Chapter 2 – The Physical Examination

Vocabulary flashcards covering vital signs, temperature regulation, pulse, respiration, blood pressure, oxygen saturation, hypoxia indicators, and systemic chest examination techniques.

Vital Signs

The primary indicators of body function: body temperature (T), pulse (P), respiration (R), and blood pressure (BP); pulse oximetry (SpO₂) is often called the fifth vital sign.

Core Body Temperature

Relatively constant internal temperature, averaging 37 °C (98.6 °F) with a daily variation of ±0.5 °C (1–2 °F).

Intermittent Fever

Body temperature that alternates regularly between fever and normal readings.

Remittent Fever

Fever that fluctuates but never returns to normal baseline.

Relapsing Fever

Recurrent episodes of fever separated by periods of normal temperature.

Constant Fever

Persistent elevated temperature with minimal fluctuations.

Hypothermia

Core temperature below normal; caused by excessive heat loss, inadequate heat production, or impaired hypothalamic regulation.

Bradycardia

Heart rate lower than 60 beats/min in adults.

Tachycardia

Heart rate greater than 100 beats/min in adults.

Pulse Rhythm

The regularity of heartbeats classified as regular or irregular.

Pulse Strength

Qualitative description of pulse amplitude: strong, weak, thready, or bounding.

Eupnea

Normal breathing rate (12–20 breaths/min in adults) with regular rhythm and moderate depth.

Bradypnea

Respiratory rate fewer than 12 breaths/min with a regular rhythm.

Tachypnea

Respiratory rate greater than 20 breaths/min with a regular rhythm.

Apnea

Complete absence of breathing, leading to respiratory arrest if prolonged.

Hypoventilation

Decreased rate and depth of breathing, causing elevated arterial CO₂ (PaCO₂).

Hyperventilation

Increased rate and depth of breathing, causing decreased PaCO₂.

Cheyne-Stokes Respiration

Cyclic pattern of increasing and decreasing tidal volumes followed by periods of apnea.

Kussmaul’s Respiration

Deep, rapid breathing pattern often associated with metabolic acidosis.

Biot’s Respiration

Clusters of rapid, deep breaths with regular or irregular periods of apnea.

Systolic Blood Pressure

Pressure exerted on arterial walls during ventricular contraction.

Diastolic Blood Pressure

Pressure in arteries during ventricular relaxation.

Hypertension

Chronically elevated blood pressure above normal range; may be primary (no known cause) or secondary (identifiable cause).

Hypotension

Blood pressure below 90/60 mm Hg.

Orthostatic Hypotension

A rapid fall in blood pressure when moving to an upright position.

Pulsus Paradoxus

Decrease in systolic BP of more than 10 mm Hg during inspiration compared with expiration.

Cardiac Output (CO)

Volume of blood ejected by the ventricles per minute; calculated as stroke volume (SV) × heart rate (HR); average about 5 L/min.

SpO₂ – Normal Range

Peripheral oxygen saturation values of 95 % to 99 %.

Mild Hypoxemia

SpO₂ of 91 % to 94 %.

Moderate Hypoxemia

SpO₂ of 86 % to 90 %.

Severe Hypoxemia

SpO₂ of 85 % or lower.

Signs of Early CNS Hypoxia

Apprehension, restlessness, or irritability.

Accessory Muscle Use

Engagement of neck, shoulder, or intercostal muscles during breathing, indicating respiratory distress.

Inspection (Chest Exam)

Visual assessment of the patient during interview, vital-sign taking, and physical examination.

Palpation

Touching the chest to assess expansion symmetry, tracheal position, temperature, tone, tenderness, and fremitus.

Chest Excursion

Measurement of symmetrical chest expansion at T8–T10 via palpation.

Tactile Fremitus

Palpable chest vibrations caused by gas moving through thick airway secretions.

Vocal Fremitus

Palpable or audible chest vibrations produced during patient phonation.

Percussion

Tapping the chest wall to evaluate underlying tissue size, borders, and consistency (air, liquid, solid).

Dull Percussion Note

Sound indicating underlying consolidation, pleural effusion, atelectasis, or pleural thickening.

Hyperresonant Percussion Note

Sound produced over areas of increased air such as COPD, pneumothorax, or asthma.

Diaphragmatic Excursion

Movement of the diaphragm between inspiration and expiration; reduced by hyperinflation, lobar collapse, or neuromuscular disease.

Auscultation

Listening to sounds of the heart, blood vessels, and air flow within the respiratory tract.

Bronchial Breath Sounds

Normal high-pitched, loud sounds heard over trachea and manubrium.

Bronchovesicular Breath Sounds

Intermediate-pitched sounds heard over main bronchi.

Vesicular Breath Sounds

Soft, low-pitched sounds heard over peripheral lung fields.

Fine Crackles

High-pitched discontinuous lung sounds, typically late inspiratory.

Coarse Crackles (Medium Crackles)

Lower-pitched, louder discontinuous sounds that may clear with coughing.

Wheezes

Continuous high-pitched musical sounds caused by airway narrowing.

Stridor

Loud, high-pitched inspiratory sound indicating upper airway obstruction.

Pleural Friction Rub

Creaking or grating sound produced when inflamed pleural surfaces rub together.

Diminished Breath Sound

Markedly reduced intensity of normal lung sounds.

Whispering Pectoriloquy

Increased transmission of whispered words through consolidated lung tissue.