Shared Flashcard Set

Details

Heart, Lungs, and Abdomen
History and Physical
102
Medical
Graduate
10/03/2012

Additional Medical Flashcards

 


 

Cards

Term
The location of the apex of the lungs
Definition
2-4 cm above clavicle
Term
The location of the lower border of the lung
Definition
crosses the 6th rib at midclavicular line and the 8th rib midaxillary
Term
Where the trachea bifurcates anteriorly
Definition
Sternal Angle
Term
Where the trachea bifurcates posteriorly
Definition
T4
Term
Sources of chest pain
Definition
Angina
Pericarditis
Dissecting Aortic Aneurysm
Bronchitis
Pneumonia
costochondritis
GERD
Term
Wheezes
Definition
musical respiratory
Term
what wheezes may represent
Definition
partial airway obstruction
Term
Acute Cough timeframe
Definition
less than 3 weeks
Term
Subacute Cough timeframe
Definition
3-8 weeks
Term
Chronic Cough timeframe
Definition
more than 8 weeks
Term
Hemoptysis
Definition
blood streaked sputum
Term
Deaths that Smoking Accounts for
Definition
1 in 5
Term
leading preventable cause of death
Definition
smoking
Term
the 5 A's
Definition
Ask
Advise
Assess
Assist
Arrange
Term
Risks that increase with smoking
Definition
infertility
preterm birth
low birth weight
SIDS
Term
placement of patient's arms when examining the posterior thorax
Definition
folded across chest
Term
The position in which wheezes are more likely to be heard
Definition
Supine
Term
Things to observe when patient is breathing normally
Definition
rate, rhythm, depth, and effort
Term
What is palpated for in chest exam
Definition
masses
tenderness
expansion
tactile fremitus
Term
what percussion elicits
Definition
sounds associated with air/fluid/solid tissues
Term
Intervals of percussion
Definition
4-5cm
Term
Disease with poor diaphragmatic excursion
Definition
COPD
Term
Associated with unilateral raised diaphragm
Definition
effusion
atelectasis
paralysis
Term
Normal Breath Sounds
Definition
Vesicular
Bronchial
Brochovesicular
Term
Normal location of vesicular sounds
Definition
over most of lung
Term
Normal location of bronchial sounds
Definition
over manubrium
Term
Normal location of bronchovesicular sounds
Definition
1 and 2 interspace between scapulas
Term
What is suspected if bronchial or brochovesicular are heard in other areas
Definition
fluid or consolidation
Term
Adventitious sounds
Definition
Crackles, wheezes, rhonchi, stridor
Term
Discontinuous adventitious sound
Definition
crackles(rales)
Term
Continuous adventitious sound
Definition
Wheezes, Rhonchi, Stridor
Term
Sound of wheezes
Definition
shrill, high pitch squeaky on expiration
Term
Sound of Rhonchi
Definition
low pitch rumble
Term
Sound of Stridor
Definition
inspiratory wheeze
Term
Transmitted Voice Sounds
Definition
Bronchophony
Egophony
Whispered Pectoriloquy
Term
Walk Test
Definition
time patient’s 8-foot walk.
repeat the walk and note the faster time as well as the effort, rate, and sound of patient’s breathing
Term
Forced Expiratory Time
Definition
patient to take a deep breath in and then breath out as quickly as possible with mouth open.
Listen over trachea with the diaphragm of the stethoscope and time the audible expiration-try to get three consistent readings
Term
Identifying a Rib Fracture
Definition
one hand on the sternum and the other on the thoracic spine, squeeze the chest and ask if it is painful
Term
physical examination findings associated with normal lungs
Definition
Percussion: Resonant

Trachea Midline

Breath Sounds: Vesicular(normal)

Adventitious sounds: none; except perhaps a few transient inspiratory crackles at the bases of the lungs

