Vitals and Heart/Lung Examination

Question 1

average temp

Answer 1

98.6 or 37

Question 2

radial pulse

Answer 2

60-100 bpm

• less than 60=bradycardia
• greater than 100= tachycardia

Question 3

respirations

Answer 3

normal = 14-20

• tachypnea = fast breathing
• bradypnea = slow breathing
• apnea = no breathing

Question 4

cheyne-stokes breathing

Answer 4

decreased rates and periods of apnea

Question 5

kussmaul’s respirations

Answer 5

hyperventalition from metabolic acidosis

Question 6

blood pressure normal

Answer 6

120/80

Question 7

pre-hypertension

Answer 7

120-139/ 80-89

Question 8

stage 1 hypertension

Answer 8

140-159/90-99

Question 9

stage 2 hypertension

Answer 9

> 160 / >100

Question 10

orthostatic BP

Answer 10

• if the systolic BP drops 20 or more, or the diastolic pressure drops 10 or more upon standing
• heart rate increases 15 beats per minute or more
• this can be due to volume depletion… normally the BP and heart rate will rise slightly as a nartural response to a change in position from supine to sitting to standing

Question 11

bell vs diaphragm

Answer 11

bell = low frequency
diaphragm = high frequency

Question 12

systolic vs diastolic

Answer 12

systolic = when first hear sounds, diastolic when sounds disappear

Question 13

hemoptysis

Answer 13

coughing up blood from lungs

- most ocmmonly caused by infections

Question 13

hemoptysis

Answer 13

coughing up blood from lungs

- most ocmmonly caused by infections

Question 14

dyspnea

Answer 14

shortness of breath

Question 14

dyspnea

Answer 14

shortness of breath

Question 15

orthopnea

Answer 15

difficulty breathing when lying flat

Question 15

orthopnea

Answer 15

difficulty breathing when lying flat

Question 16

wheezing

Answer 16

high pitched sound due to partially obstructed airway

Question 16

wheezing

Answer 16

high pitched sound due to partially obstructed airway

Question 17

pleuritic pain

Answer 17

chest wall pain associated with breathing

Question 17

pleuritic pain

Answer 17

chest wall pain associated with breathing

Question 18

respiratory examination

Answer 18

• inspection, palpation, percussion, auscultation

Question 18

respiratory examination

Answer 18

• inspection, palpation, percussion, auscultation

Question 19

dull, resonant, tympanic, flat

Answer 19

- dull = percussion over solid organ (liver) - resonant = structure containing air (lung) - tympanic = percussion over hollow/air structure (stomach) - flat = percussion over large muscle mass

Question 20

tracheal sound

Answer 20

very loud, high pitched, harsh, heard over trachea and neck

Question 21

bronchial

Answer 21

loud, high pitched - tubular sounding, heard over maubrium

Question 22

bronchovesicular

Answer 22

moderate loud, moderate pitch, tubular rustling sound, heard over mainstem bronchi

Question 23

vesicular

Answer 23

- soft, low pitch, gentle rustling, heard over most of the lungs

Question 24

rales/crackles

Answer 24

result of opening and closing of alveoli - i.e. pulmonary edema where aleveoli are filled with fluid

Question 25

5 auscultation points

Answer 25

- Aortic: right sternal 2nd ICS- RSB - Pulmonic: left 2nd ICS - LSB - Erb's point (location of S2 heard); left 3rd ICS - LSB - Tricuspid: left 4th ICS - LSB - Mitral (PMI): left 5th ICS - MCL

Question 26

rhonchi

Answer 26

low pitched sound arising from turbulent airflow and vibrations of the walls of larger airways being partially abstructed - i.e. bronchitis

Question 27

SA node

Answer 27

= pacemaker - makes AP wave that stimulates the AV node (Bundle of His). AV node spreads electrical impulse through the rest of the heart

Question 28

P wave, QRS complex, T wave

Answer 28

P = atrial contraction, QRS= ventricular contraction, Twave = ventricular repolarization

Question 29

PMI

Answer 29

The PMI – Point of Maximal Impulse or Apical Impulse Location: -fifth intercostal space (5ICS) -mid-clavicular line (MCL)

Question 30

Thrills and heaves

Answer 30

Thrill – a palpable vibration felt over the precordium. | Heave – a palpable impulse or displacement of the sternum and/or precordium.

Question 31

5 auscultation points

Answer 31

- Aortic: right sternal 2nd ICS- RSB - Pulmonic: left 2nd ICS - LSB - Erb's point (location of S2 heard); left 3rd ICS - LSB - Tricuspid: left 4th ICS - LSB - Mitral (PMI): left 5th ICS - MCL

Question 32

S1

Answer 32

s1-->S2 = systole "lub" | - closure of tricuspid and mitral valves

Question 33

S2

Answer 33

dub | - closure of aortic and pulmonic valves

Question 34

abdomen examination

Answer 34

inspection, auscultation, percussion, palpation | RLQ = best place to listen - secum: small bowel goes to large bowel

Question 35

borborygmi

Answer 35

increased bowel sounds, low pitched rumbling

Question 36

abdominal bruits

Answer 36

soft sound made by disrupted arterial flow through narrowed artery

Question 37

tympany

Answer 37

- most common abdominal percussion notes - due to presence of gas in stomach and small bowel

Question 38

percussion of liver

Answer 38

- right mid-clavicular line: should hear resonant (lungs) to dull (liver) to tympanic (intestine) - liver is on RUQ (spleen is LUQ)