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Pulmonology > Pulmonary Physical Exam > Flashcards

Flashcards in Pulmonary Physical Exam Deck (16):
1

Describe the components of a complete pulmonary physical exam

1. inspection
2. palpation
3. percussion
4. auscultation

2

Discuss the pathophysiologic reasons for abnormal percussion of the chest

Dull = fluid or solid tissue replaces air-containing lung or occupies the pleural space
Caused by: Large pleural effusions, lobar pneumonia, areas of atelectasis

Resonant = occurs with anything that increases air in the lung
Caused by: pneumothorax, emphysema, large air-filled bullae in the lung

3

Discuss the pathophysiologic reasons for abnormal palpation of the chest

Decreased fremitus may be caused by:
• excess air in the lungs (emphysema, pneumothorax)
• fluid in the pleural space (pleural effusion)
• atelectasis due to an obstructed bronchus.

Increased fremitus occurs with consolidation in the lung (replacement of air with water, blood, pus, or other fluid) as occurs in pneumonia or pulmonary edema

4

Discuss the pathophysiologic reasons for abnormal auscultation of the chest

Crackles (also known as rales): Caused by disruptive airflow through the small airways; possible pulmonary edema, pneumonia, and interstitial lung disease

Rhonchi: continuous rumbling caused by passage of air through an airway partially obstructed by mucous or secretions

Wheezes: continuous high-pitched, musical. Diffuse wheezes suggest widespread narrowing (ie asthma) while localized suggest focal obstruction

Egophony: a change in timbre but not pitch or volume. Occur over places of fluid

Stridor: musical sounds typically audible without a stethoscope and can be either inspiratory or expiratory. Represents pathology in the upper airway

5

Identify major physical exam findings associated with pneumonias

Increased fremitus, Dull percussion, bronchial breath sounds with dullness, egophony, and crackles.

6

Identify major physical exam findings associated with pleural effusions

Decreased fremitus
Dull percussion

7

Identify major physical exam findings associated with atelectasis

Decreased fremitus
Dull percussion
bronchovesicular and bronchial breath sounds over the lower lobes.

8

Identify major physical exam findings associated with pneumothorax

Resonant fremitus
asymmetry of chest wall

9

Identify major physical exam findings associated with asthma

bilateral widely spaced ribs

10

Identify major physical exam findings associated with COPD

bilateral widely spaced ribs

11

Identify major physical exam findings associated with pneumonias

x

12

Identify major physical exam findings associated with pleural effusions

x

13

Identify major physical exam findings associated with atelectasis

x

14

Identify major physical exam findings associated with pneumothorax

x

15

Identify major physical exam findings associated with asthma

x

16

Identify major physical exam findings associated with COPD

x