p.3
Chest Landmarks and Terms
What does the sternal angle connect?
The manubrium and sternal body.
What does limited chest excursion indicate?
Restricted movement of the chest during breathing.
p.53
Abnormal Tactile Fremitus
What does decreased tactile fremitus indicate?
Conditions like obstructed bronchus, COPD, pleural effusion, lung fibrosis, or pneumothorax.
p.60
Specialized Examination Techniques
What are some vocalization options instead of '99'?
Toy Boat, Scooby Doo, Blue Balloons, 71.
p.18
Inspection Techniques
What is tracheal deviation?
A condition where the trachea is displaced from its normal midline position.
p.7
Chest Landmarks and Terms
What is the Anterior Axillary Line (AAL)?
A line that drops from the anterior axillary fold.
p.1
Specialized Examination Techniques
What does IPPA stand for in chest assessment?
Inspection, Palpation, Percussion, Auscultation.
p.75
Abnormal Respiratory Patterns
What can abnormal breath sounds indicate?
Potential respiratory issues or diseases.
p.50
Specialized Examination Techniques
What should you observe as the thorax expands?
How your thumbs diverge, noting the distance and symmetry.
p.2
Chest Landmarks and Terms
What is the apex of the lungs?
The most superior portion of the lungs.
p.18
Inspection Techniques
What is stridor?
A high-pitched wheezing sound caused by disrupted airflow, often indicating an obstruction.
p.25
Abnormal Respiratory Patterns
What is scoliosis?
Abnormal lateral curvature of the spine.
p.16
Inspection Techniques
What abnormalities might be noted in the thorax during inspection?
Deformities, asymmetry, or abnormal movement.
p.20
Inspection Techniques
What are signs of respiratory distress?
Contraction of sternocleidomastoid, scalene, and supraclavicular muscles.
p.50
Specialized Examination Techniques
What should you do after placing your thumbs at the 10th ribs?
Slide your hands medially to loosen skin folds.
p.53
Abnormal Tactile Fremitus
What is the effect of lung fibrosis on tactile fremitus?
It decreases tactile fremitus.
p.25
Abnormal Respiratory Patterns
What is kyphosis?
Abnormal forward curvature of the spine.
p.50
Specialized Examination Techniques
What is the first step in checking respiratory expansion?
Place your thumbs at the level of the 10th ribs, with fingers parallel to the lateral rib cage.
p.24
Chest Assessment Anatomy
What is a characteristic of Barrel Chest?
Increased anteroposterior (A-P) diameter.
p.53
Abnormal Tactile Fremitus
Which condition is associated with obstructed bronchus?
Decreased tactile fremitus.
p.7
Chest Landmarks and Terms
What does the Midaxillary Line (MAL) represent?
A line that drops from the apex of the axilla.
p.16
Inspection Techniques
What should be assessed during the initial assessment?
Overall appearance and any immediate concerns.
p.5
Chest Landmarks and Terms
What is the spinous process of C7 used for in rib counting?
It serves as a reference point to count down to the first rib (T1).
p.24
Chest Assessment Anatomy
What is Flail Chest?
Rib fractures causing paradoxical movement of the chest wall.
p.53
Abnormal Tactile Fremitus
What happens to tactile fremitus in the case of pneumothorax?
It decreases tactile fremitus.
p.16
Inspection Techniques
What is the purpose of inspection in a clinical assessment?
To observe and identify any abnormalities.
p.75
Auscultation Techniques
Why is it important to recognize normal breath sounds?
To differentiate between healthy and abnormal respiratory conditions.
p.30
Abnormal Respiratory Patterns
What characterizes Biot's breathing?
Irregular, unpredictable, shallow or deep, with intermittent apnea.
p.54
Respiration Techniques
What is diaphragmatic excursion?
The distance of movement of the diaphragm from complete exhalation to deep inhalation.
p.42
Auscultation Techniques
What is the primary purpose of auscultation?
To determine if there is normal airflow, airway obstruction, or abnormal air or fluid within the chest or lungs.
p.53
Abnormal Tactile Fremitus
What effect does pleural effusion have on tactile fremitus?
