Untitled Quiz

Study Notes

Lung Sounds and Conditions

Midsternal line: drops vertically along sternum
Midclavicular line: drops vertically from the midpoint of the clavicle
Anterior axillary line: drops vertically from anterior axillary fold
Midaxillary line: drops vertically from the apex of the axilla
Right lung: has 3 lobes
Left lung: has 2 lobes
Oblique fissure: runs from T3 spinous process, to 6th rib
Horizontal fissure: runs close to 4th rib, meets oblique fissure near the 5th rib
Trachea: bifurcates at level of sternal angle, anteriorly and posteriorly at T4
Aspiration pneumonia: more common in right lobe due to vertical right main bronchus
Diaphragm: primary muscle of inspiration
Accessory muscles (SCM and scalenes): assist with inspiration
Shortness of Breath (Dyspnea): caused by partial lower airway obstruction, secretions, tissue inflammation
Cough: a reflex response to irritation in the larynx, trachea, bronchi, or can indicate left-sided heart failure
Acute cough: often viral, but also can be caused by ACE-inhibitors, pneumonia, asthma
Subacute cough: often post-infectious, could be acid reflux, asthma, bacterial sinusitis
Chronic cough: often due to postnasal drip, GERD, chronic bronchitis, or asthma
Purulent sputum: yellow or green, often with bacterial pneumonia
Mucoid sputum: translucent, white or gray, often with viral infections/cystic fibrosis
Foul-smelling sputum: present in anaerobic lung abscess
Thick, tenacious sputum: common in cystic fibrosis
Large volumes of sputum: common in lung abscess
Pneumonia: common symptom is fever and productive cough
Asthma: common symptom is wheezing
Acute coronary syndromes: common symptoms include chest pain, dyspnea, orthopnea
Percussion notes:
- Flat: large pleural effusion
- Dull: lobular pneumonia
- Resonant: simple chronic bronchitis

Abnormal Lung Sounds and Conditions

Hyper-resonant: COPD, pneumothorax
Tympanitic: large pneumothorax
Absent descent of diaphragm: pleural effusion, elevated hemidiaphragm from atelectasis
Crackles (Rales): discontinuous, intermittent, non-musical, brief, like dots, in time related to fluid in alveoli
Wheezes: high-pitched, related to narrowing airways (asthma, COPD, bronchitis)
Rhonchi: low-pitched, related to secretions in large airways
Stridor: audible high-pitched inspiratory whistling usually in upper airway (larynx/trachea) and a medical emergency
Consolidation: replacement of air-filled tissue in the lung, like pneumonia, bleeding, or tumor
Forced expiratory time: slowed in COPD, patients >60 years, <9 seconds at 4x likely to have COPD
Cyanosis: signals hypoxia (lack of oxygen)
Lung cancer: symptoms include cough, dry to productive sputum, weight loss, smoking history
Pulmonary embolism (PE): symptoms include dry cough with blood, tachypnea, chest/lung pain, fever, syncope
Asthma: symptoms include intermittent cough, viscous mucoid sputum, episodic wheezing and dyspnea
Tuberculosis (TB): symptoms include cough with mucoid or purulent sputum, may be bloody, early nonspecific symptoms, later anorexia, fatigue, fever, night sweats
Barrel chest: increased AP diameter, often in aging and COPD