Patient Assessment – Inspection (RC121)

Vocabulary flashcards covering major inspection findings, terms, and conditions discussed in RC121 Patient Assessment Part 2 lecture.

Inspection (in IPPA)

First and most important step of physical exam; visual (and unaided auditory) assessment of the patient.

Dyspnea

Subjective sensation of breathing discomfort, often intensified by emotional distress.

Orthopnea

Difficulty breathing except when the patient is upright; common in congestive heart failure.

Platypnea

Difficulty breathing while upright that improves on lying down; associated with hepatopulmonary syndrome.

Psychogenic Dyspnea

Breathlessness linked to panic or anxiety disorders, often with hyperventilation and chest pain.

Cough

Forceful expiratory maneuver that clears mucus/foreign material after airway receptors are stimulated.

Cough Receptors

Sensory endings in the larynx, trachea, and large bronchi that trigger the cough reflex when irritated.

Cough Effectiveness

Determined by deep inspiration, lung recoil, expiratory muscle strength, and airway resistance.

Productive Cough

Cough that brings up sputum (secretions) from the airways.

Sputum

Mucus and other material expectorated from the lower airways.

Purulent Sputum

Sputum containing pus, indicating infection.

Fetid Sputum

Foul-smelling sputum, often from anaerobic infection.

Mucoid Sputum

Clear, thick sputum often seen in asthma.

Mucopurulent Sputum

Sputum that is mostly mucus with some pus; appears clear with yellow streaks.

Hemoptysis

Blood-streaked sputum from the lungs or airways (<300 mL in 24 h).

Massive Hemoptysis

300 mL of blood in 24 h; medical emergency.

Hematemesis

Vomiting blood originating from the gastrointestinal tract.

Pleuritic Chest Pain

Sudden, sharp, stabbing pain that worsens on deep inspiration; originates from pleural structures.

Non-pleuritic Chest Pain

Constant, central pain arising from myocardium, pericardium, esophagus, or chest wall.

Peripheral Edema

Excess fluid in tissues (arms/ankles) due to heart or renal failure.

Pedal Edema

Swelling of the lower extremities (feet/ankles).

Pitting Edema

Indentation remains after pressure is applied to swollen tissue.

Weeping Edema

Fluid seeps out where pressure is applied to edematous tissue.

Digital Clubbing

Painless enlargement of distal fingers/toes and spongy nail beds caused by chronic hypoxemia.

Cyanosis

Blue-gray skin/mucous membranes when ≥5 g/dL of hemoglobin is deoxygenated.

Peripheral Cyanosis

Cyanosis limited to digits due to poor perfusion; extremities feel cool.

Central Cyanosis

Cyanosis of lips and oral mucosa indicating inadequate arterial oxygenation (urgent).

Ashen / Pallor

Gray or pale skin color from anemia, acute blood loss, or vasoconstriction.

Jaundice

Yellow discoloration from elevated bilirubin, usually linked to liver dysfunction.

Erythema

Redness of skin from capillary congestion, inflammation, or infection.

Jugular Venous Distention (JVD)

Visible bulging of the external jugular vein, most often from right heart failure.

Capillary Refill Test

Pressing nail bed and observing color return ≤2 s to assess peripheral circulation.

Diaphoresis

Profuse sweating caused by fever, heart failure, anxiety, or infections like TB.

Thoracic Configuration

Normal chest A-P to lateral ratio is 1:2; deviations signal disease.

Barrel Chest

Increased A-P diameter (1:1) from chronic air trapping, e.g., emphysema.

Air Trapping

Incomplete exhalation seen in obstructive diseases; major cause of barrel chest.

Mid-clavicular Line

Imaginary vertical line through the midpoint of the clavicle; chest landmark.

Pectus Carinatum

Pigeon chest; sternum protrudes outward, possibly causing dyspnea and infections.

Pectus Excavatum

Funnel chest; sternum sunken inward, may reduce meal capacity and body weight.

Retractions

Inward sinking of chest wall during inspiration indicating respiratory distress.

Accessory Muscles of Inspiration

Sternocleidomastoids, scalenes, pectoralis major, trapezius used when breathing effort increases.

Accessory Muscles of Expiration

Rectus abdominis, internal/external obliques, transversus abdominis used during forced exhalation.

Chest Excursion

Symmetry of chest expansion; asymmetry suggests atelectasis, pneumothorax, flail chest, etc.

Flail Chest

Segment of ribs moves paradoxically due to multiple fractures; impairs ventilation.

Eupnea

Normal breathing: VT ≈ 500 mL, 12–20 bpm, I:E ≈ 1:2.

Tachypnea

Respiratory rate >20 breaths / min.

Bradypnea

Respiratory rate <12 breaths / min.

Apnea

Complete cessation of breathing.

Apneustic Breathing

Prolonged deep inspiration with brief partial expiration; indicates brain injury.

Hyperpnea

Deep breathing with increased tidal volume.

Hypopnea

Shallow breathing with reduced tidal volume.

Hyperventilation

Increased rate and/or depth leading to decreased PaCO₂.

Hypoventilation

Inadequate ventilation causing elevated PaCO₂.

Biot’s Breathing

Clusters of fast, deep breaths with apnea; associated with CNS damage.

Cheyne-Stokes Respiration

Crescendo-decrescendo breathing with apnea; seen in brain damage or CHF.

Kussmaul’s Respiration

Deep, rapid breathing in severe metabolic acidosis (e.g., diabetic ketoacidosis).

Pursed-Lip Breathing

Exhalation through puckered lips to prolong expiration, reduce air trapping, and ease SOB.

Tripod Position

Leaning forward with arms braced to recruit accessory muscles during respiratory distress.