It decreases tactile fremitus.
What does asymmetry indicate during palpation?
It may suggest underlying pathology.
p.5
Chest Landmarks and Terms
Which rib/intercostal space correlates with the inferior tip of the scapula?
The 7th rib/intercostal space.
p.55
Specialized Examination Techniques
What is the purpose of transmitted voice sounds in auscultation?
To assess lung conditions and identify areas of consolidation or pathology.
What is the primary purpose of palpation?
To evaluate for palpable masses and tenderness.
p.57
Specialized Examination Techniques
What is the purpose of checking for Egophony during auscultation?
To assess underlying lung tissue for collapse or consolidation.
p.57
Specialized Examination Techniques
What should the patient say while auscultating lung fields to check for Egophony?
The patient should say 'EE'.
p.2
Chest Landmarks and Terms
What are the bases of the lungs?
The lowest portion of the lungs.
p.28
Abnormal Respiratory Patterns
What is Kussmaul breathing?
Rapid and deep respiration.
p.75
Auscultation Techniques
What are normal breath sounds?
Sounds produced by air moving through the respiratory tract during breathing.
p.16
Inspection Techniques
What are some abnormalities that can be observed in the face and neck?
Swelling, discoloration, or asymmetry.
p.37
Percussion Techniques
How many lateral sites are required for chest percussion and auscultation?
1 lateral site on each side.
p.13
Chest Assessment Anatomy
What are the primary techniques used in chest assessment?
Inspection, Palpation, Percussion, and Auscultation.
p.12
Respiration Techniques
What occurs during expiration?
The diaphragm relaxes, the chest wall contracts, intrathoracic pressure normalizes, and air leaves the lungs.
p.35
Percussion Techniques
What is the purpose of percussion in a clinical examination?
To assess the underlying structures and identify abnormalities.
p.14
Chest Assessment Anatomy
Which areas are included in the exam?
Anterior, posterior, and lateral thorax.
p.58
Specialized Examination Techniques
What indicates an abnormal finding in Whispered Pectoriloquy?
Louder, clearer whispered sounds.
p.46
Adventitious Breath Sounds
What are crackles in respiratory assessment?
Intermittent, nonmusical, brief, velcro-like sounds.
p.53
Abnormal Tactile Fremitus
What conditions can cause increased tactile fremitus?
Pneumonia or consolidation.
What is muscular atrophy?
A decrease in muscle mass that can be detected on palpation.
What are some causes of abnormalities found on palpation?
Pleural fibrosis, pleural effusion, lobar pneumonia, pain/splinting.
p.36
Percussion Techniques
How can you achieve louder notes during percussion?
By applying more pressure to the finger on the chest wall.
What part of the hand should be used during palpation?
Pads of fingers and/or palms.
p.29
Abnormal Respiratory Patterns
In which populations can Cheyne-Stokes breathing be considered normal?
In sleeping children and the elderly.
p.57
Specialized Examination Techniques
What does a normal lung sound like when checking for Egophony?
A muffled long 'EE' sound.
What is the primary purpose of palpation in a clinical setting?
To assess the characteristics of body tissues and organs.
p.6
Chest Landmarks and Terms
How is the Midsternal Line (MSL) different from the Midclavicular Line (MCL)?
MSL is precise, while MCL is estimated.
p.35
Percussion Techniques
What can abnormal percussion tones indicate?
Potential underlying health issues or abnormalities.
p.14
Inspection Techniques
Which part of the thorax evaluation is suggested to start with?
Posterior/lateral evaluation.
p.59
Specialized Examination Techniques
How is whispered pectoriloquy performed?
The patient whispers a phrase while the examiner listens with a stethoscope.
p.8
Chest Assessment Anatomy
Where are the lung apices located?
~2 - 4 cm above the clavicle.
p.62
Auscultation Techniques
What type of breath sounds are mostly heard in normal air-filled lungs?
Mostly vesicular, except over large bronchi (bronchovesicular to bronchial) and trachea (tracheal).
p.53
Abnormal Tactile Fremitus
What is tactile fremitus?
