Patient Assessment Part 3: Palpation, Percussion, Auscultation, Vital Signs, Lab Results

Vocabulary flashcards summarizing key terms from patient assessment lecture: palpation, percussion, auscultation, vital signs, and laboratory studies.

Palpation

Using touch to assess the chest wall for underlying structure and function.

Tracheal Deviation

Shift of the trachea from midline; detected by palpating above the sternal notch.

Trachea Shifts Toward Unaffected Side

Seen in pneumothorax or pleural effusion.

Trachea Shifts Toward Affected Side

Seen in fibrosis or atelectasis.

Chest Excursion

Symmetry of chest expansion; thumbs should move 3–5 cm equally from midline.

Tactile Fremitus

Palpable chest vibrations produced by air moving through thick secretions; ↑ with consolidation, ↓ with effusion or pneumothorax.

Crepitus (Subcutaneous Emphysema)

Coarse, crackling sensation felt when air leaks into subcutaneous tissue.

Percussion

Tapping on the chest to assess whether underlying tissue is air-, fluid-, or solid-filled.

Resonance (Percussion)

Normal, low-pitched, hollow chest sound over healthy lung.

Dullness (Percussion)

Short, thud-like note indicating increased density such as consolidation, effusion, or atelectasis.

Hyperresonance (Percussion)

Louder, lower-pitched note caused by air trapping—COPD, asthma, pneumothorax.

Diaphragmatic Excursion

Percussion measure of diaphragm movement; normal 4–8 cm, reduced with hyperinflation.

Auscultation

Listening to breath sounds with a stethoscope in a systematic zig-zag pattern.

Bronchial Breath Sounds

Harsh, tubular sounds over trachea; abnormal if heard in lung periphery (suggests consolidation).

Vesicular Breath Sounds

Soft, rustling sounds heard over most lung fields; normal peripheral breath sound.

Bronchovesicular Breath Sounds

Intermediate sounds normally heard between scapulae and around sternum.

Adventitious Breath Sounds

Any abnormal lung sound such as crackles, wheezes, rhonchi, stridor, rubs.

Diminished Breath Sounds

Low-intensity sounds due to reduced airflow or excessive chest wall tissue.

Fine Crackles

Late-inspiratory popping from collapsed small airways—atelectasis, fibrosis, early CHF.

Coarse Crackles

Gurgling sounds in large airways from excess secretions—pneumonia, COPD, CF; clear with cough.

Wheezing

High-pitched musical sound from bronchospasm; common in asthma.

Pleural Friction Rub

Creaking/grating sound from inflamed pleura; unaffected by coughing and localized.

Stridor

Loud, high-pitched inspiratory sound signaling upper-airway obstruction (croup, epiglottitis).

Vocal Fremitus

Intensity/clarity of voice sounds on auscultation; decreased with obstruction or pneumothorax.

Bronchophony

Patient says “ninety-nine”; voice becomes loud/clear over consolidation.

Whispered Pectoriloquy

Whispered “1-2-3” heard distinctly over areas of lung consolidation.

Egophony

“Ee” sounds like “ay” over pneumonia or consolidation.

S1 Heart Sound

Closure of mitral and tricuspid valves at start of systole.

S2 Heart Sound

Closure of aortic and pulmonic valves at end of systole.

Normal Adult Pulse

60–100 beats/min.

Tachycardia

100 bpm; first sign of hypoxemia, stress, or anxiety.

Bradycardia

Pulsus Paradoxus

Inspiratory pulse decrease seen in severe asthma.

Blood Pressure

Force of blood on arterial walls; measured as systolic/diastolic in mm Hg.

Hypertension

140/90 mm Hg; indicates cardiac stress or hypoxemia.

Hypotension

Orthostatic Hypotension

BP drop when standing quickly.

Normal Respiratory Rate

12–20 breaths/min in adults.

Normal Body Temperature

37 °C (98.6 °F).

Hypothermia

Abnormally low body temperature.

Hyperthermia

Abnormally high body temperature.

Afebrile

Normal body temperature; no fever.

Normal SpO₂

93–97 % for healthy adults.

5-6-7-8-9 Rule

SpO₂ 90 %=PaO₂ 60 mm Hg; 80 %=50; 70 %=40.

Complete Blood Count (CBC)

Hematology panel including RBC, Hgb, Hct, WBC, and platelets.

Red Blood Cell (RBC) Count

4–6 million/mm³; carries oxygen.

Polycythemia

High RBC count secondary to chronic hypoxemia.

Anemia

Low RBC count due to blood loss or decreased production.

Hemoglobin (Hgb)

Oxygen-carrying protein in RBCs; normal 12–16 g/dL.

Hematocrit (Hct)

Percentage of blood volume as RBCs; normal 40–50 %.

White Blood Cell (WBC) Count

5,000–10,000 /mm³; fights infection.

Leukocytosis

Elevated WBC indicating bacterial infection.

Leukopenia

Low WBC suggesting viral infection or sepsis.

Platelet Count

150,000–400,000 /mm³; essential for clotting.

Creatinine

0.7–1.3 mg/dL; elevated levels indicate kidney failure.

Blood Urea Nitrogen (BUN)

8–25 mg/dL; high value signals renal impairment.

Electrolytes

Ions (Na⁺, K⁺, Cl⁻, HCO₃⁻) essential for metabolism and fluid balance.

Sodium (Na⁺) Normal

135–145 mEq/L; major extracellular cation.

Hyponatremia

Low Na⁺ from diuretics, vomiting; flattened T-waves on EKG.

Hypernatremia

High Na⁺ from renal failure; spiked T-waves on EKG.

Potassium (K⁺) Normal

3.5–5.0 mEq/L; major intracellular cation.

Hypokalemia

Low K⁺ from diuretics or diarrhea; flattened T-waves.

Hyperkalemia

High K⁺ from kidney failure; peaked T-waves.

Chloride (Cl⁻) Normal

96–106 mEq/L; major extracellular anion.

Hypochloremia

Low Cl⁻; associated with metabolic alkalosis.

Hyperchloremia

High Cl⁻; associated with metabolic acidosis.

Bicarbonate (HCO₃⁻)

22–26 mEq/L; main base in acid-base balance.

D-Dimer

Blood test (~<0.5 mg/L) used to rule out thrombus or embolus.

BNP (Brain Natriuretic Peptide)

Troponin

Cardiac protein; >14 ng/L suggests myocardial injury.

Prothrombin Time (PT)

Measures clotting speed; reported as INR.

INR Normal Range

≤1.1 for healthy individuals; 2.0–3.0 therapeutic for patients on warfarin.