Term
Four pillars of physical examination |
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Definition
1. Inspection
2. Palpation
3. Percussion
4. Auscultation |
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Term
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Definition
"Pigeon chest"
prominent sternal protrusion
abnormally shaped chest-->distortion of lung structures |
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Term
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Definition
"Funnel chest"
Indentation of lower sternum above xiphoid process
Causes thoracic vertebrae to straighten; flat chest
Impacts on the airway, lung parenchyma |
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Term
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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).
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Term
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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 |
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Term
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Definition
Curvature of the spine 10 degrees or greater |
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Term
Normal rate of respiration (adult) |
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Definition
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Term
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Definition
Slower than 12 breaths/min |
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Term
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Definition
Faster than 20 breaths/min |
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Term
Hyperventilation (hyperpnea) |
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Definition
Faster than 20 breaths per min, deep breathing |
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Term
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Definition
varying periods of increasing depth interspersed with apnea (no breathing)
indicative of congestive HF |
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Term
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Definition
always deep and usually rapid breathing (deeper and faster than hyperventilation)
associated with metabolic acidosis |
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Term
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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 |
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Term
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Definition
The more extreme version of biot
significant disorganization with irregular and varying depths of respiration |
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Term
What increases the rate and depth of breathing? |
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Definition
Acidosis (metabolic)
Anxiety
Aspirin poisoning
CNS lesions (pons)
Fever
Oxygen need (hypoxemia)
Pain
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Term
What decreases the rate and depth of breathing? |
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Definition
Alkalosis (metabolic)
CNS lesions (cerebrum)
Myasthenia gravis
Narcotic overdose
Obesity (extreme) |
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Term
Signs of pulmonary or cardiac difficulty you can see upon inspection |
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Definition
1. Cyanosis of lips and nails
2. Pursed lips
3. Clubbing of fingers
4. Flared nostrils
5. Barrel chest |
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Term
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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 |
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Term
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Definition
Inflammation of pleural surfaces
Indicated by palpable, coarse grating vibration on inspiration |
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Term
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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 |
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Term
Causes of decreased fremitus |
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Definition
Excess air in lungs or emphysema
Pleural thickening or effusion
Massive pulmonary edema
Bronchial obstruction |
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Term
Causes of increased fremitus |
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Definition
Preence of fluids or solid mass within lungs
Lung consolidation
Heavy but nonobstructive bronchial secretions
Compressed lung
Tumor |
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Term
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Definition
Diaphragm range of motion
Dullness may indicate fluid or mass |
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Term
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Definition
Heard over most lung fields
low pitched, low intensity sounds heard over healthylung tissue |
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Term
Bronchovesicular breath sounds |
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Definition
Heard over main bronchi
Moderate pitch and intensity |
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Term
Bronchial/tracheal breath sounds |
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Definition
Heard only over trachea. High pitch.
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Term
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Definition
On auscultation, 'e' sound transformed into 'a' sound.
Present in lung consolidation |
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Term
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Definition
adventitious sound indicating airway obstruction, asthma, interstitial edema
auscultation: sounds squeaky, like whale call |
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Term
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Definition
adventitious sound, indicates pulmonary edema, pneumonia
auscultation: rubbing hair between fingers.
heard more frequently during inspiration |
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Term
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Definition
secretions in large airways
indicative of serious bronchitis
tend to disappear after coughing (unlike crackles) |
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Term
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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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