Vibration felt on the chest wall when a patient speaks.
p.7
Chest Landmarks and Terms
What is the Posterior Axillary Line (PAL)?
A line that drops from the posterior axillary fold.
p.25
Abnormal Respiratory Patterns
What is kyphoscoliosis?
A condition that involves both abnormal forward and lateral curvature of the spine.
p.1
Specialized Examination Techniques
What are the main techniques used in chest assessment?
Inspection, Palpation, Percussion, and Auscultation.
p.5
Chest Landmarks and Terms
How do you count ribs starting from the spinous process of C7?
Count down from C7, where T1 is the first rib.
p.30
Abnormal Respiratory Patterns
What is apnea?
The absence of spontaneous respiration.
p.42
Auscultation Techniques
What aspects of sounds should be listened to during auscultation?
Pitch, intensity, duration, and location of sounds.
p.56
Auscultation Techniques
What should the patient say during the bronchophony test?
The patient should say '99'.
p.35
Percussion Techniques
What should be demonstrated in a percussion exam video?
The proper technique and application of percussion.
p.27
Abnormal Respiratory Patterns
What is obstructive breathing?
Prolonged expiration and increased airway resistance.
p.58
Specialized Examination Techniques
What is the purpose of checking for Whispered Pectoriloquy?
To assess underlying lung tissue for collapse or consolidation.
p.68
Percussion Techniques
What is the percussion sound characteristic in asthma?
Resonant to diffusely hyper-resonant.
p.58
Specialized Examination Techniques
What is considered a normal finding during Whispered Pectoriloquy?
Whispered words are inaudible or barely audible.
p.14
Inspection Techniques
What is the recommended position for examining the posterior thorax/lungs?
Sitting or rolled onto their sides if unable to sit.
p.26
Abnormal Respiratory Patterns
What conditions can cause bradypnea?
Diabetic coma and drug-induced respiratory depression.
p.26
Abnormal Respiratory Patterns
What is tachypnea?
Rapid or shallow breathing, defined as more than 20 breaths/min.
p.49
Auscultation Techniques
What is bronchophony?
Auscultation technique to assess transmitted voice sounds.
p.66
Percussion Techniques
What percussion sound is typically heard over a pleural air pocket in pneumothorax?
Hyper-resonant or tympanic.
p.61
Auscultation Techniques
What are the physical findings for a normal lung?
Clear breath sounds, no abnormal lung sounds.
p.53
Abnormal Tactile Fremitus
How does COPD affect tactile fremitus?
It decreases tactile fremitus.
p.19
Inspection Techniques
What are some causes of tracheal deviation?
Large pleural effusion, large pneumothorax, mass/tumor.
p.36
Percussion Techniques
What is the purpose of percussion in chest assessment?
To determine if underlying tissues are air-filled, fluid-filled, or solid (up to 7 cm deep into the chest).
p.3
Chest Landmarks and Terms
Where is the 2nd rib located in relation to the sternal angle?
Lateral to the sternal angle.
p.10
Chest Assessment Anatomy
At what level does the trachea bifurcate into the right and left mainstem bronchi?
At the level of the sternal angle (anteriorly) and T4 (posteriorly).
p.41
Auscultation Techniques
What is the purpose of auscultation?
To assess normal and abnormal breath sounds.
p.41
Auscultation Techniques
What are the characteristics of normal breath sounds?
They are clear, consistent, and vary depending on the location in the lungs.
p.27
Abnormal Respiratory Patterns
Which conditions are associated with obstructive breathing?
Asthma, chronic bronchitis, COPD.
p.45
Adventitious Breath Sounds
How are adventitious sounds related to usual breath sounds?
They are superimposed on usual breath sounds.
p.41
Specialized Examination Techniques
What is the significance of an exam demo video in auscultation?
It provides a practical demonstration of auscultation techniques and sound identification.
p.46
Adventitious Breath Sounds
What are fine crackles?
Soft, high-pitched, very brief sounds lasting 5-10 milliseconds.
p.40
Percussion Techniques
Describe the characteristics of a resonant percussion tone.
