Respiratory 2 Flashcards
What is pulseless paradoxus?
An exaggeration of the normal decrease in blood pressure during inspiration. The ‘paradox’ is that you can detect beats on auscultation of the heart during inspiration that cannot be palpated at the radial artery due to a fall in blood pressure. Pulsus paradoxus is seen in severe obstructive airways disease and cardiac tamponade
What is flapping asterixis?
Tremor produced upon sharp forced flexion of the wrist likened to the flapping of a birds wing, present in respiratory failure (and hepatic encephalopathy and failure)
What does raised JVP indicate?
Venous HTN (R heart failure, Cor pulmonale; raised and non-pulsatile may be due to SVC obstruction from a lung cancer – will result in oedema of face and neck An increase during inspiration (instead of expected decrease) = Kussmaul sign (constrictive pericarditis, pericardial effusion, RHF etc)
What is Horner’s syndrome
Due to damage to the sympathetic trunk
Triad of ptosis, meiosis and anhydrosis
What is chemosis?
Conjunctival oedema, may be seen with hypercapnia secondary to COPD
What might cause a trachea to deviate?
Away – tumour, effusion, pneumothorax
Towards – collapsed lung, scar tissue/fibrosis
What are you assessing when looking at tactile vocal fremitus or vocal resonance?
Decreased tactile fremitus – pneumothorax or (stony dull) pleural effusion
Resonant/increased tactile fremitus – consolidation i.e. pneumonia
What is pectoriloquy?
Increased conduction of whispers (ninety-nine) over an area of consolidation when auscultated (wouldn’t normally here)
What is the pathology behind some different added sounds?
Wheeze - asthma, COPD (mostly expiratory)
Course crackles - pneumonia, bronchiectasis, fluid overload (will change quality after cough)
Fine ‘velco’ crackers - pulmonary fibrosis (do not clear after a cough)