Tactile Fremitus and transmitted voice sounds normal.
Term
physical examination findings associated with chronic Bronchitis
Definition
i. Percussion: Resonant
ii. Trachea Midline
iii. Breath Sounds: Vesicular(normal)
iv. Adventitious sounds: none or scattered coarse crackles in early inspiration and perhaps expiration; or wheezes or rhonchi
v. Tactile Fremitus and transmitted voice sounds normal.
Term
physical examination findings associated with left-sided heart failure
Definition
i. Percussion: Resonant
ii. Trachea: Midline
iii. Breath Sounds: Vesicular(normal)
iv. Adventitious sounds: late inspiratory crackles in dependent portions of the lungs; possibly wheezes
v. Tactile Fremitus and transmitted voice sounds normal
Term
physical examination findings associated with consolidation
Definition
i. Percussion: Dull-over airless area
ii. Trachea: Midline
iii. Breath Sounds: Bronchial over the involved area
iv. Adventitious sounds: : late inspiratory crackles over involved area
v. Tactile Fremitus and transmitted voice sounds: increased over involved area with bronchophony, egophony, and pectoriloquy.
Term
physical examination findings associated with atelectasis
Definition
i. Percussion: Dull-over airless area
ii. Trachea: may be shifted toward involved side
iii. Breath Sounds: usually absent when bronchial plug persists. Exceptions include right upper lob atelectasis where adjacent tracheal sounds may be transmitted
iv. Adventitious sounds: none
v. Tactile Fremitus and transmitted voice sounds: usually absent when bronchial plug persists-in exceptions may be increased (right upper atelectasis).
Term
physical examination findings associated with pleural effusion
Definition
i. Percussion: Dull to flat over the fluid
ii. Trachea: shifted toward opposite side in a large effusion
iii. Breath Sounds: decreased to absent but bronchial may be heard near top of large effusion
iv. Adventitious sounds: none-except possible pleural rub
v. Tactile Fremitus and transmitted voice sounds: decreased to absent, but may be increased toward the top of a large effusion
Term
physical examination findings associated with Pneumothorax
Definition
i. Percussion: Hyperresonant or typanitic over pleural air
ii. Trachea: shifted toward opposite side in a large pneumo
iii. Breath Sounds: decreased to absent over pleural air
iv. Adventitious sounds: none-except possible pleural rub
v. Tactile Fremitus and transmitted voice sounds: decreased to absent over pleural air
Term
physical examination findings associated with COPD
Definition
i. Percussion: Diffusely Hyperresonant
ii. Trachea: midline
iii. Breath Sounds: decreased to absent
iv. Adventitious sounds: none (or the crackles, wheezes, and rhonchi of associated bronchitis)
v. Tactile Fremitus and transmitted voice sounds: decreased
Term
physical examination findings associated with Asthma
Definition
i. Percussion: Resonant to diffusely Hyperresonant
ii. Trachea: midline
iii. Breath Sounds: often obscured by wheezes
iv. Adventitious sounds: wheezes, possibly crackles
v. Tactile Fremitus and transmitted voice sounds: decreased
Term
Funnel Chest(depression in lower portion of sternum)
Definition
Pectus Excavatum
Term
Barrel Chest
Definition
Increased anteroposterior diamter
Term
Pigeon Chest
Definition
Sternum displaced anteriorly
Term
Traumatic Flail Chest
Definition
multiple rib fx which may lead to paradoxical movements of chest
Term
Thoracit Kyphoscoliosis
Definition
abnormal spinal curvatures and vertebral rotation deform chest
Term
thorax is wider than it is deep
Definition
normal chest
Term
Breath Sounds in Pneumonia
Definition
predominantly vesicular
Term
Transmitted voice sounds in Pneumonia
Definition
spoken words louder, clearer
Term
Tactile Fremitus in Pneumonia
Definition
increased vibrations
Term
Thrill
Definition
a vibratory feeling associated with aortic and pulmonic stenosis
Term
what squatting does to venous return
Definition
increases
Term
what standing does to venous return
Definition
decreases
Term
Where the Apical impulse (PMI) is located
Definition
5th interspace L mid-clavicular line
Term
what valsalva does to murmur of MVP and HCM
Definition
increases
Term
what valsalva does to AS murmur
Definition
decreases
Term
Where Aortic valve is heard during auscultation
Definition
RT 2nd interspace close to sternum
Term
Where Pulmonic valve is heard during auscultation
Definition
LT 2nd interspace close to sternum
Term
Where tricuspid valve is heard during auscultation
Definition
4th interspace left lower sternal border
Term
Where mitral valve is heard during auscultation
Definition
LT 5th interpace @ MCL
Term
The murmur best heard in the Left Lateral Decubitus
Definition
diastolic murmur of mitral stenosis
Term
Representation of S1 Sound
Definition
closing of mitral and tricuspid valves
Term
Representation of S2 Sound
Definition
closing of aortic and pulmonic valves
Term
Representation of S3 Sound
Definition
Ventricular Gallop of CHF;Kentucky
Occurs right after S2
Term
Representation of S4 Sound
Definition
atrial gallop; Tennessee; occurs at the end of Diastole right before S1
Term
Murmur grade 1
Definition
Faint
Term
Murmur grade 2
Definition
Quiet, readily heard
Term
Murmur grade 3
Definition
Moderate
Term
Murmur grade 4
Definition
Loud with palpable thrill
Term
Murmur grade 5
Definition
very loud, thrill, may be heard with scope partially off the chest
Term
qMurmur grade 6
Definition
very loud, thrill, heard with scope completely off the chest
Term
Pulse alternans
Definition
Alternating amplitude of palpated radial/femoral pulse