Loud tone, low pitch, and long duration.
p.17
Inspection Techniques
What skin characteristics are evaluated during the inspection?
Lesions, scars, and color.
p.63
Abnormal Respiratory Patterns
What is consolidation in the context of pneumonia?
Alveoli filled with fluid, blood, or pus, increasing the density and opacity of lung tissue.
p.44
Auscultation Techniques
What is the duration of tracheal breath sounds?
Inspiration and expiration are about equal.
p.2
Chest Landmarks and Terms
What are the three lung fields?
Upper, middle, and lower lung fields.
p.18
Inspection Techniques
What does the use of accessory muscles indicate during inspection?
It indicates respiratory distress or difficulty in breathing.
p.19
Inspection Techniques
What is tracheal deviation?
Displacement of the trachea from midline.
p.55
Specialized Examination Techniques
What is bronchophony?
Auscultation technique where spoken voice sounds are transmitted through lung tissue, indicating areas of consolidation.
p.13
Specialized Examination Techniques
What does IPPA stand for in chest assessment?
Inspection, Palpation, Percussion, Auscultation.
p.12
Abnormal Respiratory Patterns
What characterizes normal respiration in terms of thoracic and abdominal movement?
Normally quiet with slight thorax movement and more prominent abdominal movement.
p.56
Auscultation Techniques
What is the normal finding when assessing bronchophony?
Spoken words are muffled and indistinct.
Why should fingertips not be used during palpation?
Because it can be uncomfortable for the patient.
p.21
Inspection Techniques
What is stridor?
A high-pitched usually inspiratory wheeze.
p.6
Chest Landmarks and Terms
What type of landmarks are MSL, MCL, and AAL?
Circumferential landmarks.
p.4
Chest Assessment Anatomy
What is the method for counting ribs and intercostal spaces?
Continue down at an angle from the 2nd rib.
p.4
Chest Assessment Anatomy
What is an intercostal space?
The space between two ribs, numbered by the rib above.
p.26
Abnormal Respiratory Patterns
What conditions can lead to tachypnea?
Restrictive lung disease, elevated diaphragm, and pain.
p.48
Adventitious Breath Sounds
What is a Pleural Friction Rub?
Crackle-like creaking sounds caused by inflamed pleural surfaces rubbing together.
p.17
Inspection Techniques
What is the purpose of the initial inspection assessment?
To evaluate skin and chest size/shape.
p.55
Specialized Examination Techniques
What does egophony refer to?
A change in the quality of voice sounds during auscultation, often described as a nasal or bleating quality, indicating lung pathology.
p.16
Abnormal Respiratory Patterns
What are abnormal respiratory patterns?
Irregularities in breathing rate, rhythm, or depth.
p.29
Abnormal Respiratory Patterns
What are some causes of Cheyne-Stokes breathing?
Heart failure, brain damage, or drug-induced effects.
p.52
Specialized Examination Techniques
What is Tactile Fremitus?
Palpable vibrations transmitted through the bronchopulmonary tree to the chest wall with patient verbalization.
p.74
Abnormal Respiratory Patterns
What is the term for a breathing pattern characterized by deep, rapid breaths followed by periods of apnea?
Cheyne-Stokes respiration.
p.69
Auscultation Techniques
What type of breath sounds are typically heard in chronic bronchitis?
Vesicular (normal), with possible crackles, wheezes, or rhonchi.
How can palpation help in diagnosing conditions?
By identifying areas of pain, swelling, or abnormal masses.
What are some causes of subcutaneous emphysema?
Lung injury (such as rib fractures) and postoperative thoracic surgery.
p.64
Abnormal Respiratory Patterns
What is pleural effusion?
Fluid collection within the chest but outside the lung, causing lung compression.
p.9
Chest Assessment Anatomy
What does the major (oblique) fissure do in the lungs?
Divides each lung in half.
p.67
Percussion Techniques
What percussion finding is associated with COPD?
Diffusely hyper-resonant.
p.61
Auscultation Techniques
What physical findings indicate pneumonia?
