Bates Physical Exam of the Chest and Lungs Questions and Answers 100% Verified

"Match test"? - Not sure about the name of this test. Assesses the pulmonary system of the px. Ask px to hold a match at arms length and blow it out. slide 54 "Walk test" - 1. assesses the pulmonary function 2. ask the px to walk 8 feet at patients pace, repeat and note a faster time 3. normal 3.1 seconds; geriatrics 5.6 seconds 4. Observe px rate; effort; breathing sounds *Angle of Louis - sternal angle that joins the manubrium and sternum *Crackles - Also called rales. Intermittent and brief explosive breath sounds. Usually leads to the Dx of cardiac or pulmonary conditions. Suggest abnormal lung tissue. Crackles may be from abnormalities of the lungs (pneumonia, fibrosis, early congestive heart failure) or of the airways (bronchitis, bronchiectasis) *Fremitus - palpable vibrations felt on the human body *Rhonchi - a low-pitched breath sound with snoring quality. Rhonchi suggest secretions in large airways. *Wheezing - a continuous, course,whistling sound produced in the respiratory airways during breathing. Wheezes suggest narrowed airways, as in asthma, COPD, or bronchitis. 2nd intercostal space - used during needle decompression for tension pneumothorax4th - 6th intercostal space - used for chest tube insertion AP diameter - anteroposterior diameter AP diameter of chest - May increase with age, or COPD At risk categories of pneumococcal vaccine - age - elderly environment - prevalent in area genetics - immuno-suppressed patients ethnicity - native americans medical history Ataxic breathing - Breaths may be shallow, deep and stop for short periods. This is also a ominous sign Auscultation of chest - Listen for 1. sounds generated by breathing 2. adventitious sounds 3. if abnormalities are present listen to the transmitted sounds as the px speaks Before starting exam - Make sure the px removes dip, gum, candy... Biot's Breathing - Ataxic Breathing Bradypnea - Slow breathing. May be secondary to such causes as diabetic coma, drug induced respiratory depression, and increased intracrainal pressure. bronchophony - Ask px to say "99". Normal sound is muffled and indistinct.Causes of Obstructive breathing - Asthma, chronic bronchitis and COPD Chest expansion - Check chest expansion at the 10th rib Cheyne-Stokes Breathing - Children and aging people normally may show this pattern of sleep. Other causes include heart failure, uremia, drug-induced respiratory depression and brain damage. Cheyne-Stokes Breathing & Shock - An ominous sign Circumference of the chest - A series of vertical lines. The midsternal and vertebral lines are precise and others are estimated. Midclavicular line, Anterior and Posterior axillary lines, midaxillary line, vertebral line. slide 23 pg cough - a reflex response to stimuli that irritate receptors in the larynx, trachea, or large bronchi Dimensions of describing chest abnormalities - vertical axis - ribs horizontal axis - around the circumference of the chest; use a series of vertical lines Divisions of lungs - both are separated by oblique (major) fissure located at T3 down to the 6th rib right is further divided by horizontal (minor) fissure Dyspnea - shortness of breath egophony - ask pc to say "ee". Normal is a muffled EE. Abnormal is a "ay" sound Expiatory time test - adult 4 - 5 seconds normal older 60 years 6- 8 seconds normalFive "A"s - Ask about tobacco use Advise to quit Assess willingness Assist to quit Arrange follow-up and support