Flashcards
lung exam CLPR
Cards in this deck (80)
- 1Increased rate of breath >20Tachypnea
- 2if cyanosis shows in the fingers what is it due toVasoconstriction
- 3increased distal finger tip mass and increased longitudinal and transverse nail plate curvatureclubbing
- 4early clubbing180 all around
- 5late clubbingless than 180 degrees
- 6what causes tracheal devationatelectasis, fibrosis, pulmonary TB
deviate towards affected side - 7where does the tracheal deviate in pleural effusionaway from affected side
- 8pain on anterior-posterior compression is indicative ofrib fracture
- 9pain on lateral compression could be indicative ofcostochondritis
- 10normal lung transmits a palpable vibratory sensation to the chest wallis called fremitus
- 11what causes decreased transmission in tactile fremitusanything separating the lung from the chest wall
- 12what causes a increase in sound transmissionfluid within the lung
- 13increased tactile fremitus findingsPneumonia
- 14Decreased tactile fremitus findsingsUnilateral
Pneuoothorax
Pleural Effusion
Bronchial obstruction
Atelectasis (Incomplete expansion of the lung tissue
Bilateral
Chronic obstructive lung disease
Chest wall thickening - 15when would asymmetric lung expansion occurwhen anything fills the pleural space but there has to be a lot of pleural disease before this occurs
- 16what do you say for a pertinet positive for respiratory expansionrespiratory expansion is equal bilaterally
- 17why do we percussto determine whether the underlying tissues are filled with air, fluid, or solid material.
Tapping on the chest wall produces sounds based on the amount of air in the lungs - 18Tympanic is Resonance isTympanic is abdomen
Chest is resonance - 19a surface that is covered with an airfilled structure will producea resonant note wile repeating the same maneuver over a fluid or tissue filled cavity generates a relatively dull sound
- 20type of sound that resonance producelow pitched, hollow sounds over normal lung tissue
flat or extremely dull sounds are normally heard over solid areas such as bones - 21when are percussion findings abnormalwhen there is fluid or solid tissue that replaces the dullness
- 22where are percussion dullness heardover the heart or liver
- 23louder and lower pitched than resonant and normal in children and very thin adultshyperresonant sounds
- 24when are hyperresonat sounds abnormalCOPD and Pneumothorax
- 25what do tympanic sound likehollow, high, drumlike sounds
- 26where are tymapanic sounds normalabdomen
- 27where are tympanic sounds not normalover the chest because it is suppose to be resonance
could be indicative of pneumothorax - 28what is the goal of diaphragmatic excursionto find the level of diaphragmatic on both sides at the level of T10
- 29how many positions on the lung fields6 anteriorly and 7 posteriorly on each side
- 30where do you stay during inhalationin one space for the entire inhalation
- 31where do you auscultate for lungsthere is no precise location
- 32where do you auscultate anteriorlythe 6 anterior lung spots
1st above the clavicle to assess the apex of the lung
the next 4 spots are equal distances apart starting from the 2nd intercostal space to extend to the anterior base of the lungs
the last spot is on the axillary border - 33where to auscultate posteriorly7 lung spots posteriorly
the first 5 spots are located between the scapula and spine extending from the apex of the lung to approximately T9 - 34What are breath sounds produced byturbulent air flow, categorized by the size of the airways that transmit them to the chest wall
- 35where are vesicular sounds heard and what's the pitchnormally heard over most flung fields
Inspiration is greater than expiration - 36tracheal sounds heard whereover the trachea
inspiration is equal to expiration - 37bronchovesicular sounds heard whereover bronchi
inspiration is equal to expiration - 38where are broncial sounds heardover the manubrium
inspiration is less than expiration - 39continuous musical notes that often sound like whistling or wind blowing through the treeswheezes
- 40causes of wheezesAsthma
Pulmonary edema