Dullness on percussion, decreased breath sounds, and crackles.
p.22
Inspection Abnormalities
What is Pectus Carinatum?
A chest deformity characterized by a protruding sternum.
p.17
Inspection Techniques
What chest characteristics are assessed in the initial inspection?
A-P diameter, symmetry, obvious deformity, and body habitus.
p.61
Auscultation Techniques
What are the signs of chronic bronchitis?
Rhonchi, wheezing, and possible cyanosis.
p.44
Auscultation Techniques
What is the duration of broncho-vesicular breath sounds?
Inspiration and expiration are about equal.
p.1
Chest Assessment Anatomy
What is the purpose of chest assessment anatomy?
To understand terms and landmarks related to normal respiration.
p.23
Chest Assessment Anatomy
What characterizes Pectus Carinatum?
Anterior displacement of the sternum (convexity).
p.42
Auscultation Techniques
Why is it important to listen to multiple areas during auscultation?
To allow for accurate assessment of any underlying pathology.
p.11
Techniques of Examination
What are the primary techniques used in chest assessment?
Inspection, Palpation, Percussion, and Auscultation.
p.57
Specialized Examination Techniques
What indicates the presence of Egophony?
If the 'EE' sound changes to 'AAY'.
What is crepitus?
A crackling or grating feeling or sound.
p.35
Percussion Techniques
What are the two types of percussion tones?
Normal and abnormal percussion tones.
p.45
Adventitious Breath Sounds
What type of sounds are wheezes?
Continuous, high-pitched sounds.
p.58
Specialized Examination Techniques
What should the patient do during the Whispered Pectoriloquy exam?
Whisper '1 - 2 - 3' while auscultating lung fields.
p.68
Auscultation Techniques
What type of breath sounds are typically heard in asthma?
Obscured by high pitched wheezes, possible crackles.
p.43
Auscultation Techniques
What is important to compare during auscultation?
Compare sides by moving from one side to the other at the same level before changing levels.
p.49
Auscultation Techniques
What does egophony indicate during auscultation?
Changes in voice sounds that suggest lung pathology.
p.15
Specialized Examination Techniques
How should a patient position their gown for an anterior exam?
Ask the patient to lower the gown to the top of the breasts/chest and lift it to examine the lower region.
p.40
Abnormal Respiratory Patterns
What condition is associated with dull percussion tones?
Pleural effusion and pneumonia.
p.17
Inspection Techniques
What aspects of respiration are evaluated during the inspection?
Rate, rhythm, signs of distress, audible sounds, and accessory muscle use.
p.47
Adventitious Breath Sounds
What conditions are associated with Wheezes?
Asthma, COPD, chronic bronchitis, bronchus obstruction.
p.36
Percussion Techniques
What technique is used in percussion?
One finger strikes the finger of the other hand.
p.56
Auscultation Techniques
What is the purpose of checking for bronchophony?
To assess underlying lung tissue for collapse or consolidation.
p.11
Specialized Examination Techniques
What does IPPA stand for in chest assessment?
Inspection, Palpation, Percussion, Auscultation.
p.6
Chest Landmarks and Terms
What does the Midclavicular Line (MCL) represent?
An estimated circumferential landmark.
What technique is commonly used during palpation?
Using the fingers to feel for abnormalities in texture, temperature, and tenderness.
p.41
Adventitious Breath Sounds
What are adventitious breath sounds?
Abnormal sounds heard during breathing, indicating potential respiratory issues.
p.68
Inspection Techniques
What might be observed during the inspection of a patient with asthma?
Possible accessory muscle use.
p.67
Abnormal Respiratory Patterns
What is COPD?
Chronic Obstructive Pulmonary Disease characterized by over distention of distal airspaces, limited expiratory flow, and lung hyperinflation.
p.9
Chest Assessment Anatomy
Where does the minor (horizontal) fissure run?
Close to the 4th rib, meeting the major fissure at the midaxillary line near the 5th rib.
p.48
Adventitious Breath Sounds
What condition is associated with Mediastinal Crunch?
Mediastinal emphysema (pneumomediastinum).
p.47
Adventitious Breath Sounds
What is the duration of continuous adventitious sounds?
