Notes in lung exam

To Subscribe, use this Key

Status	Last Update	Fields
Published	09/08/2024	the most likely causes of acute cough in children are {{c1::common cold}}, {{c1::bronchitis/bronchiolitis}}, {{c3::asthma}}, and {{c3::influenza}}. {{…
Published	09/08/2024	{{c1::bronchitis}} has a production of mucus with some chest discomfort while {{c1::bronchiolitis}} has a dry, raspy cough and difficulty feeding&nbsp…
Published	09/08/2024	{{c1::bronchitis}} typically affects older children/adults while {{c1::bronchiolitis}} typically affects children under 2
Published	09/08/2024	bronchiolitis is an {{c1::acute}}(time) infection
Published	09/08/2024	bronchitis is an {{c1::acute or chronic}} (time) infection
Published	09/08/2024	{{c1::Bronchiolitis}} is acute, however if severe and not treated can be fatal or have lasting effects into teenage years.
Published	09/08/2024	Bronchiolitis is mostly a  viral etiology ({{c2::RSV}}), and peaks in {{c1::winter}} months
Published	09/08/2024	{{c1::croup}} typically has inspiratory stridor, cough, and hoarsness
Published	09/08/2024	{{c1::croup}} usually affects children aged 6 months - 3 years
Published	09/08/2024	a {{c1::barking}} cough is associated with croup
Published	09/08/2024	the most common etiology of croup is {{c1::parainfluenza}} virus
Published	09/08/2024	In children, the tripod position along drooling and dyspnea can be a hallmark sign for {{c1::epiglottis }}
Published	09/08/2024	While inspecting respirations you are looking at:1. {{c1::rate and rhythm}}2. {{c2::depth}}3. {{c3::effort}}4. {{c4::inspiration to expiration ratio&n…
Published	09/08/2024	during inspection, signs of respiratory difficulty can be: Accessory Muscle Use: {{c1::SCM, Scalene}}, {{c2::Supraclavicular Retractions}}, …
Published	09/08/2024	Normal Inspiration to Expiration Ratio is {{c1::1:2}} or {{c1::1:3}}
Published	09/08/2024	A prolonged expiratory time is a cardinal sign of {{c1::expiratory airflow obstruction}}
Published	09/08/2024	Normal respiratory rate is {{c1::14-20}} resp/minute (may see {{c1::12-20}} in some resources)
Published	09/08/2024	during inspection you are looking at the {{c1::chest wall}} shape and the {{c2::anteroposterior(AP) }} diameter.
Published	09/08/2024	during inspection you are comparing the AP diameter to {{c1::lateral }}
Published	09/08/2024	a barrel chest will have a  {{c1::1:1}} ratio or be very {{c2::round}}
Published	09/08/2024	a barrel chest is due to inability to {{c1::expel}} all air
Published	09/08/2024	barrel chest may increase with {{c1::aging}} or {{c2::COPD }}
Published	09/08/2024	normal AP diameter to lateral ratio is {{c1::2:1}}
Published	09/08/2024	during chest palpation you are palpating for: –{{c1::Landmarks}} –{{c1::Tenderness}} (spine, ribs, muscles) –{{c2::Crepitus}} or {{c4::grating vi…
Published	09/08/2024	during thoracic expansion, you are palpating for {{c1::equal chest}} expansion on the posterior chest
Published	09/08/2024	–{{c3::Uni}}lateral decrease in expansion can occur in:  –{{c1::Chronic Fibrosis}} –{{c1::Pleural Effusion}} –{{c2::Lobar Pneumonia}} –{{c2::Obst…
Published	09/08/2024	Decrease in expansion means one hand does not {{c1::rise}} and {{c1::fall}} as much as the contralateral hand
Published	09/08/2024	thoracic expansion is most reliable when performed on the {{c1::posterior}} chest. Can also be performed on {{c1::anterior}} chest.
