Respiratory examination Flashcards
(53 cards)
What should you look for during general inspection of the patient in a resp exam?
Colour change (cyanosis/pallor), shortness of breath, cachexia, resp rate, scars, added sounds
What should you look for during general inspection of the bedside in a resp exam?
Cigarettes, oxygen/ oxygen masks, nebulisers, inhalers, sputum pot, cigarettes, vape
What should you look for when inspecting the hands in a resp exam?
Tar staining Clubbing Peripheral cyanosis Flap/ tremor Temperature Small muscle wasting Dilated veins Cap refill
What are the respiratory causes of clubbing?
Low blood oxygen
Lung cancer
Pulmonary fibrosis
Bronchiectasis
Does COPD cause clubbing?
NO
What may cause a fine tremor of the hands in the context of a resp exam?
Drugs like salbutamol
What do dilated veins of the hand suggest in a resp exam?
Hypercapnia
How do you test for asterixis and what would a positive test mean?
Ask them to hold out their hands and cock them back, if they flap they may have co2 retention
How should you take the pulse and resp rate?
Take the radial pulse for 15 secs then the resp rate for 30 secs, don’t tell them you are taking the resp rate
If the pulse is irregular how long should you take it for?
30 seconds/ a minute (just longer than 15 seconds)
What are the main causes of tachycardia in a resp exam?
Infection
Pulmonary embolism
Asthma
Why may conjunctival pallor be relevant in a resp exam?
It is a sign of anaemia which occurs if there is significant shortness of breath
What is whiteness of the tongue called medically?
Oral candida
What common medication does not cause oral candida? (but people often think it does)
Inhaled salbutamol
What causes oral candida?
Inhaled steroids
Amoxicillin
What are the 3 notable features of Horner’s syndrome?
Ptosis
Anhydrosis
Decreased pupil size
What is the significance of Horner’s syndrome when identified in a resp exam?
It could be due to lung cancer, specifically a pancoast tumor which is an apical cancer
What will polycythemia do to someones complexion?
Cause it to be plethoric/ruddy due to widened blood vessels
What examinations are done on the neck in a resp exam?
Tracheal position
JVP
What causes the trachea to deviate away from the problematic side?
Tension pneumothorax
Pleural effusion
What causes the trachea to deviate towards the problematic side?
Lobar collapse
Pneumonectomy
On inspection what will a scar under the pecs near the midline of the axilla indicate?
Lateral thoracotomy
When inspecting the chest what should you always ask the patient to do?
Lift their arms to see any subtle or hidden scars
What is the medical name for a funnel shaped chest and what causes it?
Pectus excavatum
Congenital condition or from connective tissue disease
