Ignore for now, resp rest of ppt

What patient instruction is given when performing the Bronchophony technique?

Ask the patient to repeat "99-99-99" while listening with a stethoscope over the chest.

What is the normal auscultation finding for Bronchophony?

The sound is soft, muffled, and indistinct, and the words "99" cannot be clearly heard.

An abnormal Bronchophony finding, where "99" is heard clearly and loudly, indicates what underlying condition?

Lung consolidation or increased lung density.

What patient instruction is given when performing the Egophony technique?

Ask the patient to say "ee-ee-ee" in a high-pitched voice.

What is the normal auscultation finding for Egophony?

The examiner should hear the "EE" sound clearly each time.

What sound change characterizes "positive egophony"?

The "EE" sound changes to a long, nasal-sounding "AA" (bleating) sound.

Positive egophony is indicative of which two lung conditions?

Consolidation or compression.

What patient instruction is given when performing the Whispered Pectoriloquy technique?

Ask the patient to whisper a phrase like "1-2-3" or "99".

What is the normal auscultation finding for Whispered Pectoriloquy?

The sounds are muffled, faint, and almost inaudible.

In Whispered Pectoriloquy, hearing the whispered "1-2-3" distinctly and clearly indicates _.

Consolidation

What is the primary characteristic of adventitious lung sounds?

They are added sounds that are not normally heard in the lungs.

Describe the sound of fine crackles (rales).

Discontinuous, high-pitched, short crackling or rattling sounds.

During which part of the respiratory cycle are fine crackles primarily heard?

Inspiration

What mechanical action produces fine crackles?

Inhaled air suddenly opens small, deflated air passages coated and sticky with exudate.

List three common causes of fine crackles.

Pneumonia, congestive heart failure, and restrictive lung diseases.

True or False: Fine crackles are cleared by coughing.

FALSE

In which conditions do fine crackles occur specifically early in inspiration?

Bronchitis, asthma, or emphysema.

Describe the sound of coarse crackles (coarse rales).

Continuous, mostly loud, low-pitched, bubbling, snoring, and gurgling sounds.

What mechanical action produces coarse crackles?

Inhaled air comes into contact with secretions in the large bronchi and trachea.

List four causes of coarse crackles.

Pulmonary edema, pneumonia, pulmonary fibrosis, and long-term COPD.

How does coughing or suctioning typically affect coarse crackles?

The sounds may decrease.

What characterizes atelectatic crackles compared to pathological crackles?

They are nonpathological and dissipate after a few deep breaths or coughing.

What is the sound quality of sibilant wheezes?

High-pitched and musical.

Sibilant wheezes are caused by air passing through _.

Constricted passages (swelling, secretions, or tumors).

Which two conditions are primary causes of high-pitched (sibilant) wheezes?

Asthma and chronic emphysema.

Describe the sound of sonorous wheezes (rhonchi).

Low-pitched snoring or rattling musical sounds.

In which part of the respiratory cycle are sonorous wheezes primarily heard?

Expiration (though they may be heard throughout).

What are two common causes of sonorous wheezes (rhonchi)?

Bronchitis or single obstructions.

What is the clinical description of stridor?

A continuous, inspiratory, high-pitched crowing sound.

Where is stridor heard most loudly?

Over the neck (larynx/trachea) rather than the chest wall.

Why is stridor considered a medical emergency?

It indicates a serious upper airway obstruction.

List three potential causes of stridor.

Croup, epiglottitis, or foreign body aspiration.

Describe the sound of a pleural friction rub.

A low-pitched, dry, grating sound similar to crackles but more superficial.

During which phase(s) of the respiratory cycle does a pleural friction rub occur?

Both inspiration and expiration.

What is the cause of a pleural friction rub?

Pleuritis (inflammation of the pleural surfaces rubbing against each other).

What is the normal adult respiratory rate and pattern?

12\text{--}20 breaths/min and regular.

Define Tachypnea.

A respiratory rate of more than 24 breaths/min and shallow.

Tachypnea is a normal response to which three factors?

Fever, anxiety, or exercise.

Define Bradypnea.

A respiratory rate of less than 10 breaths/min and regular.

List three potential causes for Bradypnea.

Well-conditioned athletes, diabetic coma, or neurologic damage.

Describe Kussmaul respiration.

Rapid, deep, and labored breathing.

Kussmaul respiration is a classic clinical sign of _.

Diabetic ketoacidosis (DKA)

Describe the pattern of Cheyne-Stokes respiration.

A regular pattern characterized by alternating periods of deep, rapid breathing followed by periods of apnea.

List three causes of Cheyne-Stokes respiration.

Severe congestive heart failure, drug overdose, or renal failure.

What is Thoracentesis?

A diagnostic procedure used to remove fluid from the pleural space for analysis or symptom relief.

Define 'Forced expiratory time'.

