Advanced Health Assessment Test 2 Respiratory

Palpable vibrations of the chest resulting from speech

Tactile Femitus

Tactile Fermitus is best felt

Posteriorly and Laterally at the bifurcation of the bronchi

Excess air in the lungs, emphysema, pleural thickening, effusion, massive pulmonary edema, or bronchial obstruction results in _____ Tactile Fermitus

Decreased or absent

In the presence of fluids or solid masses maybe due to lung consolidation or non obstructive bronchial secretions Tactile Fermitus will be

Increased

Dullness to percussion and tactile femitus ore the most useful finding for

Pleural Effusion

The absence of reduced tactile femitus makes the diagnosis of pleural effusion

Less likely

The expected sound usually heard over all areas of the lungs during percussion

Resonance

Hyperinflation due to emphysema, pneumothorax, or asthma should result in

Hyperresonance

Pneumonia, Pleural effusion, pneumothorax, or asthma should result in resonance sounding

Dull or flat

Greater Clarity and increased loudness of spoken sounds is defined as

Bronchophony

When bronchophony is extreme (due to consolidation) even a whisper can be heard with the stethoscope. This is called

Whispered Pectoriloquy

When the intensity of spoken voice is increased and there is a nasal quality (e's sound like a's). This is called

Egophony

Sounds are transmitted more clearly through consolidation or air?

Consolidation

To differentiate between a respiratory friction rub and a cardiac friction rub ask the patient to

Hold their breath

A dry, crackly, grating, low pitched sound heard on both inspiration and expiration with a machine like quality is defined as a

Friction Rub

When trying to differentiate between Rhonchi and crackles the practitioner should ask the patient to

Cough

Which adventitious lung sound disappears with coughing

Rhonchi

Crackles are heard more during

Inspiration

Rhonchi are heard more during

Expiration

Which noise is caused by the passage of air through an air obstructed thick secretions, muscular spasms, new growth, or external pressure

Rhonchi (sonorous wheeze)

a friction rub is heard loudest over

Lower lateral anterior surface

Which sound can be high pitched and sibilant as well as low pitched and sonorous

Crackles (Rales)

Noise heard during inspiration and /or expiration and described as musical like a whistle or squeak

Wheeze (sibilant wheeze)

Low in pitch and intensity, heard in the most peripheral parts of the lungs. This noise occurs over health lung tissue. Generally heard on inspiration longer than expiration

vesicular sounds

Noise moderate in pitch and intensity, heard mostly over the major bronchi

Bronchovesicular

Noise highest in intensity and pitch, heard over the trachea

Bronchial

A chronic condition resulting from compromised respirations (asthma, emphysema, or cystic fibrosis)

Barrel Chest

Dyspnea that increases in the upright position

Platypnea

Dyspnea that increases with laying down

Orthopnea

Increased respiratory rate >20

Tachypnea

Decreased respiratory rate <12

Bradypnea

Abnormally shallow breaths

Hypopnea

Chronic pulmonary or cardiac difficulty can result in

Clubbing of the fingers

Pigeon Chest- structural variation

Pectus Carinatum

Ration of the anteroposterior diameter to the lateral diameter

1:0

The degree and level or retraction depend on the level of obstruction. So... The more sever the obstruction, the ____ the retraction

Higher

Diminished and delayed respiratory movement on affected side, Apical pulse shifted contra laterally, diminished fremitus, tachycardia, dullness or flat with percussion, hyperresonance in area superior to effusion, bronchophony, whispered pectoriloquy, ego

Pleural Effusion

Consolidation upon inspection, Tachypnea, Hypopnea, flaring of nasi, ocassional cyanosis, Increased fremitus, dullness to percuss, crackles, ocassional rhonchi, bronchial breath sounds, egophony, bronchophony, whispered pectoriloquy.

Pneumonia

Diaphragmatic excursion

...

Excess air in the lungs, emphysema, pleural thickening, effusion, massive pulmonary edema, or bronchial obstruction results in _____ Tactile Fermitus

...