle lobes

45
Q

right posterior segment

A

prone with right side slightly elevated
- posterior right upper lobe

46
Q

left posterior segment

A

prone w/ head of bed raised and pillow under stomach/left side slightly elevated
- posterior upper left lobe

47
Q

right middle lbe

A

supine with right side slightly elevated by pillow and foot of bed raised 12 inches
- anterior lower right lobe

48
Q

left lingular

A

supine with left side slightly elevated by pillow and foot of bed raised 12 inches
- anterior lower left lobe

49
Q

anterior segments (lower lobes)

A

supine w/ pillow under knees and foot of bed raised 18 inches
- anterior middle/lower lobes

50
Q

right lateral segment

A

left side lying with foot of bed raised 18 inches
- right lower lobe

51
Q

left lateral segment

A

right side lying with foot of bed raised 18 inches
- left lower lobe

52
Q

posterior segments

A

prone with foot of bed raised 18 inches
- lower posterior lobes

53
Q

superior segments

A

prone with pillows under stomach and feet
- middle posterior lobes

CardioPulm (7 decks)

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