Bronchitis
Congestive heart failure - 41inspiratory wheeze associated with upper airway obstruction, such as in croup of foreign body aspirationStridor
- 42Low pitch, snoring type sound these are caused by narrowed larger airways from secretion, mucus, edema, bronchospasm, or obstructionRhonchi
- 43causes of rhonchiBronchitis
COPD
Bronchiectasis
Pneumonia
Cystic fibrosis - 44caused by fluid in small airways or lung collapse Discontinuous notes, bubbling, pops, fizz, moist or dry mainly heard on inspiration often clears with coughingRales/Crackles
- 45causes of rales and cracklesPneumonia. bronchitis
acute respiratory distress syndrome
pulmonary edema
atelectasis
Congestive heart failure - 46with rales Large and small airways causelarge airways have low pitch bubbling coarse
small airways have high pitch, fine/ velcro dry crackles - 47like creaking leather or balloonrubs
the pleural and visceral membranes rub together - 48causes of rubsPericarditis
Pleurisy
Neoplasm
Pulmonary infarction - 49fluid, blood, or air between lung and chest wall complete airway blockage causesdiminished absent breath sounds
- 50causes of diminished absent breath soundspneumonia
Serve emphysema
Lung resection
obesity
pleural effusion - 51if you hear "ay" when you when ask your patient to say a long "ee" serval times what is that indicative ofEgophony positive you should only hear a muffled ee sound
- 52bronchophony positive findingslouder, clearer sounds
- 53what is a normal bronchophonyMUFFLED and indistinct
- 54when the patient whispers 123 several timeswhispered pectoriloquy
- 55what sounds should you hear in whispered pectoriloquythe normal sounds should be faint or nothing at all if you hear sounds clearly this is a positive whispered pectoriloquy
- 56sign of consolidationfluid is the most common
- 57what do we inspect for during the chest examLevel of consciousness
Respiratory pattern and rate
Chest abnormalities
Accessory muscle use and retractions
Symmetry
Cyanosis - 58decreased depth of breath shallow breathinghypopnea
- 59decreased rate of breathingbradypena
- 60causes of bradypenaDrugs (narcotics, sedatives, alcohol)
Hypothermia
Uremia
Increased intracrainal pressure - 61increased depth of breathingHyperpena
- 62hypoventation hypervenlationhypo-decreased rate and depth of breathing
Hyper-increased rate and depth of breathing - 63causes of tachyenadrugs or withdrawal from drugs
pain
metabolic acidosis
hyperthermia
restrictive lung disease - 64difficulty breathingdyspena
- 65absence of breathapena
- 66tachypnea in ages 12 or older bradypnea>12 breaths per min
<12 breaths per min - 67breathing associated with respiratory metabolic acidosiskussmal
- 68pauses in breathing during sleepSleep apena
- 69apena alternaing with hyperventilationcheyne-strokes
- 70shortness of breath when laying flatOrthopnea
- 71what to consider if there is decreased movement on one side of the chestPneumothorax
Fibrosis
old lung recection
hemi-diaphragm paralysis - 72what are you looking for during chest inspectionChest abnormalitis
pectus excavatum
Pectus Carinatum
Barrel chest
Thoracic Kyphoscoliosis - 73possible causes of barrel chest (Carnatium)emphysema
chronic asthma
chronic bronchitis
Cystic fibrosis
senile kyphosis - 74spinal convexity to the right when the patient bends forwardthoracic kyphoscoliosis
- 75what causes retractionshigh work of breathing or airway blockage
bulging in intercostal spaces may indicate a pneumothorax - 76if a patient is using their accessory muscles what could be the reasonhypoxia
Obstruction
COPD - 77what do you check if a patient has cynaosischeck o2 saturation because visual may be unreliabe
- 78what is clubbingincreased distal finger tip mass
increased longitudinal and transverse nail plate curvature - 79what is clubbing associated withpulmonary or cardiovascular disease
- 80where does clubbing beginthumb and index finger
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- Flashcards on lung exam CLPR, created by Natosha Ash on 01/02/2021.
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- Natosha Ash
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