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Cardiopulm > Pulmonary Exam (Lab) > Flashcards

Pulmonary Exam (Lab) Flashcards

1
Q

What should you look for for general appearance?

A

Look for pallor, cyanosis, or normal coloring of the skin of the face and extremities including blanching of nail beds, digital clubbing, and JVD.

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2
Q

The thoracic cage is out more on one and comes out; occurs mostly with multiple rib fractures.
This clinical presentation is describing…

A

Flail chest

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3
Q

The sternum is sinking in and sits down in the chest. This clinical presentation is describing…

A

Pectus excavatum

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4
Q

The sternum protrudes and the ribs come out to a point at the sternum.
This clinical presentation is describing…

A

Pectus carinatum

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5
Q

A patient who demonstrates a more barrel chest (increased A-P) compared to our typical elliptical chest is found with what diagnosis?

A

COPD

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6
Q

What breathing pattern is being described?
1 side moving more or less than the other; typically the side that is moving less is involved.

A

Lateral costal

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7
Q

What breathing pattern is being described?
Increase in anterior and apical movement of thoracic cage; chest breather.

A

Apical

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8
Q

What breathing pattern is being described?
Opposite movement of the thoracic cage and abdomen; sink and expand in opposite motions.

A

Paradoxical

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9
Q

What breathing pattern is being described? Person is breathing out longer than normal.

A

Prolonged expiration

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10
Q

What breathing pattern is being described? The patient’s mouth is just opening and closing when breathing.

A

Fish-mouthed

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11
Q

What breathing pattern is being described? Irregular depth of respiration with periods of apnea.

A

Cheyne-Stokes

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12
Q

What breathing pattern is being described? Slow rate, shallow depth, followed by period of apnea (brain kicks in to breathe more because of increased CO2 in tissues), followed by irregular depths, then settles back into slow and shallow. Seems like the person isn’t really breathing.

A

Apneustic

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13
Q

What breathing pattern is being described? Sudden stop in breathing pattern. Usually one side or the other but can be both, typically due to pain.

A

Doorstop

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14
Q

Any use of accessory muscles at rest, in the absence of hypertrophy, is indicative of an acute or chronic respiratory insufficiency?

A

Acute

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15
Q

To assess lung expansion or chest wall excursion, should you tell your patient to breathe in through their mouth or nose?

A

Nose

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16
Q

What test listens to the air moving inside the lung?

A

Fremitus

17
Q

To test for Fremitus, what should you tell your patient to do?

A

Say “99”

18
Q

How would you describe your findings for Fremitus?

A

Normal resonance, hyporesonance, or hyperresonance

19
Q

What test listens to air in the tissue beneath?

A

Percussion

20
Q

What are the options for interpretation when testing percussion?

A

Resonant, dull, flat, or tympanic (hyper-resonant)

21
Q

When completing auscultation, do you want your patient to breathe through their nose or mouth, and why?

A

Have them take a deep breath through their mouth because the nose has hair cells that may contain mucous that can be picked up by the stethoscope.

22
Q

Signs of pallor or cyanosis (tips of ears and nose) suggest…

A

Low PO2 and high CO2

23
Q

Slow return of pink color in nail beds after compression is indicative of…

A

PVD

24
Q

Signs of digital clubbing are indicative of…

A

Long-standing high CO2 retention

25
Q

If the mediastinum is shifted to one side, this could mean…

A

A space-occupying lesion on the other side of the shift, or partial collapse or underdevelopment of lung tissue on the same side of the shift.

26
Q

Signs of barrel chest are indicative of…

A

Overinflation of lungs that can lead to larger than normal residual volume as a result of COPD; or gross asymmetry from kyphosis or scoliosis that could suggest low ventilatory capacity.

27
Q

Limited lung excursion suggests…

A

Regional ventilation impairment

28
Q

Hyporesonance with Fremitus is associated with…

A

Either low ventilatory effort, air trapping, or fluid accumulation.

29
Q

Hyperresonance with Fremitus is associated with…

A

Increased tissue density such as consolidated pneumonia.

30
Q

Elevated diaphragm or hemi-diaphragm is an indication of…

A

Impaired ventilation may occur as a result of atelectasis or increased intra-abdominal pressure from gas, pregnancy, or even subphrenic abscess.

31
Q

Dull percussion is indicative of…

A

Low inflation of underlying tissue which may be the result of low, ventilatory effort, fluid accumulation, accumulation of mucous, or pneumonia.

32
Q

Flat sounds are heard with percussion when…

A

You are over visceral tissue.

33
Q

Tympanic sounds are heard with percussion when…

A

The lungs are over-inflated such as with COPD.

Cardiopulm (4 decks)

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