Longer than or equal to 250 msec.
p.63
Auscultation Techniques
What type of breath sounds are present over the involved area in pneumonia?
Bronchial breath sounds and crackles.
p.70
Auscultation Techniques
What lung sounds are noted in normal exam findings?
Clear to auscultation bilaterally (CTAB), without wheezes, crackles, or rhonchi.
p.44
Auscultation Techniques
Where are broncho-vesicular breath sounds best heard?
Anterior: 1st & 2nd interspaces; Posterior: inter-scapular.
p.30
Abnormal Respiratory Patterns
What can cause Biot's breathing?
Respiratory depression or brain damage.
p.13
Chest Landmarks and Terms
What is the significance of terms and landmarks in chest assessment?
They help in identifying anatomical structures and guiding examination techniques.
p.29
Abnormal Respiratory Patterns
What characterizes Cheyne-Stokes breathing?
Periods of gradually increasing and decreasing depth of respirations with periods of apnea.
p.6
Chest Landmarks and Terms
What is the Midsternal Line (MSL)?
A precise circumferential landmark.
p.27
Abnormal Respiratory Patterns
What is hyperventilation?
Faster, deeper respiration.
p.6
Chest Landmarks and Terms
What is the Anterior Axillary Line (AAL)?
An estimated circumferential landmark.
What are some abnormal findings that can be detected through palpation?
Lumps, swelling, tenderness, or unusual temperature changes.
p.41
Adventitious Breath Sounds
What does the nomenclature of adventitious breath sounds refer to?
The terminology used to describe abnormal breath sounds.
p.43
Auscultation Techniques
What is the first step in the auscultation technique?
Place the diaphragm of the stethoscope on the bare chest.
p.14
Inspection Techniques
Why is it easier to combine exams for the anterior lung and cardio?
Starting with posterior/lateral evaluation allows for easier combination.
p.26
Abnormal Respiratory Patterns
What is bradypnea?
Slow breathing, defined as less than 12 breaths/min.
p.65
Specialized Examination Techniques
What does effusion typically refer to in a medical context?
Effusion typically refers to the accumulation of fluid in a body cavity, such as pleural effusion in the lungs.
p.9
Chest Assessment Anatomy
What is unique about the minor (horizontal) fissure?
It is present only in the right lung.
p.15
Specialized Examination Techniques
What should be done for a posterior exam?
Most patients will be comfortable with having the back of their gown entirely open (both ties).
p.73
Percussion Techniques
What percussion note is expected over a pneumothorax?
Hyperresonant or tympanic.
p.61
Auscultation Techniques
What are the physical findings for Chronic Obstructive Pulmonary Disease (COPD)?
Wheezing, prolonged expiration, and decreased breath sounds.
p.17
Inspection Techniques
Which muscles are assessed for use during respiration?
Intercostal and supraclavicular muscles.
p.63
Auscultation Techniques
What is whispered pectoriloquy and how is it affected in pneumonia?
Whispers sound loud; it is present.
p.1
Chest Landmarks and Terms
What is the significance of terms and landmarks in chest assessment?
They help in identifying normal respiration and conducting examinations.
p.13
Abnormal Respiratory Patterns
What is normal respiration?
The typical pattern and rate of breathing in a healthy individual.
How should pressure be applied during palpation?
With moderate firmness, covering large areas.
What should the practitioner ask the patient during palpation?
If there is any discomfort or tenderness.
p.45
Adventitious Breath Sounds
How are rhonchi characterized?
Continuous, low-pitched sounds.
p.52
Specialized Examination Techniques
What are the signs of abnormal Tactile Fremitus?
Increased or decreased vibrations.
p.21
Inspection Techniques
What are common causes of stridor?
Foreign body or airway disease.
p.4
Chest Assessment Anatomy
What is the designation for the space below the 2nd rib on the left side?
2nd left intercostal space (2nd LICS).
p.49
Specialized Examination Techniques
What technique is used to assess respiratory expansion?
Inspection and palpation.
p.65
Specialized Examination Techniques
Can infiltration and effusion occur simultaneously?
