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6013 EXAM 2 Questions and Correct
Answers/ Latest Update / Already Graded
Respiratory Physical exam
Ans: IPPA order
Inspection
Ans: Thoracic expansion/rib expansion (causes of symmetrical
and asymmetrical changes)
Normal: Symmetrical movement. Normal is 1-3cm
Symmetrically decreased: Obstructive lung disease
Asymmetrically decreased: Pneumonia, pneumothorax, pleural
effusion, or unilateral atelectasis
Barrel chest: Increased anteroposterior diameter; chronic air
trapping (associated with COPD/emphysema)
Accessory muscle use, retractions, cyanosis: Indicates
respiratory distress or increased work of breathing
Palpation
Ans: General: Tenderness, masses. Palpate in a ladder pattern.
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Chest expansion: Look for unilateral changes in expansion
(pneumothorax, foreign body)
Focus on tenderness, expansion, fremitus, masses or lesions
Thoracic Expansion (Rib excursion): Place hands on either side
of chest at 10th rib, ask patient to inhale, look for asymmetrical
movement of fingers!
Tactile Fremitus
Ans: Patient says "99" feel for lateral symmetry, increased
vibration (consolidation is pneumonia), decreased vibration
(pleural effusion or pneumothorax, COPD)
Percussion
Ans: Resonant: Normal sound over healthy lung tissue (Most
common normal tone)
Dull: Thud-like; decreased air. Causes- Pneumonia, pleural
effusion, tumor, atelectasis
Hyperresonant: Louder, lower-pitched; increased air. Causes-
COPD, asthma, and pneumothorax
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Flat: Very dull. Causes- Bone or large effusion
Auscultation
Ans: Instruct patient to breath in and out through MOUTH,
listen for FULL inspiration and expiration.
Vesicular: Low-pitched, soft, heard longer on inspiration. Over
most lung fields (normal and most common)
Bronchovesicular: Medium pitch, equal inspiration/expiration.
Heard near mainstream bronchi and between scapulae
Bronchial: Loud, high-pitched, expiration longer than
inspiration. Normally heard only over trachea, if heard
peripherally-> consolidation
Abnormal (Adventitious) breath sounds
Ans: Crackles (rales): Discontinuous popping. Caused by
pneumonia, HF, pulmonary fibrosis
Wheezes: High-pitched musical; from narrowed airways.
Caused by Asthma, COPD, and exacerbation
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Rhonchi: Low-pitched, snoring quality. Caused by secretions in
larger airways (bronchitis)
Stridor: Upper airway obstruction, croup, and foreign bodies
COPD (Chronic Obstructive Pulmonary Disease)
Ans: Onset in mid-life, symptoms slowly progressive, long
smoking history.
Key presentation; consider chronicity, smoking history: Chronic
cough, sputum production, progressive dyspnea, smoking or
pollutant exposure history
Physical findings: Barrel chest, prolonged expiration, decreased
breath sounds, wheezes/rhonchi, pursed-lip breathing
Diagnostic criteria: FEV1/FVC ratio <70% on spirometry- Post
bronchodilator confirms airflow limitation (GOLD)
Risk factors: Aging populations, genes, infections,
socioeconomic status
Asthma
All rights reserved © 2025/ 2026 |
6013 EXAM 2 Questions and Correct
Answers/ Latest Update / Already Graded
Respiratory Physical exam
Ans: IPPA order
Inspection
Ans: Thoracic expansion/rib expansion (causes of symmetrical
and asymmetrical changes)
Normal: Symmetrical movement. Normal is 1-3cm
Symmetrically decreased: Obstructive lung disease
Asymmetrically decreased: Pneumonia, pneumothorax, pleural
effusion, or unilateral atelectasis
Barrel chest: Increased anteroposterior diameter; chronic air
trapping (associated with COPD/emphysema)
Accessory muscle use, retractions, cyanosis: Indicates
respiratory distress or increased work of breathing
Palpation
Ans: General: Tenderness, masses. Palpate in a ladder pattern.
All rights reserved © 2025/ 2026 |
, Page |2
Chest expansion: Look for unilateral changes in expansion
(pneumothorax, foreign body)
Focus on tenderness, expansion, fremitus, masses or lesions
Thoracic Expansion (Rib excursion): Place hands on either side
of chest at 10th rib, ask patient to inhale, look for asymmetrical
movement of fingers!
Tactile Fremitus
Ans: Patient says "99" feel for lateral symmetry, increased
vibration (consolidation is pneumonia), decreased vibration
(pleural effusion or pneumothorax, COPD)
Percussion
Ans: Resonant: Normal sound over healthy lung tissue (Most
common normal tone)
Dull: Thud-like; decreased air. Causes- Pneumonia, pleural
effusion, tumor, atelectasis
Hyperresonant: Louder, lower-pitched; increased air. Causes-
COPD, asthma, and pneumothorax
All rights reserved © 2025/ 2026 |
, Page |3
Flat: Very dull. Causes- Bone or large effusion
Auscultation
Ans: Instruct patient to breath in and out through MOUTH,
listen for FULL inspiration and expiration.
Vesicular: Low-pitched, soft, heard longer on inspiration. Over
most lung fields (normal and most common)
Bronchovesicular: Medium pitch, equal inspiration/expiration.
Heard near mainstream bronchi and between scapulae
Bronchial: Loud, high-pitched, expiration longer than
inspiration. Normally heard only over trachea, if heard
peripherally-> consolidation
Abnormal (Adventitious) breath sounds
Ans: Crackles (rales): Discontinuous popping. Caused by
pneumonia, HF, pulmonary fibrosis
Wheezes: High-pitched musical; from narrowed airways.
Caused by Asthma, COPD, and exacerbation
All rights reserved © 2025/ 2026 |
, Page |4
Rhonchi: Low-pitched, snoring quality. Caused by secretions in
larger airways (bronchitis)
Stridor: Upper airway obstruction, croup, and foreign bodies
COPD (Chronic Obstructive Pulmonary Disease)
Ans: Onset in mid-life, symptoms slowly progressive, long
smoking history.
Key presentation; consider chronicity, smoking history: Chronic
cough, sputum production, progressive dyspnea, smoking or
pollutant exposure history
Physical findings: Barrel chest, prolonged expiration, decreased
breath sounds, wheezes/rhonchi, pursed-lip breathing
Diagnostic criteria: FEV1/FVC ratio <70% on spirometry- Post
bronchodilator confirms airflow limitation (GOLD)
Risk factors: Aging populations, genes, infections,
socioeconomic status
Asthma
All rights reserved © 2025/ 2026 |
