Bates' Guide to Physical Examination Abnormalities
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Questions and Answers

What is the principal muscle of inspiration during breathing?

  • Intercostal muscles
  • Abdominal muscles
  • Diaphragm (correct)
  • Scalenes
  • Which nerves richly innervate the parietal pleura?

  • Intercostal and phrenic nerves (correct)
  • Femoral nerves
  • Sciatic nerves
  • Radial nerves
  • What produces pleuritic pain in conditions like viral pleurisy and pneumonia?

  • Irritation of abdominal muscles
  • Irritation of parasternal intercostal muscles
  • Irritation of diaphragm
  • Irritation of visceral pleura (correct)
  • What assists in expiration during breathing?

    <p>Abdominal muscles</p> Signup and view all the answers

    Which muscles help expand the thorax during breathing, especially running from the cervical vertebrae to the first two ribs?

    <p>Scalenes</p> Signup and view all the answers

    Where does oxygen diffuse into during breathing?

    <p>Alveoli</p> Signup and view all the answers

    Which of the following is NOT listed as a possible source of chest pain?

    <p>The appendix</p> Signup and view all the answers

    Which condition is associated with the esophagus as a source of chest pain?

    <p>Gastroesophageal reflux disease</p> Signup and view all the answers

    What initial question is recommended to ask a patient presenting with chest pain?

    <p>Do you have any discomfort or unpleasant feelings in your chest?</p> Signup and view all the answers

    Which of the following is NOT listed as an attribute of chest pain to distinguish among its various causes?

    <p>Ethnicity</p> Signup and view all the answers

    Which condition is associated with the chest wall as a source of chest pain?

    <p>Costochondritis</p> Signup and view all the answers

    What percentage of patients with panic and anxiety disorders report chest pain?

    <p>25%</p> Signup and view all the answers

    What is the most common cause of acute cough?

    <p>Viral upper respiratory infections</p> Signup and view all the answers

    Which of the following is NOT listed as a potential cause of subacute cough?

    <p>Chronic bronchitis</p> Signup and view all the answers

    What color sputum is associated with bacterial pneumonia?

    <p>Yellow or green</p> Signup and view all the answers

    Which type of sputum is seen in viral infections and cystic fibrosis?

    <p>Mucoid</p> Signup and view all the answers

    Which of the following is NOT listed as a potential cause of chronic cough?

    <p>Bacterial sinusitis</p> Signup and view all the answers

    What should be assessed when a patient complains of cough?

    <p>All of the above</p> Signup and view all the answers

    What percentage of smokers who try to quit on their own resume smoking within 30 days?

    <p>More than 80%</p> Signup and view all the answers

    What causes the powerful and reinforcing rush effect when inhaling nicotine?

    <p>Release of dopamine in the brain</p> Signup and view all the answers

    What cognitive therapy techniques are recommended to help smokers quit?

    <p>Recognizing and designing strategies to combat craving, triggers, and withdrawal signs</p> Signup and view all the answers

    How do counseling and pharmacotherapies affect quit rates for smokers?

    <p>Quit rates roughly double when counseling is combined with pharmacotherapies</p> Signup and view all the answers

    What is the leading cause of cancer death for both men and women in the United States?

    <p>Lung cancer</p> Signup and view all the answers

    What factor is associated with a higher risk of lung cancer?

    <p>Longer smoking histories and higher numbers of cigarettes smoked</p> Signup and view all the answers

    What does foul-smelling sputum indicate in a patient?

    <p>Lung abscess</p> Signup and view all the answers

    Which condition is associated with thick tenacious sputum?

    <p>Cystic fibrosis</p> Signup and view all the answers

    What is the term for blood coughed up from the lower respiratory tract?

    <p>Hemoptysis</p> Signup and view all the answers

    In which of the following conditions is hemoptysis rare?

    <p>Infants, children, and adolescents</p> Signup and view all the answers

    What volume of blood is considered massive hemoptysis?

    <p>&gt;200 cm3</p> Signup and view all the answers

    Before using the term 'hemoptysis,' what should be confirmed?

    <p>Source of the bleeding</p> Signup and view all the answers

    Study Notes

    • Chest pain can originate from various sources, including the myocardium, pericardium, aorta, trachea, and large bronchi, parietal pleura, chest wall, and esophagus
    • Other sources of chest pain include extrathoracic structures, such as the neck, gallbladder, and stomach
    • Angina pectoris, myocardial infarction, myocarditis, pericarditis, and aortic dissection are potential causes of chest pain
    • Parietal pleura irritation can produce pleuritic pain with deep inspiration in conditions such as viral pleurisy, pneumonia, pulmonary embolism, pericarditis, and collagen vascular diseases

    Breathing and Respiration

    • Breathing is primarily automatic, controlled by respiratory centers in the brainstem
    • The principal muscle of inspiration is the diaphragm
    • During inspiration, the diaphragm contracts, descends in the chest, and expands the thoracic cavity, compressing the abdominal contents and pushing out the abdominal wall
    • The muscles in the rib cage also expand the thorax, especially the scalenes and parasternal intercostal muscles

    Cough and Hemoptysis

    • Cough can be caused by various stimuli, including mucus, pus, blood, allergens, dust, foreign bodies, or extremely hot or cold air
    • Inflammation of the respiratory mucosa, pneumonia, pulmonary edema, and compression of the bronchi or bronchioles from a tumor or enlarged peribronchial lymph nodes can also cause cough
    • Cough can signal left-sided heart failure
    • Acute cough can be caused by viral upper respiratory infections, acute bronchitis, pneumonia, left-sided heart failure, asthma, foreign body, smoking, and ace-inhibitor therapy
    • Subacute cough can be caused by postinfectious cough, pertussis, acid reflux, bacterial sinusitis, and asthma
    • Chronic cough can be caused by postnasal drip, asthma, gastroesophageal reflux, chronic bronchitis, and bronchiectasis

    Smoking and Nicotine Addiction

    • More than 80% of smokers who try to quit on their own resume smoking within 30 days
    • Daily smokers inhale enough nicotine to achieve almost complete receptor saturation, leading to a powerful and reinforcing rush effect
    • Quit rates roughly double when counseling is combined with pharmacotherapies such as nicotine replacement, bupropion, and varenicline

    Lung Cancer Epidemiology

    • Lung cancer is the second most frequently diagnosed cancer in the United States and the leading cause of cancer death for both men and women
    • Over 200,000 new cases and nearly 160,000 deaths were expected in 2014
    • Cigarette smoking is the leading risk factor for lung cancer, accounting for about 90% of lung cancer deaths

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    Description

    Test your knowledge on examples of abnormalities in sensory nerves related to the parietal pleura, and conditions such as viral pleurisy, pneumonia, and pericarditis. Explore concepts related to breathing control by respiratory centers in the brainstem.

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