Published	09/08/2024	a technique for chest percussion is to {{c2::withdraw}} striking finger to avoid {{c1::dampening vibration}}
Published	09/08/2024	Percuss the chest in a {{c1::ladder-like}} pattern comparing sides
Published	09/08/2024	–Thoroughly evaluate {{c1::anterior}}, {{c1::lateral}}, and {{c1::posterior}} lung fields during chest percussion
Published	09/08/2024	–Females may need to displace {{c1::breast tissue}} for anterior assessment
Published	09/08/2024	How many spots should I percuss? - enough to thoroughly evaluate all lung fields {{c1::anteriorly}} and {{c1::posteriorly}}
Published	09/08/2024	Must have arms crossed in front (ask patient to give self a hug) for posterior assessment – you do this for all posterior assessment except {{c1::Ausc…
Published	09/08/2024	{{c1:: Dull}} note increases likelihood of {{c3::pneumonia}} 5x or {{c2::pleural effusion}} 18x
Published	09/08/2024	{{c1::Anterior / Lateral }}
Published	09/08/2024	{{c1::Posterior / Lateral}}
Published	09/08/2024	if a {{c3::hyperresonance}} is percussed {{c2::unilaterally}}, a {{c1::pneumothorax}} may be the cause
Published	09/08/2024	if a {{c3::hyperresonance}} is percussed {{c2::bilaterally}}, {{c1::asthma}} or {{c1::COPD }}may be the cause
Published	09/08/2024	if a {{c2::dullness}} is percussed, it could be caused by a (4) {{c1::lobar pneumonia, pleural effusion, fibrous tissue, or a tumor }}
Published	09/08/2024	{{c1::Tactile Fremitus}} is perform when abnormal percussion or adventitious sounds heard upon auscultation
Published	09/08/2024	Tactile Fremitus examines palpable {{c1::vibrations}} through {{c2::bronchopulmonary tree}}
Published	09/08/2024	Must use {{c1::bony prominence}} of hand when conducting tactile fremitus
Published	09/08/2024	3 general causes of dyspnea are increased {{c1::awareness}} of normal breathing, increased {{c1::work}} of breathing, and abnormalities in {{c1::venti…
Published	09/08/2024	{{c1::cough}} is an inspiration followed by explosive expiration
Published	09/08/2024	{{c1::cough}} is a protective mechanism → {{c2::reflex}} response to {{c3::irritating}} stimuli by minimalizing {{c4::inhalat…
Published	09/08/2024	supportive care for acute bronchitis includes a {{c1::b2}} agonist such as {{c1::albuterol}}. must inform pt that cough may remain for 5 days to 4 wee…
Published	09/08/2024	throat clearing up may be due to {{c1::post nasal drip}}
Published	09/08/2024	dry and brassy cough may be due to {{c1::pharyngeal}} or {{c1::tracheal}} irritation, or {{c1::allergy}}
Published	09/08/2024	a loose and moist cough may be due to {{c1::asthma}} or {{c1::CF}}
Published	09/08/2024	a barking cough is due to irritation in {{c1::glottic}}/{{c1::subglottic}} area (croup)
Published	09/08/2024	a short burst/staccato cough in infants is due to {{c1::chlamydia}}
Published	09/08/2024	bronchiolitis can be caused due to {{c1::smoke}} exposure
Published	09/08/2024	most common causes of chronic cough in children are {{c2::asthma}}, {{c2::protracted bronchitis}}, {{c1::PND/ UACS}}, and {{c1::GERD}}
Published	09/08/2024	{{c1::hemoptysis}} is expectoration of blood from the {{c2::tracheobronchial}} tree
Published	09/08/2024	hemoptysis will have {{c1::bright}}, {{c1::red}} bloood and can be {{c1::foamy}}
Published	09/08/2024	Tripod position forces the diaphragm {{c1::down}} and {{c1::forward}} and {{c2::stabilizes}} the chest while reducing the work of breathing
Published	09/08/2024	tripod position is a sign of respiratory {{c1::difficulty}}
Published	09/08/2024	Intercostal tenderness associated with {{c1::costochondritis}} or {{c1::MSK}} strain
Published	09/08/2024	a {{c2::dull}} sound that is relatively medium for intensity, pitch, and duration is heard normally over the {{c1::liver}}
Published	09/08/2024	a {{c2::resonant}} sound that has a loud relative intensity, low relative pitch, and long relative duration is heard over a healthy {{c1::lung}}
Published	09/08/2024	a {{c1::hyper-resonant}} sound that has a very loud relative intensity, lower relative pitch, and longer relative durati…
Published	09/08/2024	hyperresonance will be heard over {{c1::air}}
Published	09/08/2024	dullness is heard over {{c1::fluid}} or {{c1::solid tissue}}
Published	09/08/2024	Fremitus {{c1::decreases}} with higher pitch, softer sounds
Published	09/08/2024	increased tactile fremitus is due to {{c1::unilateral consolidated pneumonia}}
Published	09/08/2024	decreased tactile fremitus is due to a {{c1::thick}} chest wall, {{c1::COPD}}, obstruction in {{c1::bronchus}}, {{c2::pleural effusion}}, {{c2::pneumo…
Published	09/08/2024	•Fluid INSIDE the lung pushes the lung tissue {{c1::closer}} to the thorax wall = {{c1::increased}} sensation felt during tactile fremitus
Published	09/08/2024	•Fluid/air/thick wall big space {{c1::BETWEEN}} lung and thorax wall= {{c2::decreased}} sensation felt during tactile fremitus
Published	09/08/2024	{{c1::Pleural effusion}} is fluid around the lungs that collects between the lung and chest wall.
