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(3) Cardio-Pulmo-Renal Rehabilitation > S1 L2.2: Physical Examination of the Respiratory System > Flashcards

S1 L2.2: Physical Examination of the Respiratory System Flashcards

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1
Q

What can you tell about a patient in a tripod position?

A

They are in respiratory distress

There is an exchange of O2 and
CO2 in the pulmonary bed

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2
Q

General color indication with a pt who suffers from hypoxemia

A

Cyanotic, bluish discoloration, pale

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3
Q

Type of chest that is a sign of air trapping, chronic asthma, or emphysema

A

Barrel Chest

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4
Q

Type of chest where it creates a compression of the heart & great vessels may cause murmurs.

A

Pectus Excavatum

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5
Q

Another name for Pectus Carinatum

A

Pigeon Chest

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6
Q

Curve of the spine where it definitely compromises heart & lungs

A

Kyphosis

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7
Q

T/F: If symmetrical chest, expect equal expansion on both sides

A

True

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8
Q

When there is unequal expansion of the chest, you want to observe ___

A

The collar or movement of the shirt (collapsed lung on the lagging side)

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9
Q

Etiology

Air is now in the pleural cavity compressing normal lungs

A

Extrapleural Air

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10
Q

This mechanism acts like a vacuum effect on the thorax that suggests an obstruction to inspiration at any point in the respiratory tract

A

Retractions

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11
Q

Signs of Upper Airway Obstruction

A
  1. Inspiratory Stridor
  2. Alar Flaring
  3. Retraction at the suprasternal notch
  4. Cyanosis
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12
Q

Signs of Supraglottic Obstruction

A
  1. Stridor tend to be quieter
  2. Muffling voice
  3. Dysphagia
  4. No cough
  5. Awkwards position of head and neck to preserve the airway
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13
Q

Signs of Infraglottic Obstruction

A
  1. Stridor tend to be louder, rasping
  2. Hoarse Voice
  3. Swallowing not affected
  4. Cough is harsh, barking
  5. Head positioning is not a factor
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14
Q

Peripheral Signs in Physical Examination

A
  1. Cyanosis
  2. Pursing
  3. Clubbing
  4. Alar Flaring
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15
Q

Auscultation

Statement 1: Listen to the chest anteriorly and medially as the patient breathes with mouth open
Statement 2: Listen to the breath sounds, noting their intensity and identifying any variations from normal vesicular breathing.

a. TF
b. FT
c. TT
d. FF

A

b. FT

Statement 1: Anteriorly and laterally

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16
Q

T/F: Breath sounds are usually louder in the upper anterior lung fields.

A

True

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17
Q

Normal Breath Sounds

Inspiratory sounds > expiratory sounds

a. Vesicular
b. Bronchovesicular
c. Bronchial
d. Tracheal

A

a. Vesicular

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18
Q

Normal Breath Sounds

Inspiratory = expiratory, relatively high intensity of expiratory

a. Vesicular
b. Bronchovesicular
c. Bronchial
d. Tracheal

A

d. Tracheal

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19
Q

Normal Breath Sounds

Inspiratory = expiratory, intermediate intensity of expiratory

a. Vesicular
b. Bronchovesicular
c. Bronchial
d. Tracheal

A

b. Bronchovesicular

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20
Q

Normal Breath Sounds

Normally heared over most of both lungs

a. Vesicular
b. Bronchovesicular
c. Bronchial
d. Tracheal

A

a. Vesicular

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21
Q

Normal Breath Sounds

Normally heard over the manubrium (larger proximal airways)

