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Essential Examination - Respiratory

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benryan95's version from 2015-10-14 14:13

Section 1

Question Answer
From the end of bed inspection, what should be looked for?General appearance of the patient, accessory muscle use, pursed-lip breathing, nutritional status, oxygen, fluids, medication, sputum pot
What does pursed lip breathing show?Airway obstruction (usually COPD)
What should be looked for in inspection of the hands?Peripheral cyanosis, temperature, tar staining, coal dust tattoos, 1st web space wasting
What does 1st web space wasting show?A T1 lesion (Pancoast tumour)
What should be looked for in inspection of the nails?Finger clubbing, Koilonychia
What does koilonychia show?Iron deficiency anaemia
What are the respiratory causes of finger clubbing?Interstitial lung disease, malignancy,suppurative lung disease - bronchiectasis, abscess, empyema, cystic fibrosis
What should be looked for in inspection of the wrist?Flapping tremor (asterixis), fine physiological tremor, respiratory rate, radial pulse
What does flapping tremor (asterixis) show?Respiratory failure, hepatic failure, renal failure
What causes a fine physiological tremor?B2 agonist (salbutamol)
What should be looked for in inspection of the eyes?Conjunctival pallor, ptosis, miosis (constriction of the pupil)
What causes ptosis and miosis?Horner's syndrome
What should be looked for in inspection of the mouth?Central cyanosis and candida
What should be looked for in inspection of the neck?JVP,Trachea, Cricosternal distance, lymph nodes
What causes elevated JVP?Right side heart failure, PE, SVC obstruction
What should be looked for in inspection of the chest?A-P diameter, scars, deformity of chest/spine, intercostal indrawing (Hoover's sign, lower ribs moving in during inspiration)
What does Hoover's sign show?Hyperinflation (COPD)
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Section 2

Question Answer
What should be checked in palpation of the chest?Chest expansion, apex beat, RV heave
In chest expansion, what should be assessed?Symmetry (and degree?)
what should be checked in percussion of the chest?Resonance, comparing side to side, liver edge
What should be checked in auscultation of the chest?Breath sounds and added noises, wheeze, crepitations, vocal resonance
What should be looked for in the back?Sacral oedema
What should be looked for in the ankles?Peripheral oedema
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Section 3

Question Answer
What causes dull percussion in the lungs?Consolidation, lung collapse, effusion, pneumonectomy
What causes hyperresonant percussion in the lungs?pneumothorax
What causes decreased or absent breath sounds?consolidation, collapse, effusion, pneumothorax, pneumonectomy
What causes bronchial breath sounds?consolidation
what causes increased vocal resonance?consolidation
What causes decreased vocal resonance?collapse, effusion, pneumothorax, pneumonectomy
memorize

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