Shared Flashcard Set

Details

POM Chest and Lung
SUNY Upstate College of Medicine Class of 2015
31
Medical
Professional
09/13/2011

Additional Medical Flashcards

 


 

Cards

Term
Four pillars of physical examination
Definition

1. Inspection

2. Palpation

3. Percussion

4. Auscultation

Term
Pectus carinatum
Definition

"Pigeon chest"

 

prominent sternal protrusion

 

abnormally shaped chest-->distortion of lung structures

Term
Pectus excavatum
Definition

"Funnel chest"

 

Indentation of lower sternum above xiphoid process

 

Causes thoracic vertebrae to straighten; flat chest

 

Impacts on the airway, lung parenchyma

Term
Barrel chest
Definition

results in compromised respiration as in, for example, chronic asthma, emphysema, COPD or cystic fibrosis

 

ribs are more horizontal, spine somewhat kyphotic, sternal angle more prominent

 

the ratio of anteroposterior to transverse diameter are approx equal as AP enlarges. (AP:transverse is 1:2 in healthy patient). 

 

Term
Kyphosis
Definition

Exaggerated thoracic curvature of spine (Anatomy-recall "humpback" table 22. POM notes-can affect cervical spine too).

 

Marked by posture change, abnormal breathing

 

Diminished lung capacity. Pulmonary hypertension

Term
Scoliosis
Definition
Curvature of the spine 10 degrees or greater
Term
Normal rate of respiration (adult)
Definition
12-20 breaths/min
Term
Bradypnea
Definition
Slower than 12 breaths/min
Term
Tachypnea
Definition
Faster than 20 breaths/min
Term
Hyperventilation (hyperpnea)
Definition
Faster than 20 breaths per min, deep breathing
Term
Cheyne-Stokes
Definition

varying periods of increasing depth interspersed with apnea (no breathing)

 

indicative of congestive HF

Term
Kussmaul
Definition

always deep and usually rapid breathing (deeper and faster than hyperventilation)

 

associated with metabolic acidosis

Term
Biot
Definition

Irregular respirations varying in depth and interrupted by intervals of apnea

 

Associated with severe and persistent increased intracranial pressure, medulla (brainstem damage), or respiratory compromise from drug poisoning

Term
Ataxic
Definition

The more extreme version of biot

 

significant disorganization with irregular and varying depths of respiration

Term
What increases the rate and depth of breathing?
Definition

Acidosis (metabolic)

Anxiety

Aspirin poisoning

CNS lesions (pons)

Fever

Oxygen need (hypoxemia)

Pain

 

 

Term
What decreases the rate and depth of breathing?
Definition

Alkalosis (metabolic)

CNS lesions (cerebrum)

Myasthenia gravis

Narcotic overdose

Obesity (extreme)

Term
Signs of pulmonary or cardiac difficulty you can see upon inspection
Definition

1. Cyanosis of lips and nails

2. Pursed lips

3. Clubbing of fingers

4. Flared nostrils

5. Barrel chest

Term
Crepitus
Definition

a crackly or crinky sensation. 

 

sounds like rubbing leather or popping bubble wrap

 

indicates air in subcutaneous tissue from rupture somewhere in respiratory system or infection with gas producing organism

Term
Pleural friction rub
Definition

Inflammation of pleural surfaces

 

Indicated by palpable, coarse grating vibration on inspiration

Term
Tactile fremitus
Definition

palpable vibration of chest wall resulting from speech or other verbalizations.

 

have patient say a few numbers or words (ex. 99). you'll feel fremitus best parasternally at second intercostal space where bronchi bifurcate

Term
Causes of decreased fremitus
Definition

Excess air in lungs or emphysema

Pleural thickening or effusion

Massive pulmonary edema

Bronchial obstruction

Term
Causes of increased fremitus
Definition

Preence of fluids or solid mass within lungs

Lung consolidation

Heavy but nonobstructive bronchial secretions

Compressed lung 

Tumor

Term
Percussion
Definition

Diaphragm range of motion

 

Dullness may indicate fluid or mass

Term
Vesicular breath sounds
Definition

Heard over most lung fields

low pitched, low intensity sounds heard over healthylung tissue

Term
Bronchovesicular breath sounds
Definition

Heard over main bronchi

Moderate pitch and intensity

Term
Bronchial/tracheal breath sounds
Definition

Heard only over trachea. High pitch.

 

Term
Egophony
Definition

On auscultation, 'e' sound transformed into 'a' sound. 

 

Present in lung consolidation

Term
Wheezing
Definition

adventitious sound indicating airway obstruction, asthma, interstitial edema

 

auscultation: sounds squeaky, like whale call

Term
Crackling
Definition

adventitious sound, indicates pulmonary edema, pneumonia

 

auscultation: rubbing hair between fingers.

 

heard more frequently during inspiration

Term
Rhonchi
Definition

secretions in large airways

 

indicative of serious bronchitis

 

tend to disappear after coughing (unlike crackles)

Term
Clubbing of fingers
Definition

Sign patient has a 'bad disease' (ex congenital heart disease, heart failure, cystic fibrosis, COPD, endocarditis, cirrhosis, lung cancer, lethal pulmonary fibrosis...young patients-usually CF or cong HD)

 

look at small concave depression by the cuticle (phalangeal depth). normal fingers are at 160 degrees. in clubbing, you'll see hypertrophy of soft tissue at end of nails and angle will be over 180 degrees. 

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