Untitled Quiz

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