Respiratory & Cardiovascular Physical-Exam Vocabulary

Vocabulary flashcards covering major examination techniques, respiratory and cardiac sounds, pathologies, and associated clinical terms from the lecture transcript.

Inspection (Respiratory Exam)

First step of the chest exam; observe for distress, tracheal position, respiratory rate/rhythm/effort, accessory-muscle use, skin color, and chest-wall shape.

Respiratory Excursion (Chest Expansion)

Palpation technique assessing symmetric expansion by placing thumbs at T9–T10 and watching them diverge during deep inspiration.

Tactile Fremitus

Palpable vibrations felt while the patient says “99”; increased with consolidation, decreased with fluid/air outside lung.

Percussion (Chest)

Tapping to evaluate whether underlying tissue is air-, fluid-, or solid-filled; resonant = air, dull = fluid/solid, hyper-resonant = excess air.

Diaphragmatic Excursion

Distance the diaphragm moves between full inspiration and expiration; normal 3–5 cm.

Auscultation

Listening with a stethoscope for normal and adventitious breath or heart sounds.

Stridor

Harsh, high-pitched inspiratory or expiratory sound from upper-airway obstruction; medical emergency.

Inspiratory Reserve Volume

Maximum additional air that can be inhaled after a normal inspiration.

Expiratory Reserve Volume

Maximum additional air that can be exhaled after a normal expiration.

Tidal Volume

Amount of air inhaled and exhaled during a normal breath.

Tachypnea

Respiratory rate > 20/min; fast shallow breathing.

Bradypnea

Respiratory rate < 12/min; slow breathing.

Hyperventilation

Ventilation that lowers arterial CO₂; can be fast or deep; example: Kussmaul breathing in acidosis.

Kussmaul Breathing

Deep, labored hyperventilation associated with metabolic acidosis.

Cheyne-Stokes Respiration

Cyclic pattern of crescendo–decrescendo breathing with apnea periods.

Ataxic (Biot) Breathing

Unpredictable, irregular respirations with apnea; seen in brain injury/death.

Paradoxical Breathing

Inward diaphragmatic motion on inspiration causing lung deflation; indicates diaphragmatic dysfunction or flail chest.

Normal A:P Ratio

Anterior-posterior to transverse chest diameter of 1:2.

Barrel Chest

Increased A:P ratio seen in COPD from chronic air trapping.

Pectus Excavatum

Sunken sternum; can compress heart if severe.

Pectus Carinatum

Anteriorly protruding sternum (“pigeon chest”).

Kyphoscoliosis

Combined anterior and lateral spinal curvature affecting chest mechanics.

Kyphosis

Exaggerated thoracic posterior curvature (“hunchback”).

Fine Crackles

Soft, high-pitched late-inspiratory pops from small airway reopening or fluid.

Coarse Crackles

Loud, early-inspiratory “Velcro” sounds from large airway secretions.

Sonorous Rhonchi

Low-pitched snoring expiratory wheeze from airway mucus (e.g., bronchitis).

Sibilant Wheeze

High-pitched musical sound in inspiration/expiration from narrowed airways (e.g., asthma).

Pleural Friction Rub

Grating inspiratory/expiratory sound when inflamed pleurae rub (e.g., PE, cancer).

Bronchophony

Increased clarity/loudness of “99” over consolidation.

Egophony

“E” heard as nasal “A” over pneumonia-filled lung.

Whispered Pectoriloquy

Loud, distinct whispered “99” over consolidated lung.

Atelectasis

Alveolar collapse; ↓fremitus, ↓breath sounds, possible tracheal deviation.

Bronchitis

Bronchial inflammation with mucus; resonant percussion, vesicular sounds, coarse crackles or rhonchi.

Emphysema

Progressive alveolar destruction → hyperinflation, barrel chest, hyper-resonant percussion, decreased fremitus.

Asthma

Reversible airway narrowing; attack shows ↓fremitus, hyper-resonance, expiratory wheezes.

Pleural Effusion

Fluid in pleural space; dull percussion, absent breath sounds, ↓fremitus.

Pneumothorax

Air in pleural space; hyper-resonant, absent sounds, shifted trachea if tension.

Pulmonary Edema

Fluid in alveoli/interstitium from pressure overload; vesicular sounds with crackles, possible pink sputum. Percussion full

Pulmonary Embolism

Obstructing clot in pulmonary artery; pleuritic chest pain, dyspnea, tachycardia; usually normal lung exam.

Lobar Pneumonia

Alveolar infection; ↑fremitus, dull percussion, bronchial breath sounds.

Gynecomastia

Benign enlargement of male breast tissue, palpable mobile disk under nipple.

Fibroadenoma

Benign, mobile, rubbery breast mass common in young women.

Fibrocystic Breast Disease

Benign nodular breast changes with cysts; cyclic tenderness ages 30-50.