Yes, infiltration and effusion can occur simultaneously in certain medical conditions.
p.15
Specialized Examination Techniques
What is required for a proper exam?
Proper disrobing/uncovering.
p.15
Specialized Examination Techniques
How should a patient be assisted with their gown during an exam?
Assist the patient with untying the gown if necessary or if they prefer assistance.
p.40
Percussion Techniques
What is the tone and intensity of hyper-resonant percussion?
Very loud tone with low pitch and long duration.
p.73
Specialized Examination Techniques
What is the expected voice sound transmission in pneumonia?
Increased: bronchophony, egophony.
p.61
Percussion Techniques
What physical findings are associated with pneumothorax?
Hyperresonance on percussion, decreased breath sounds.
p.22
Inspection Abnormalities
What is Flail Chest?
A condition where a segment of the rib cage breaks and becomes detached from the rest of the chest wall.
p.22
Inspection Abnormalities
What is Scoliosis?
A lateral curvature of the spine, often forming an 'S' or 'C' shape.
p.63
Auscultation Techniques
What is bronchophony and how is it affected in pneumonia?
Bronchophony is present; spoken words are louder and clearer.
p.23
Chest Assessment Anatomy
What characterizes Pectus Excavatum?
Depression of the distal sternum (concavity).
p.12
Respiration Techniques
What happens during inspiration?
The diaphragm contracts, the chest wall expands, and negative intrathoracic pressure draws air into the lungs.
p.56
Auscultation Techniques
What indicates an abnormal lung during bronchophony assessment?
Louder voice sounds, known as bronchophony.
p.52
Specialized Examination Techniques
What technique is used to assess Tactile Fremitus?
Place the palmar or ulnar side of the hand against the chest wall and ask the patient to say '99'.
p.21
Inspection Techniques
What does stridor indicate?
Obstruction in the trachea or larynx.
p.59
Specialized Examination Techniques
What is whispered pectoriloquy?
A clinical examination technique used to assess lung function by listening to whispered sounds.
p.59
Specialized Examination Techniques
What does a positive whispered pectoriloquy indicate?
Increased lung density or consolidation.
p.65
Specialized Examination Techniques
What is the primary difference between infiltration and effusion?
Infiltration refers to the process of substances entering tissues or spaces, while effusion refers to the escape of fluid into a cavity or space.
p.65
Specialized Examination Techniques
In which context is infiltration commonly used?
Infiltration is often used in medical contexts to describe the penetration of fluids or cells into tissues.
What is tactile fremitus?
A palpation technique used to assess vibrations in the chest.
p.46
Adventitious Breath Sounds
When are crackles typically heard?
When small airways pop open during inspiration or when air bubbles flow through secretions or closed airways.
p.46
Adventitious Breath Sounds
What are coarse crackles?
Louder, lower-pitched, brief sounds lasting 20-30 milliseconds.
p.15
Specialized Examination Techniques
What should a patient do based on their comfort level during the exam?
The patient may lower the gown completely based on their level of comfort.
p.48
Adventitious Breath Sounds
How does Mediastinal Crunch present?
Precordial crackles in sync with heartbeat, not respiration.
p.22
Inspection Abnormalities
What is Pectus Excavatum?
A chest deformity where the sternum is sunken inward.
p.17
Inspection Techniques
What is the normal respiratory rate for adults?
12 to 20 breaths per minute.
p.47
Adventitious Breath Sounds
Describe the pitch and sound of Wheezes.
High-pitched, hissing, shrill, whistling.
p.70
Adventitious Breath Sounds
What abnormal sound is noted during auscultation in abnormal exam findings?
Diffuse wheezing, with bibasilar crackles.
p.44
Auscultation Techniques
What is the duration of bronchial breath sounds?
Shorter inspiration with longer expiration.
p.11
Chest Landmarks and Terms
What is the significance of terms and landmarks in chest assessment?
They help in identifying anatomical structures and guiding examination.
What is normal respiration?
The regular and rhythmic process of inhaling and exhaling air.
