Cardioresp assessment - palpation, percussion, aucultation

chest wall expansion

a palpation technique to provide info on lungs ability to expand symmetrically, in different lobes and if there is brhoncal fremitus

subcutaneous emphysema

occurs w air under the skin causing swelling and sounds of popping when palpated

tracheal shift

occurs when the trachea shifts away or towards a lung segment due to changes in lung volumes/pressures

towards

if there is dec lung volumes then the trachea will shift ___ the lungs

away

if there is inc lung volumes/pressures then the trachea will shift ___ the lungs

atelectasis in left lung

example of a condition causing the trachea to move to the to Left lung

pneumothorax in left lung

example of a condition causing the trachea to move to the to right lung

pneumothorax

occurs when there is air in pleural space which can occur randomly, trauma, incorrect line insertion, or excessive pressure from chronic disease

pleural effusion

occurs when fluid fills the pleural space which can occur from Heart failure, cancer or post op

tactile fremitus

an assessment which uses vocal sounds that are transmitted through the lungs to feel the vibrations in the different lung segments

increased intensity

if there is inc density within the lung then tactile fremitus will have a ____

decreased intensity

if there is anything within the pleural space then tactile fremitus will have a ____

pneumonia w consolidation

an example of a condition which shows inc intensity of tactile fremitus is

pleural effusion in pleural space

an example of a condition which shows dec intensity of tactile fremitus is

percussion

the use of sound to assist in the identification or normal and abnormal ventilation and to detect changes in lung density

true

during percussion an abnormality will only be detected if it is atleast 2-3 cm in diameter and up to 5cm in depth

t or f

false

during percussion an abnormality will only be detected if it is atleast 4-5 cm in diameter and up to 2cm in depth

t or f

normal resonant

during percussion ____ sounds occur over normal lung for normal air to tissue ratio

hyperresonant

during percussion _____ sounds occur when the air/tissue ratio is above normal due to more air

dull

during percussion _____ sounds occur when the air/tissue ratio is below normal due to less air

auscultation

listening to the breath sounds, adventitia and vocal sounds

vesicular

a type of breath sounds which is loud on inspiration, has no gap, and quieter/softer on expiration

most of lungs, esp on base and periphery

vesicular breath sounds are usually located over the____

bronchovesicular

a type of breath sound which has equal loudness bw inspiration and expiration that is high pitched and no gap bw insp and exp

manubrium and mainstem bronchi

bronchovesicular breath sounds are usually located over the ____

bronchial

very loud, high pitched and equal bw inspiration and expiration w a gap bw the two

trachea but abnormal everywhere else

bronchial breath sounds are usually located over the ____

true

if bronchial breath sounds are heard over the low lob of the lung then it indicates inc density/airless

t or f

false

if bronchial breath sounds are heard over the low lob of the lung then it indicates inc hollowness/air

t or f

decreased/diminished

when air entry is ____ then there is less air flowing through the airways

absent

when air entry is ____ then there is less no flowing through the airways

COPD

example of dx w hyperresonant percussion

cystic fibrosis

example of dx w dull percussion

fine crackles

a type of adventitious sound which occurs when the alveolar sacs are opening and closing

coarse crackles

a type of adventitious sound which occurs when the air is moving through liquid in the alveolar/distal sacs

high pitched wheezes

a type of adventitious sound which occurs when the air is moving through a narrow space

low pitched wheezes

a type of adventitious sound which occurs when the air is moving through a liquid in a tube AKA sonorous wheezing

distal airways

crackle adventitious sounds occur in the ____

proximal airways

wheezing adventitious sounds happen in the ___

stridor

a type of adventitious sound which can be heard w/o a stethoscope and is very high pitched loud whistling

pleural rub

a type of adventitious sound which sounds like squeaking/rubbing

crunches

a type of adventitious sound which sounds like crunching sound or popping bubble wrap

secretions in lower airways/severe pulmonary edema

a condition which causes coarse crackles

atelectasis/pulmonary fibrosis/mild pulmonary edema

a condition which causes fine crackles

bronchospasm/asthma/COPD

a condition which causes high pitched wheezes

secretions in upper airways/pneumonia

a condition which causes low pitched wheezes

upper airway obstruction/medical emergency

a condition which causes stridor

fluid in pleural space

a condition which causes pleural rub sound

subcutaneous emphysema

a condition which causes crunches sounds

whispered pectroiloquy

a type of vocal sound auscultation which helps detect increased density due to whispered voice coming in w clear transmission

bronchophony

a type of vocal sound auscultation which helps detect increased density due to vocal sounds transmitting sound clearly though a dense tissue

egophony

a type of vocal sound auscultation which helps detect increased density due distorting soundwaves causing it to alter sound