Paget’s Disease of Nipple

Eczematous scaling of nipple skin; indicates underlying carcinoma.

Mammary Carcinoma (Female)

Malignant breast tumor—firm, fixed, upper outer quadrant, > age 50.

Mammary Carcinoma (Male)

Breast cancer beneath/around male nipple, usually > 60 yrs.

BRCA1 / BRCA2 Mutation

Genetic variants greatly increasing breast (and ovarian) cancer risk.

Stable Angina

Predictable exertional chest pain relieved by rest/nitroglycerin; no tissue death.

Unstable Angina

Resting or worsening chest pain; part of acute coronary syndrome; no infarct yet.

Variant (Prinzmetal) Angina

Resting chest pain from coronary artery spasm.

Myocardial Infarction

Coronary artery occlusion causing cardiac muscle death; severe, persistent chest pain.

Mitral Valve Prolapse

Billowing mitral leaflet into atrium during systole; may cause midsystolic click.

Pericarditis

Pericardial inflammation; sharp chest pain eased by sitting forward; friction rub.

Dissecting Aneurysm

Tear in aortic intima producing sudden ripping chest/back pain.

Paroxysmal Nocturnal Dyspnea

Sudden nighttime SOB from pulmonary congestion, often LV failure.

Palpitation

Awareness of rapid, strong, or irregular heartbeat.

Syncope

Transient loss of consciousness from cerebral hypoperfusion.

Anasarca

Generalized, severe edema from heart, liver, or renal failure.

Systolic Blood Pressure (SBP)

Peak arterial pressure during ventricular contraction.

Diastolic Blood Pressure (DBP)

Arterial pressure during ventricular relaxation.

Orthostatic Hypotension

≥20 mm Hg SBP or ≥10 mm Hg DBP drop within 3 min standing.

Carotid Bruit

Blowing sound over carotid artery from turbulent flow (stenosis).

Jugular Venous Distension (JVD)

Visible jugular bulge ≥ 3 cm above sternal angle at 45°; indicates elevated right atrial pressure.

Point of Maximal Impulse (PMI)

Apical impulse felt at 4th–5th ICS MCL; enlarged/displaced in volume overload.

Systole

Phase between S1 and S2 when ventricles contract.

Diastole

Phase between S2 and next S1 when ventricles relax and fill.

S1

“Lub” from closure of mitral & tricuspid valves; loudest at apex.

S1 heard at

Apex

S2 heard at

Base

diastolic is … (s2–s1)

After s2 before s1

S1 is which valve

Mitral and tricuspid valves

S2

“Dub” from closure of aortic & pulmonic valves; loudest at base.

S2 valves

Aortic and pulmonic

S3

Early diastolic “ventricular gallop” signifying volume overload/heart failure.

S4

Late diastolic “atrial gallop” from stiff ventricle (e.g., LVH).

S4 is which diastolic

Late

S3 is which diastolic

Early diastolic

Murmur

Turbulent heart sound graded 1–6; described by timing, shape, pitch, and location.

1/6 heart murmur

Very faint

2/6 heart murmur

Heard immediately

3/6 heart murmur

Moderately loud

4-6/6 heart murmur

Palpable thrill

Crescendo Murmur

Intensity increases throughout the murmur.

Decrescendo Murmur

Intensity decreases over time.

Holosystolic (Pansystolic) Murmur

Uniform intensity throughout systole (e.g., mitral regurgitation).

Heart Murmur Grading

1/6 faint … 6/6 audible with stethoscope off chest; grades 4–6 have thrill.

Aortic Stenosis

Harsh crescendo–decrescendo midsystolic murmur at 2nd RICS radiating to neck.

Pulmonic Stenosis

Midsystolic murmur at 2nd LICS.

Mitral Regurgitation

Blowing holosystolic murmur at apex radiating to axilla.

Tricuspid Regurgitation

Holosystolic murmur at left lower sternal border.

Aortic Regurgitation

Early diastolic blowing decrescendo murmur at left sternal border or 2nd RICS

Pulmonic Regurgitation

Early diastolic murmur at 2nd LICS.

Mitral Stenosis

Low-pitched diastolic rumble at apex, best in left lateral position.

Tricuspid Stenosis

Diastolic rumble at left lower sternal border.

Pericardial Friction Rub

Scratchy, triphasic sound over pericardium, increases when patient leans forward.

Innocent Murmur

Benign flow murmur in children, pregnancy, fever, or anemia.

Pulse Pressure

SBP minus DBP; widens with age due to arterial stiffness.

Allen Test

Assessment of collateral ulnar flow before radial artery puncture.

Allen test performed

Before testing ABG from radial artery

Homan’s Sign

Calf pain on passive dorsiflexion suggesting DVT (low sensitivity).