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Inspection Techniques
What does the acronym IPPA stand for in examination techniques?
Inspection, Palpation, Percussion, Auscultation.
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Chest Assessment Anatomy
How do you start counting ribs from the sternal angle?
Walk fingers laterally to the 2nd rib.
What is subcutaneous emphysema?
Air displacing in the subcutaneous tissue, creating a sensation like 'Rice Krispies' under the skin.
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Auscultation Techniques
What should the patient do while auscultating?
Inhale and exhale through the mouth.
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Specialized Examination Techniques
What is the significance of the number 70 in whispered pectoriloquy?
It may refer to a specific measurement or threshold in clinical assessments, but context is needed for clarity.
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Chest Assessment Anatomy
Where does the major (oblique) fissure start and end?
From the T3 spinous process to the 6th rib at the midclavicular line.
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Abnormal Respiratory Patterns
What is pneumothorax?
Air collection within the chest but outside the lungs, causing lung compression.
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Auscultation Techniques
What is whispered pectoriloquy?
An auscultation technique to assess clarity of whispered sounds.
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Inspection Techniques
What inspection finding is common in patients with COPD?
Increased anterior-posterior (A-P) diameter of the chest and possible accessory muscle use.
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Abnormal Respiratory Patterns
Which conditions are associated with hyper-resonant percussion tones?
Large pneumothorax and COPD.
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Inspection Abnormalities
What defines a Barrel Chest?
A rounded, bulging chest that resembles a barrel, often associated with chronic respiratory conditions.
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Abnormal Respiratory Patterns
What does A&O X 3 indicate in a normal exam finding?
Patient is alert and oriented to person, place, and time.
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Chest Assessment Anatomy
What is noted about the chest wall in normal exam findings?
It is symmetric, without obvious deformity.
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Adventitious Breath Sounds
What is Stridor?
An inspiratory wheeze indicating larynx/tracheal obstruction.
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Adventitious Breath Sounds
What conditions are associated with crackles?
Bronchitis, pulmonary fibrosis, and congestive heart failure (CHF).
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Adventitious Breath Sounds
What conditions can lead to a Pleural Friction Rub?
Recent upper respiratory infections (URI), pneumonia, etc.
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Percussion Techniques
What are the signs of pleural effusion?
Dullness on percussion, decreased breath sounds, and possible friction rub.
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Adventitious Breath Sounds
What breath sounds are associated with pneumonia?
Decreased, crackles over the area.
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Inspection Abnormalities
What is Kyphosis?
An abnormal curvature of the spine resulting in a hunchback appearance.
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Abnormal Respiratory Patterns
What indicates moderate respiratory distress in abnormal exam findings?
Patient appears to be in moderate respiratory distress.
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Auscultation Techniques
Where are tracheal breath sounds best heard?
Over the trachea in the neck.
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Auscultation Techniques
Where are vesicular breath sounds best heard?
Most of the peripheral lung.
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Percussion Techniques
What are the characteristics of a tympanic percussion tone?
Loud tone, high pitch, and moderate duration.
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Percussion Techniques
What are the characteristics of a flat percussion tone?
Soft tone, high pitch, and short duration.
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Adventitious Breath Sounds
What do Rhonchi suggest?
Secretions in larger airways, often clearing with a cough.
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Percussion Techniques
What percussion finding is noted in normal exam findings?
Resonance over all lobes.
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Percussion Techniques
What is the intensity and pitch of a dull percussion tone?
Medium intensity with moderate pitch and duration.
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Auscultation Techniques
What physical findings are typical in asthma?
Wheezing, prolonged expiration, and possible use of accessory muscles.
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Adventitious Breath Sounds
Describe the pitch and sound of Rhonchi.
Low pitched, snoring 'wheeze'.
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Adventitious Breath Sounds
What causes Wheezes?
Rapid airflow through narrowed (almost closed) bronchi.
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Auscultation Techniques
What change occurs in egophony during pneumonia?
The change from 'EE' to 'AAY' is present.
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Auscultation Techniques
What is the duration of vesicular breath sounds?
Inspiration longer than expiration.