a. Vesicular
b. Bronchovesicular
c. Bronchial
d. Tracheal

A

c. Bronchial

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22
Q

Normal Breath Sounds

Often normally heard in the 1st and 2ns iS ant. & between the scapulae

a. Vesicular
b. Bronchovesicular
c. Bronchial
d. Tracheal

A

b. Bronchovesicular

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23
Q

Normal Breath Sounds

Normally heard over the trachea in the neck

a. Vesicular
b. Bronchovesicular
c. Bronchial
d. Tracheal

A

d. Tracheal

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24
Q

Normal Breath Sounds

Pitch of Expiratory: Intermediate

a. Vesicular
b. Bronchovesicular
c. Bronchial
d. Tracheal

A

b. Bronchovesicular

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25
# Normal Breath Sounds Pitch of Expiratory: Relatively high a. Vesicular b. Bronchovesicular c. Bronchial d. Tracheal
c. Bronchial & d. Tracheal
26
# Normal Breath Sounds Pitch of Expiratory: Relatively low a. Vesicular b. Bronchovesicular c. Bronchial d. Tracheal
a. Vesicular
27
# Vesicular Breath Sounds Statement 1: More prominent in thin individuals or children Statement 2: Diminished in the underweight individuals a. TF b. FT c. TT d. FF
a. TF Diminished in the overweight or muscular individuals
28
# Vesicular Breath Sounds Statement 1: More prominent in thin individuals or children Statement 2: Diminished in the underweight individuals a. TF b. FT c. TT d. FF
a. TF Diminished in the overweight or muscular individuals
29
# Adventitious Breath Sounds High-pitched, discrete, brief, discontinuous crackling at the end of inspiration a. Fine Crackles b. Medium Crackles c. Coarse Crackles d. Ronchi e. Wheeze f. Pleural Friction Rub
a. Fine Crackles
30
# Adventitious Breath Sounds Lower, moist sound during the midstage of inspiration & not cleared by a cough a. Fine Crackles b. Medium Crackles c. Coarse Crackles d. Ronchi e. Wheeze f. Pleural Friction Rub
b. Medium Crackles
31
# Adventitious Breath Sounds Musical noise like a squeak (asthmatic = kitten sounds) Most often heard continuously during inspiration or expiration; tubular sound but tube is smaller because of bronchial constriction a. Fine Crackles b. Medium Crackles c. Coarse Crackles d. Ronchi e. Wheeze f. Pleural Friction Rub
e. Wheeze
32
# Adventitious Breath Sounds Loud, bubbly noise that is heard during inspiration a. Fine Crackles b. Medium Crackles c. Coarse Crackles d. Ronchi e. Wheeze f. Pleural Friction Rub
c. Coarse Crackles
33
# Adventitious Breath Sounds Dry, rubbing, or grating usually caused by inflammation of pleural surfaces (Heard during inspiration or expiration) a. Fine Crackles b. Medium Crackles c. Coarse Crackles d. Ronchi e. Wheeze f. Pleural Friction Rub
f. Pleural Friction Rub
34
# Adventitious Breath Sounds Sonorous wheeze, snore-like; “low pitched wheezes” and often heard in pts with COPD, cystic fibrosis, bronchiectasis, pneumonia a. Fine Crackles b. Medium Crackles c. Coarse Crackles d. Ronchi e. Wheeze f. Pleural Friction Rub
d. Ronchi
35
# Fine Crackles Statement 1: That is the process by which we create crackles in the lungs that has pneumonia or fluid inside the air sacs Statement 2: That crackling is produced at the end of inspiration; it’s the entry of air breaking into the fluid that is present in the air sacs a. TF b. FT c. TT d. FF
c. TT
36
Early inspiratory and expiratory crackles are classic lung exam findings in what condition?
Chronic bronchitis
37
# Palpation You palpate by placing a thumb on the midline and ask the pt to take a deep breath. You use this to check for lung expansion.
Thoracic Expansion
38
# Palpation You felt a palpable, coarse, grating vibration during thoracic expansion. What is your finding?
Pleural Friction Rub
39
