Respiratory Exam Flashcards
1
Q
Causes of clubbing
A
CLUBBING (L= ABCDE)
- Cyanotic heart disease
- Lung disease
- > Abscess
- > Bronchiectasis
- > Cystic fibrosis
- > Don’t say COPD
- > Empyema
- Ulcerative colitis
- Biliary cirrhosis
- Bronchogenic carcinoma
- Infective endocarditis
- Neoplasias (eg. mesothelioma)
- GI (crohns/coeliac)
2
Q
tracheal deviation
A
Towards lesion
- fibrosis
- atelectasis
- pneumonectomy
Away from lesion
- massive pleural effusion
- massive pneumothorax
3
Q
reduced chest expansion
A
unilateral
- fibrosis
- consolidation
- collapse
- effusion
- pneumothorax
bilateral
- COPD
- fibrosis
4
Q
apex beat
A
displaced towards lesion
- collapse
- fibrosis
displaced away from lesion
- massive effusion
- massive pneumothorax
not palpable
-COPD
5
Q
Traubes space
A
area
- 6th interspace mid-clavicular
- 9th interspace anterior-clavicular
- down to costal margin
percussion
-tympanitic compared to rest of chest
significance of loss
- represents stomach bubble
- effusion
- > fluid seeps into costophrenic angle
- > obliterates tympanitic sound
- consolidation
- > limited by lung margin above traubs space
- > remains tympanitic
- full stomach after eating
- splenomegaly
6
Q
COPD
A
General inspection
- tripod stance
- increased work of breathing
- > pursed lip breathing
- > nasal flaring
- > accessory muscles
- > increased RR
- cupping supraclavicular fossa
- hypertrophied sternocliedomastoid
- inspiratory descent of trachea
Hands
- nicotine staining
- asterixis in severe
Face
-central cyanosis
Trachea
-inspiratory descent
Chest
- inspection
- > hyperinflated
- > limited movement
- > harrisons sulcus
- > widened substernal angle
- expansion
- > reduced
- > harrisons sign
- percussion
- > hyperresonate
- > loss of cardiac dullness
- > resonate below liver margins
Auscultation
- wheeze
- long expiratory component
- inspiratory crackles
- reduced breath sounds
7
Q
Percussion
A
Liver
- margins
- > 5th interspace mid-clavicular
- > 7th interspace mid-axillary
- > 9th interspace mid-scapular
- resonance below
- > hyperinflation
- dullness above
- > consolidation
- > effusion
- > collapse
Cardiac
- margins
- > fist shaped over left pec
- loss of dullness
- > hyperinflation
8
Q
breath sounds
A
vesicular
- description
- > inspiratory component louder and longer
- > no gap
- correlation
- > normal
bronchial
- description
- > similar to listening over trachea
- > gap between inspiration and expiration
- > expiratory component louder than inspiratory
- correlation
- > consolidation conducting sound better
9
Q
crackles
A
early
- cease before middle inspiration
- correlation
- > diseased small airway
- > COPD
late/pan
- fine (rubbing hair)/velcro
- > interstitial lung disease
- medium
- > left HF and consolidation
- coarse/gurgling
- > bronchiectasis
- > pneumonia
10
Q
vocal resonance
A
increased resonance
- description
- > easiest to distinguish when asymmetrical
- > loud 99
- correlation
- > consolidation
aegophony
- description
- > bee becomes bay
- correlation
- > consolidation
whispered pectorlioquy
- description
- > transmission of whispered 99
- correlation
- > consolidation
11
Q
pneumonary oedema findings
A
Pneumonia
- tracheal displacement
- > no
- chest expansion
- > reduced over area
- percussion
- > dull
- breath sounds
- > bronchial
- added sounds
- > medium crackles
- vocal resonance
- > increased over area
- > aegophony
- > whispered pectoriloquy
12
Q
effusion findings
A
Effusion
- tracheal displacement
- > away from lesion if massive
- chest expansion
- > reduced over affected area
- percussion
- > stony dull
- > loss of traubs space
- breath sounds
- > absent over fluid
- > may be bronchial above fluid
- added sounds
- > no
- vocal resonance
- > decreased
13
Q
atelectasis findings
A
- tracheal displacement
- > to side of lesion
- chest expansion
- > decreased over area
- percussion
- > dull
- breath sounds
- > absent or reduced
- added sounds
- > absent
- vocal resonance
- > decreased
14
Q
pneumothorax findings
A
- tracheal displacement
- > away from lesion
- chest expansion
- > decreased over area
- percussion
- > tympanitic
- breath sounds
- > absent or reduced
- added sounds
- > no
- vocal resonance
- > decreased
15
Q
interstitial fibrosis findings
A
- tracheal displacement
- > towards lesion
- chest expansion
- > decreased bilaterally
- percussion
- > normal
- breath sounds
- > normal
- added sounds
- > fine/velcro pan/late inspiratory crackles
- vocal resonance
- > normal or slightly increased