Published	09/08/2024	when auscultating must use diaphragm with {{c1::firm}} pressure
Published	09/08/2024	must instruct patient to breathe {{c2::deeply}} in and out through {{c1::open mouth}} when auscultating
Published	09/08/2024	Adventitious = {{c1::added}}
Published	09/08/2024	{{c1::vesicular}}: inspiratory sounds last longer than expiratory sounds
Published	09/08/2024	{{c2::vesicular}} sounds have soft intensity of expiratory sound, relatively low pitch of expiratory sound
Published	09/08/2024	{{c2::bronchovesicular}} sounds have intermediate intensity of expiratory sound, intermediate pitch of expiratory sound
Published	09/08/2024	{{c2::bronchial}} sounds have loud intensity of expiratory sound, relatively high pitch of expiratory sound
Published	09/08/2024	{{c1::tracheal}} sounds have very loud intensity of expiratory sound, relatively high pitch of expiratory sound
Published	09/08/2024	{{c1::tracheal}}: inspiratory and expiratory sounds are almost equal
Published	09/08/2024	{{c1::tracheal}} sound is best heard over the trachea in the neck
Published	09/08/2024	{{c1::bronchial}}: expiratory sounds last longer than inspiratory ones
Published	09/08/2024	{{c1::bronchial}} are heard normally over the manubrium (larger proximal airway)
Published	09/08/2024	{{c1::bronchovesicular}}/{{c1::tracheal}} inspiratory and expiratory sounds are almost equal
Published	09/08/2024	{{c1::bronchovesicular}} sound is normally heard often in the first and second interspaces anteriorly and between the scapulae
Published	09/08/2024	If bronchovesicular or bronchial sounds REPLACE vesicular sounds, suspect {{c1::fluid}} or {{c1::solid lung tissue}} pathology
Published	09/08/2024	Easier to detect changes from vesicular to bronchovesicular when listening in {{c1::expiration}}
Published	09/08/2024	Silent chest is {{c1::OMINOUS}}
Published	09/08/2024	{{c1::Crackles}}: Air-bubbles flowing through secretions or closed airways
Published	09/08/2024	crackles suggests {{c1::pneumonia}}, {{c1::heart failure}}, {{c1::bronchiectasis}}
Published	09/08/2024	if crackles clear with cough, more suggestive of {{c1::bronchitis}} or {{c1::ateletasis}}
Published	09/08/2024	{{c1::Rhonchi}}: Low pitched; Think snoring
Published	09/08/2024	rhonchi is suggestive of {{c1::secretions}} in {{c1::large}} airways
Published	09/08/2024	{{c1::Wheezing}}:  Abnormally high-pitched noise resulting from partially obstructed {{c2::bronchial}} airway
Published	09/08/2024	wheezing is typically louder during {{c1::expiration}}
Published	09/08/2024	wheezing suggests {{c1::Asthma}}, {{c1::COPD}}, {{c1::Bronchitis}}
Published	09/08/2024	{{c1::Stridor}}:  Abnormally high-pitched noise resulting from partially obstructed {{c2::upper respiratory tract}}
Published	09/08/2024	stridor is typically heard best during {{c1::inspiration}}
Published	09/08/2024	stridor suggests {{c1::foreign body}}, {{c1::epiglottitis}}, tracheal {{c1::stenosis}}, {{c1::anaphylaxis}}
Published	09/08/2024	If there is something {{c1::INSIDE}} the lung (pneumonia/consolidation, hemorrhage, pulmonary edema), this {{c2::PUSHED}} the lung {{c2::CLOSER}} to t…
Published	09/08/2024	If there is something on the {{c1::OUTside}} of the lung (pleural effusion), or if there is NOT a consolidation, then there is {{c2::NO}} change in so…
Published	09/08/2024	a positive egophany test will change the E sound to a {{c1::bleating A}}
Published	09/08/2024	if transmitted voice sounds are louder it could be caused by {{c1::pneumonia/consolidation}}, {{c1::hemorrhage}}, {{c1::pulmonary edema}}
Published	09/08/2024	Presence of Fever, Cough, Egophony: 3x likelihood for {{c1::pneumonia}}
Status	Last Update	Fields