Respirtatory System

Question 1

4 HISTORY TAKING

Answer 1

Current Symptoms
Past History
Family History
Lifestyle and Health Practices

Question 2

A clenched fist over the sternum (Levine sign) →

Answer 2

angina pectoris

Question 3

a finger pointing to a tender spot on the chest wall →

Answer 3

musculoskeletal pain

Question 4

a hand moving from the neck to the epigastrium →

Answer 4

heartburn

Question 5

problems with snoring, witnessed apneas (defined as breathing cessation for ≥10 seconds), awakening with a choking sensation, or morning headache.

Answer 5

obstructive sleep apnea

Question 6

EQUIPMENT

Answer 6

Examination gown anddrapes
Mask
Gloves
Stethoscope
Light source
Skin marker
Centimeter ruler

Question 7

Palpate for fremitus, using the ball or ulnar edge of one
hand while the client says “_____”.

Answer 7

ninety-nine

Question 8

Palpate for chest expansion. Place hands on the posterior
chest wall with your thumbs at the level of ___

Answer 8

T9 or T10,

Question 9

is the most
important examination
technique for assessing air
ow through the
tracheobronchial tree

Answer 9

Auscultation

Question 10

The most commonly heard adventitious sounds

Answer 10

crackles
rhonchi
wheezes
*Stridor
*rubs

Question 11

Normal Sounds

Answer 11

egophony
bronchophony
Whisper Pectoriloquy

Question 12

ask the client to repeatthe letter “E”

Answer 12

Egophony

Question 13

ask the client to repeat the phrase “ninety-nine.”

Answer 13

Bronchophony

Question 14

ask the client to whisper the phrase “one-two-three” or “ninety-nine.”

Answer 14

whisper pectoriloquy.

Question 15

INSPECTION Note the following in the respiratory system

Answer 15

▪ Tracheal deviation
▪ Chest wall deformities
▪ Kyphosis
▪ Scoliosis
▪ Barrel Chest
▪ Pectus excavatum
▪ Pectus carinatum

Question 16

curvature of the spine (anterior/posterior)

Answer 16

Khyposis

Question 17

curvature of the spine (lateral)

Answer 17

Scoliosis

Question 18

Increased anterior/posterior chest wall.

Answer 18

▪ Barrel Chest

Question 19

Abnormal spinal curvature and , vertebral rotation deform chest. Distortion of the underlying lungs interpretation of lung findings are difficult

Answer 19

Thoracic Kyphoscoliosis

Question 20

Normal Adult
The lateral diameter of the thorax in the normal adult is greater than its AP diameter which is

Answer 20

0.7 up to 0.9 increases with age

Question 21

Note depression in the lower portion of the sternum.
Compression of the heart and greater vessels may cause murmurs.

Answer 21

Funnel Chest (Pectus Excavatum)

Question 22

the sternum is displaced anteriorly. increasing the AP diameter.
Costal cartilages adjacent and protruding sternum are depressed.

Answer 22

Pigeon Chest (Pectus Carinatum)

Question 23

SIGNS
OF RESPIRATORY DISTRESS

Answer 23

▪Tachypneic (>25/bpm)
▪Cyanosis (hypoxia) or pallor (heart failure)
▪ Pursed-lip breathing
▪ Accessory muscle use
▪ Diaphragmatic paradox
▪ Intercostal indrawing

Question 24

2 Chronic Obstructive Pulmonary Disease

Answer 24

Pink Puffer (Emphysema Dominant)
Blue Bloater (Bronchitis Dominant)

Question 25

Accessory muscles of ventilation:

Answer 25

1. scalene 2. sternocleidomastoid 3. pectoralis major 4. trapezius 5. external intercostals.

Question 26

when the chest expands during inhalation and the abdomen is drawn inwards and then during exhalation the abdomen is pushed outwards

Answer 26

Paradoxical Breathing

Question 27

Inspiratory Sound longer than expiratory sound soft and relatively low. over both lungs

Answer 27

Vesicular

Question 28

inspiratory and expiratory are almost equal. intermediate 2nd interspaces anterior between the scapula

Answer 28

Bronchovesicular

Question 29

Expiratory sounds last longer than the inspiratory ones. loud relatively high over the manubrium

Answer 29

Bronchial

Question 30

inspiratory and expiratory sound are almost equal. very loud relatively high over the trachea in the neck

Answer 30

Tracheal

Question 31

Discontinuous Intermittent, nonmusical, and brief like dots in time

Answer 31

Crackles

Question 32

louder, lower in pitch 350Hz 15-30ms

Answer 32

Coarse Crackles

Question 33

soft, high-pitched 650Hz 5-10ms

Answer 33

fine crackles

Question 34

Continuous Sinusoidal, musical, prolonged like a dash in time

Answer 34

Wheezes and Rhonchi

Question 35

relatively high-pitched >400Hz with hissing/shrill >80ms

Answer 35

Wheezes

Question 36

relatively low-pitched 150-200Hz with snoring quality >80ms

Answer 36

Rhonchi

Question 37

is a continuous, high-frequency, high-pitched musical sound produced during airflow through a narrowing in the upper respiratory tract.

Answer 37

Stridor

Question 38

is a discontinuous low frequency: grating sound that arises from inflammation and roughening of the Visceral pleura as it slides against the parietal pleura.

Answer 38

A pleural rub