The number of seconds it takes to exhale from total lung capacity to residual volume.

What is the clinical utility of measuring forced expiratory time?

It serves as a screening measure for airflow obstruction.

What is the primary function of a Spirometer in ambulatory care?

To measure lung health and pulmonary function.

A pulse oximeter is a noninvasive method used to assess _.

$SpO2$

What is the normal SpO2 range for a healthy person without lung disease or anemia?

97% to 98%.

Name three factors that must be considered when evaluating an SpO2 result.

Hemoglobin (Hb) level, acid-base balance, and ventilatory status.

What is the purpose of the 6-minute walk test (6 MWT)?

To provide a safe, simple, and clinical measure of functional status in aging adults.

List four common radiologic diagnostic studies for the respiratory system.

Chest x-ray, CT scan, MRI, and Ventilation-perfusion (V/Q) scan.

What physical exam finding for tactile fremitus is expected in Pneumonia?

Increased fremitus ($ \uparrow $).

What percussion sound is expected over areas of Pneumonia?

Dullness

Which specific adventitious sound is commonly associated with Pneumonia?

Crackles

What are the three main types of Atelectasis?

1. Compression, 2. Obstruction, 3. Micro-atelectasis.

In Atelectasis, the trachea shifts toward the _ side.

Affected

What is the cause of compression atelectasis?

A lesion external to the lung causing collapse.

What is the cause of micro-atelectasis?

Decreased surfactant leading to alveolar collapse.

In Pleural Effusion, how is tactile fremitus affected?

Decreased fremitus.

How does chest expansion change in a patient with Pleural Effusion?

It becomes asymmetrical with decreased or delayed expansion on the affected side.

In Pleural Effusion, the trachea shifts toward the _ side.

Unaffected

What percussion sound is expected over the area of a Pneumothorax?

Hyper-resonance

What happens to breath sounds over the area affected by a Pneumothorax?

They are decreased or absent.

In Pneumothorax, the trachea shifts toward the _ side.

Unaffected

What is the primary cause of Chronic Obstructive Pulmonary Disease (COPD)?

Smoking

What three disorders are involved in the spectrum of COPD?

Chronic bronchitis, emphysema, and asthma.

Advanced COPD is characterized by an increased _ ratio.

A-P (Anterior-Posterior)

How does Tactile Fremitus change in Emphysema?

It is decreased ($ \downarrow $).

What change in the expiration phase is observed in Emphysema?

Prolonged expiration.

In Emphysema, diaphragmatic excursion is _.

Decreased ($ \downarrow $)

What are the common advanced symptoms of Tuberculosis?

Fever, productive cough, weight loss, fatigue, and anorexia.

What type of rales are typically associated with Tuberculosis?

Coarse rales.

What respiratory sign regarding crackles is specific to Heart Failure?

Bibasilar crackles.

Define 'Orthopnea' as a symptom of Heart Failure.

Difficulty breathing that occurs when lying flat.

How does tactile fremitus typically present in Heart Failure?

Equal

What is the respiratory consequence of decreased alveolar surface area in aging adults?

Decreased $O2$-$CO2$ exchange.

Aging leads to a decreased ventilatory response to which two blood gas states?

Hypoxia and hypercapnia.

Why is there an increased risk for infection in the respiratory system of older adults?

Reduced ciliary action leading to increased secretions.

What mechanical change in aging leads to silent aspirations?

Impaired protective airway reflexes.

Fibrotic changes in the thoracic muscles and rib cage of older adults result in _.

Decreased chest expansion.

True or False: Bibasilar crackles in older adults due to fibrotic changes will clear with a cough.

FALSE

How do aging-related changes in elasticity affect lung volumes?

Decreased vital capacity and decreased forced expiratory volume.

In older adults, tenderness at the costochondral junction of the ribs is associated with _.

Fractures, especially in clients with osteoporosis.

Define 'Kyphosis' as seen in older adults.

An increased curve of the thoracic spine.

Why might chest pain related to pleuritis be absent in older clients?

Due to age-related alterations in pain perception.

Why is the ability to cough effectively decreased in older adults?

Weaker muscles and increased rigidity of the thoracic wall.

Why do the sternum and ribs often appear more prominent in older clients?

Because of the loss of subcutaneous fat.

During the inspection phase of a thorax exam, what five elements are assessed?

Thoracic cage, respirations, skin color/condition, facial expression, and level of consciousness (LOC).

What is the primary goal of Palpation during a lung examination?

To confirm symmetric expansion/tactile fremitus and detect lumps, masses, or tenderness.

What is the primary goal of Percussion during a lung examination?

To assess lung fields and estimate diaphragmatic excursion.

Auscultation is used to assess breath sounds and perform which three specific voice sound tests if needed?

Bronchophony, whispered pectoriloquy, and egophony.