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Physical Diagnosis
Exam 2- Thorax and Lungs
30
Other
Graduate
04/07/2009

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Cards

Term
Left oblique fissure (of left lung) medial ending.
Definition
Sixth rib mid-clavicular line.
Term
Bottom corners of Right upper lung lobe is located at __ rib medially and __ rib laterally.
Definition
Fourth rib @ sternal border and fifth rib mid-axillary line.
Term
Where do the horizontal fissure and the right oblique fissure meet?
Definition
Fifth rib, midaxillary line.
Term
What spinal level to lungs end at?
Definition
T10
Term
What spinal level are oblique fissures at?
Definition
T3
Term
What is diaphragmatic excursion?
Definition
Diaphragmatic excursion is the distance the base of the lung moves between deep inspiration and full exhalation.
Term
What is pectus excavatum?
Definition
lower costal cartilage becomes deformed, allowing the inferior sternum and xiphoid to curve toward the spine. This “caved-in” appearance of the chest can cause cardiac as well as respiratory compromise
Term
Pectus carinatum
Definition
the sternum protrudes forward like the keel of a ship
Term
Wheeze
Definition
High-pitched squeaking sound most often hear during full inspiration or expiration
Term
Pleural friciton rub
Definition
Dry, grating sound caused by inflammation of pleural surfaces; heard during inspiration, expiration, or both; loudest over lower lateral anterior S of chest wall.
Term
What is standard # breaths per min?
Definition
12-20
Term
What is Kussmaul breathing?
Definition
Rapid, deep, labored breathing seen in DKA, strokes
Term
What is Biot breathing?
Definition
Disorganized pattern of breathing of varying volume w/periods of apnea (seen w/head injury)
Term
What is ataxic breathing?
Definition
Extreme form of Biot respirations with greater variation in volume of air exchanged.
Term
How do you determine if grating sensation on inspiration is pleural or pericardial?
Definition
Have pt hold breath, see if vibration ceases.
Term
Tactile vocal fremitus- what would decreased sensation during pt vocalization indicate?
Definition
collapsed lung, bronchial obstruction
Term
Tactile vocal fremitus- what would increased sensation during pt vocalization indicate?
Definition
Fluid, blood, pus, or a mass within lung parenchyma
Term
Does standard pneumothorax push trachea away or pull trachea toward affected side?
Definition
collapse of lung tissue pulls trachea toward affected side.
Term
Does tension pneumothorax pull or push trachea from affected side?
Definition
Trapped air pushes trachea away from affected side.
Term
What does hyperresonance of the lung indicate?
Definition
emphysema, pneumothorax, asthma
Term
What does dull or flat percussion sounds in lung indicate?
Definition
atelectasis, solid mass, pleural effusion, hemothorax, empyema
Term
Use diaphragm or bell to examine thorax?
Definition
Diaphragm- most pathologic sounds are of higher pitch.
Term
What are vesicular lung sounds?
Definition
Heard over most of the lung fields- low pitch, longer inspirations with soft, short expirations.
Term
Bronchovesicular lung sounds?
Definition
Heard over mainstem bronchi and upper R posterior lung field heart is in this area on the L), medium pitch, expiration = inspiration.
Term
Bronchial lung sounds?
Definition
Heard only over the trachea- high pitch with loud and long expirations.
Term
What are fine crackles/rales?
Definition
High pitched, discrete, discontinuous crackling sounds heard during the end of inspiration; not cleared by coughing.
Term
What are course crackles?
Definition
Loud, bubbly sounds heard during inspiration; not cleared by coughing.
Term
Bronchophony
Definition
Listen to corresponding lung areas on R and L lung as pt vocalizes a phrase respectivelky such as "1, 2, 3"
Term
Egophony
Definition
Have the patient vocalize "eeeee..." over and over as you listen. A change in the auditory quality fron E to A may indicate consolidation.
Term
Whispered pectoriloquy
Definition
Pt whispers phrase repeatedly- if the whisper is heard louder on one side, it may indicate consolidation.
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