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Year 3 CCA > Respiratory Examination > Flashcards

Respiratory Examination Flashcards

1
Q

On inspection of the surrounding are, what are you looking for?

A
  1. Drips
  2. Oxygen
  3. Medication
  4. Sputum pots
  5. Inhalers
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2
Q

On general inspection of the patient, what are you looking for?

A
  1. Body habitus
  2. Well/ unwell
  3. Breathlessness
  4. Pursed lips breathing
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3
Q

What might pursed lips breathing indicate?

A

COPD

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4
Q

On inspection of the nails, what are you looking for?

A
  1. Clubbing

2. Koilonychia

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5
Q

What are respiratory causes of clubbing?

A
  1. Interstitial lung disease
  2. Lung cancer
  3. Bronchiectasis
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6
Q

Why is koilonychia relevant to a respiratory examination?

A

Iron deficiency anaemia causing shortness of breath.

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7
Q

On inspection of the hands, what are you looking for?

A
  1. Temperature
  2. Capillary refill time
  3. Peripheral cyanosis
  4. Tar staining
  5. Flapping tremor
  6. Fine tremor
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8
Q

What might a flapping tremor indicate?

A

Severe CO2 retention.

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9
Q

What might a fine tremor indicate?

A

Excessive use of beta 2 agonist

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10
Q

On inspection of the face in general, what are you looking for?

A

A Cushingoid appearance

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11
Q

On inspection of the eyes, what are you looking for?

A
  1. Horner’s syndrome
  2. Conjunctival pallor
  3. Iritis, conjuctivitis
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12
Q

What signs indicate Horner’s syndrome?

A
  1. Miosis
  2. Ptosis
  3. Anhydrosis
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13
Q

What might Horner’s syndrome indicate in a respiratory examination?

A

Pancoast tumour pressing on sympathetic chain of nerves in chest.

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14
Q

What might conjunctival pallor indicate?

A

Anaemia causing shortness of breath

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15
Q

What may eye problems like iritis, conjunctivitis indicate in a respiratory examination?

A
  1. TB

2. Sarcoidosis

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16
Q

On inspection of the mouth, what are you looking for?

A

Central cyanosis

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17
Q

What might a raised JVP indicate?

A
  1. Right heart failure
  2. Overload
  3. Massive PE
  4. Tension pneumothorax
  5. Cardiac tamponade
  6. SVC obstruction
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18
Q

What is a tracheal tug and what might it indicate?

A

Trachea pulls down on inspiration due to hyperinflation (COPD)

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19
Q

What does a trachea deviate towards?

A
  1. Collapse

2. Pneumonectomy

20
Q

What does a trachea deviate away from?

A
  1. Tension pneumothorax

2. Very big effusion

21
Q

What should the cricosternal distance be and when might it be reduced?

A

2-3 finger breadths, reduced with hyperinflation.

22
Q

What are you looking for on inspection of the chest?

A
  1. Deformity and symmetry
  2. Scars
  3. Respiratory pattern
  4. Intercostal drawing
23
Q

What does a barrel chest indicate?

A

Hyperinflation

24
Q

What does pectus excavatum (funnel chest) indicate?

A

Developmental defect

25
Q

What does pectum carinatum (pigeon chest) indicate?

A

Increased respiratory effort during development.

26
Q

What does paradoxical movement of the chest and abdomen indicate?

A

COPD or obstruction

27
Q

What types of scars might you look out for?

A
  1. Thoracotomy
  2. Chest drain
  3. Radiotherapy tattoo
28
Q

What might a prolonged expiratory phase coupled with pursed lips breathing indicate?

A

Sign of smoking related lung disease.

29
Q

What does intercostal drawing indicate?

A

COPD due to hyperinflation

30
Q

What does a parasternal heave indicate?

A

Cor pulmonale

31
Q

What might a shift in apex beat indicate (respiratory related)?

A
  1. Collapse

2. Tension pneumothorax

32
Q

What might hyper-resonance on percussion indicate?

A
  1. Pneumothorax

2. Emphysematous bullae

33
Q

What might dullness on percussion indicate?

A
  1. Consolidation
  2. Collapse
  3. Alveolar fluid
  4. Pleural thickening
  5. Neoplasm
34
Q

What might stony dullness on percussion indicate?

A

Pleural effusion

35
Q

What might a local area of diminished breath sounds indicate?

A
  1. Effusion
  2. Tumour
  3. Pneumothorax
  4. Pneumonia
  5. Collapse
36
Q

What might globally diminished breath sounds indicate?

A

COPD

37
Q

What might bronchial breath sounds indicate?

A
  1. Consolidation

2. Upper boarder of pleural effusion

38
Q

What might a polyphonic wheeze indicate?

A
  1. Asthma

2. COPD

39
Q

What might a monophonic wheeze indicate?

A
  1. Carcinoma

2. Foreign body

40
Q

What might crepitations indicate?

A
  1. Infection
  2. Fluid
  3. Fibrosis
41
Q

What should you do if you hear crepitations?

A

Ask patient to cough and listen again - it may clear secretions.

42
Q

What might a rub on auscultation indicate?

A
  1. Pneumonia

2. PE with infarction

43
Q

What does increased sound when testing vocal resonance indicate?

A

Consolidation

44
Q

What does decreased sound when testing vocal resonance indicate?

A
  1. Effusion

2. Pneumothorax

45
Q

Where do lung bases extend to posteriorly?

A

11th ribs

46
Q

What may sacral and ankle oedema indicate?

A

Right heart failure

Year 3 CCA (3 decks)

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