Present in LV failure
Term
Paradoxical pulse
Definition
o Pulse becomes weaker with inspiration & stronger with expiration
o Present in cardiac tamponade, constrictive pericarditis, & emphysema
Term
Where Dependent edema appears when sitting
Definition
feet and lower legs
Term
Where Dependent edema appears when bedridden
Definition
sacrum
Term
causes of dependent edema
Definition
CHF; hyperalbuminemia; positional
Term
How the abdomen is divided
Definition
RUQ
LUQ
RLQ
LLQ
Epigastric
Periumbilical
Suprapubic
Term
What an adequate exam needs
Definition
good light
relaxed patient
full exposure
empty bladder
warm hands
Term
What is looked for during inspection of abdominal skin
Definition
scars, striae, vessels, rashes, lesion
Term
what is looked for during inspection of abdominal exam
Definition
skin
umbilicus
hernias
contour
Aortic pulsation
Term
Order of abdominal exam
Definition
Inspection
Auscultation
Percussion
Palpation
Term
Amount of time to listen to each quadrant during auscultation (if BS not heard)
Definition
2 mins
Term
what hyperactive BS may indicate
Definition
pending obstruction
Term
what absent BS may indicate
Definition
peristalsis has stopped and there is a blockage
Term
what dullness in both flanks may indicate
Definition
ascites
Term
sound over masses and solid organs
Definition
dull
Term
where palpations should start
Definition
areas of no pain
Term
what light palpations are used to identify
Definition
tenderness, masses, guarding
Term
what deep palpations are used to identify
Definition
deeper masses
Term
what the rebound palpation looks for
Definition
inflammation (peritonitis)
Term
the progression of purcussion of the liver
Definition
From RLQ superior(from areas of tympani to dullness)
From Nipple inferior (from tympani to dullness)
Term
Normal liver span
Definition
6-12 cm in mid-clavicular line
Term
Murphy's Sign
Definition
pain over gallbladder as you push on RUQ while patient inspires
Term
McBurney's Point
Definition
1/3-1/2 between rt ASIS and and Umbilicus
Term
Pain on RT side as you push then let up on LT side
Definition
Rovsing Sign
Term
Obturator sign
Definition
RLQ pain as flex RT hip and internally rotate
Supporting users have an ad free experience!