# Palpation You hear a crackly or crinkly sensation or a gentle or bubbly feeling (when pressing the chest) which indicates air in the subcutaneous tissue from a rupture. What is your finding?
Crepitus
40
# Palpation You palpated a vibration on the patient's chest walls around the 2ns ICS at the level of the bifurcation of bronchi that results from speech or other verbalizations. What is the finding?
Tactile Fremitus
41
# Type of Percussion Tones Intensity: Soft Pitch: High Duration: Short Quality: Very Dull
Flat
42
# Type of Percussion Tones Intensity: Very Loud Pitch: Very Low Duration: Longer Quality: Booming
Hyperresonant
43
# Type of Percussion Tones Intensity: Loud Pitch: Low Duration: Long Quality: Hollow
Resonant
44
# Type of Percussion Tones Intensity: Medium Pitch: Medium to High Duration: Medium Quality: Dull thud
Dull
45
# Type of Percussion Tones Intensity: Loud Pitch: High Duration: Medium Quality: Drum-like
Tympanic
46
# Common Diagnostic Modalities Favorite & most commonly done diagnostic x-ray
Chest X-ray | Shows cardiac outline, lungs, blood vessels, bones
47
# Common Diagnostic Modalities Sound waves Can be used to detect water in lungs, visualizing the heart
Ultrasound
48
# Common Diagnostic Modalities Ionizing radiation 3D image of a one-dimensional shot
Computed Tomograohy
49
# Common Diagnostic Modalities Considered to be the gold standard for diagnosis of PE, it is invasive and has been thought to have increased morbidity and mortality
Pulmonary Ateriography
50
# Common Diagnostic Modalities Magnetic field & radiowaves More sensitive and expensive compared to CT scan
Magnetic Resonance Imaging
51
# Common Diagnostic Modalities To measure the regional distribution of ventilation in the lungs the patient breathes xenon gas.
Ventilation and Perfusion Scans
52
# Common Diagnostic Modalities Permit observation of normal and variant anatomy and of gross pathological changes in the bronchial wall and lumen.
Bronchography
53
# Common Diagnostic Modalities Radioactive tracers and used to trace cancer spread
Positron Emission Tomography
54
# Common Diagnostic Modalities Contrast dye used to visualize the pulmonary tree whether it's okay or not
Pulmonary Angiogram
55
# Most Common Pulmonary Function Tests You measure the volume of air and time by asking the patient to maximally breath in and out
Spirometry
56
Pt is asked to forcefully expire the fastest he could, then the volume of air exhaled in the first second will a parameter of whether he has the disease/improving or not
Forced expiratory volume in one second (FEV1)
57
Statement 1: Inspiratory Restrictive conditions limit lung expansion when inhaling Statement 2: This happens when lungs become stiff as a result of scaring, fibrosis within lung tissue, or the respiratory muscles are too weak (diaphragm) to inflate the lungs a. TF b. FT c. TT d. FF
c. TT
58
Expiratory restrictive occurs when exhalation volume is limited due to weakness of ____ involved in deep exhalation
Accessory Muscles
59
# Ventilatory Dysfunction Pattern Identify the Pattern: 1. Decreased lung volume 2. FVC is ALWAYS low 3. FEV1 & FEV1/FVC is usually normal
Restrictive Defect
60
# Ventilatory Dysfunction Pattern Identify the Pattern: 1. Decreased airflow 2. FVC is usually normal 3. FEV1 & FEV1/FVC is ALWAYS low
Obstructive Defect
61
Measures peak RR and is usually utilized in the ER
Peak Flow Meter
62
Measures O2 and CO2 levels, pH of blood, and NaHCO3
Arterial Blood Gas
63
Measures O2 levels by detecting changes of light absorption in the hemoglobin
Pulse Oximetry
64
Measures volatile organic compounds in exhaled breath
Chemical Breath Analysis
65
One of the more common and must know Measures cardiac and pulmonary performance during exercise and rest
Cardiopulmonary Exercise Test

(3) Cardio-Pulmo-Renal Rehabilitation (34 decks)

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