Thorax and lungs

Question 1

What are environmental asthma triggers?

Answer 1

Higher risk in inner city because of more pollution

Pet dander, dust, pollen, smoking around children

Question 2

Who is at higher risk for tuberculosis?

Answer 2

Those in prisons, extended care facilities

Older adults

Smokers

Question 3

What conditions can cause a barrel chest?

Answer 3

COPD
emphysema

Question 4

When are Cheyne-stokes respirations seen?

Answer 4

Can be seen in overdoses, heart failure

Most often associated with being close to death

Question 5

When do you usually see Biot’s respirations?

Answer 5

When there is trauma

Question 6

What are the signs of early hypoxia?

Answer 6

RAT- restlessness, anxiety, tachycardia/tachypnea

Question 7

What are the signs of late hypoxia?

Answer 7

BED- bradycardia, extreme restlessness, severe dyspnea

Question 8

How does hypoxia present in pediatrics?

Answer 8

F- feeding difficulty
I- inspiratory stridor
N- nares flare
E- expiratory grunting
S- sternal retractions

Question 9

What are the lung sound fields from high to low?

Answer 9

Bronchial

Bronchio-vesicular

Vesicular

Question 10

What are atelectacic breath sounds?

Answer 10

Heard after surgery sometimes or when on bed rest

Similar in sound to crackles but if pt takes a deep breath and coughs and crackles go away, it’s atelectacic

Question 11

How do you test egophony?

Answer 11

pt says eee

Question 12

How do you test bronchophony?

Answer 12

99; it should sound muffled

Question 13

How do you test whispered pectoriloquy?

Answer 13

123; should be almost not audible

Question 14

What conditions cause wheezing?

Answer 14

Asthma
Acute bronchitis
COPD
Heard during expiration

Question 15

What conditions cause stridor?

Answer 15

Croup
Foreign body obstruction

Question 16

What conditions cause fine crackles and what does it sound like?

Where is it best heard?

Answer 16

Sounds like hair rubbing near the ear
Congestive heart failure
Pulmonary fibrosis

Base of the lungs during inspiration

Question 17

What conditions cause coarse crackles and what does it sound like?

Where are they best heard?

Answer 17

Low pitched and moist
Pulmonary edema
Bronchitis

Base of the lungs during inspiration

Question 18

What does pleural friction rub sound like and what conditions cause it?

Where is it best heard?

Answer 18

Harsh grating or creaking
TB
pneumonia

Best heard in the lower anterior lungs and lateral chest

Question 19

What is sibilant wheezing?

Answer 19

When air is passing through a narrowed airway

Question 20

What is a sonorous wheeze?

Answer 20

Deep, low-pitched rumbling or coarse sound

Question 21

What percussion sound is caused by bronchitis?

Answer 21

Resonance

Loud, low-pitched and has long duration

Question 22

What percussion sound is caused by pneumonia?

Answer 22

Dullness

Question 23

What percussion sound is caused by pneumothorax?

Answer 23

Tympany

Question 24

What percussion sound is caused by pleural effusion?

Answer 24

Flatness

Question 25

What does capillary of more than 3 seconds indicate?

Answer 25

Arterial insufficiency to the extremities

Question 26

What are manifestations of pulmonary tuberculosis?

Answer 26

Night sweats Low-grade fever Blood in the sputum Weight loss

Question 27

What is an expected finding of a toddler having heart failure?

Answer 27

Orthopnea- difficulty breathing while lying down

Question 28

What is a manifestation of atelectasis?

Answer 28

Hypoxemia- decreased oxygenation of the red blood cells and cyanosis due to poor oxygen exchange

Question 29

What is an expected finding for atelectasis for someone who is postoperative?

Answer 29

Increasing dyspnea

Question 30

What area of the body is the most reliable indicator of central cyanosis?

Answer 30

Oral mucosa

Question 31

What does rhonchi sound like and what causes it?

Answer 31

Rumbling, snoring or rattling sound resulting from fluid or mucous

Question 32

What is a sign of DVT?

Answer 32

Dull, aching calf pain Edema, warmth, and redness in the calf

Question 33

What finding is expected for a newborn who has a large patent ductus arteriosus?

Answer 33

Systolic murmur

Question 34

What is an expected finding for right sided heart failure?

Answer 34

Elevated central venous pressure (CVP)

Question 35

What are manifestations of PAD?

Answer 35

Skin that is cool or cold to the touch Pale and cyanotic when the extremity is elevated above the heart, and dark red when it is dangling normally Leg pain at rest Thickened toenails

Question 36

What does an S3 sound represent specifically?

Answer 36

Ventricular gallop- cussed by a rush of blood into a ventricle that is stiff or dilated Can be found in heart failure and hypertension