Chest and Lung Examination Lab
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Questions and Answers

What is the normal time for full expiration during pulmonary function measurement?

  • 5 seconds or less
  • 3 seconds or less
  • 6 seconds or less
  • 4 seconds or less (correct)

    • What is the normal range for SpO2 measurement?

  • 97% to 99% (correct)
  • 96% to 98%
  • 94% to 95%
  • 95% to 96%

    • What is the primary objective of assessing heart and neck vessels?

  • To determine normal findings of heart and neck (correct)
  • To measure blood pressure
  • To identify abnormal heart sounds
  • To assess cardiovascular health

    • What does it mean when a node is enlarged, tender, or fixed in area?

    <p>It is upnormal and requires further examination</p> Signup and view all the answers

    How should a woman be prepared for a chest examination?

    <p>She should leave her gown on and open at the back</p> Signup and view all the answers

    Why is it important to measure the calf circumference?

    <p>To identify any edema or atrophy</p> Signup and view all the answers

    Where should the assessment of the chest begin?

    <p>Posterior thorax</p> Signup and view all the answers

    What is the purpose of palpating for temperature and tenderness?

    <p>To detect any changes or abnormalities in the skin</p> Signup and view all the answers

    What is an important consideration during the examination?

    <p>Safety, infection control, and patient dignity</p> Signup and view all the answers

    Why is it important to measure the other leg in exactly the same place?

    <p>For symmetry and comparison</p> Signup and view all the answers

    What is the purpose of depressing the skin over the tibia or medial malleolus?

    <p>To detect any signs of edema</p> Signup and view all the answers

    How is pitting edema graded?

    <p>1+ for mild pitting, 2+ for moderate pitting</p> Signup and view all the answers

    Why is it important to ask the person to stand up?

    <p>To assess the venous system</p> Signup and view all the answers

    What is the purpose of the manual compression test?

    <p>To identify the beginning and end of the varicose vein</p> Signup and view all the answers

    What is the primary objective of the chest and lung examination?

    <p>To determine normal chest and lung examination</p> Signup and view all the answers

    How should a woman be prepared for the examination?

    <p>She should leave her gown on and open at the back</p> Signup and view all the answers

    What is the correct ratio of anteroposterior (AP) to transverse diameter in adults?

    <p>0.70 to 0.75</p> Signup and view all the answers

    What is the first step in the examination process?

    <p>History taking and subjective data</p> Signup and view all the answers

    What is the purpose of inspecting the posterior chest?

    <p>To note the shape and configuration of the chest wall</p> Signup and view all the answers

    What is the purpose of noting the position of the person's arms during the assessment?

    <p>To ensure the person is in a relaxed posture</p> Signup and view all the answers

    What equipment is needed to perform the examination?

    <p>A stethoscope, alcohol wipe, and pulse oximeter</p> Signup and view all the answers

    What should be the color of the person's skin?

    <p>Consistent with the person's genetic background</p> Signup and view all the answers

    What is the purpose of palpating the posterior chest?

    <p>To assess the person's skin temperature and moisture</p> Signup and view all the answers

    Why should the patient sit upright during the examination?

    <p>To make it easier to examine the posterior chest</p> Signup and view all the answers

    What should be done with the woman's gown when examining the anterior chest?

    <p>Lift it up and drape it on her shoulders</p> Signup and view all the answers

    What is the correct way to assess symmetric expansion of the chest?

    <p>By placing the hands on the posterolateral chest wall with thumbs pointing together</p> Signup and view all the answers

    What is tactile fremitus used to assess?

    <p>The sounds transmitted through bronchi and lung parenchyma to the chest wall</p> Signup and view all the answers

    What should you avoid when percussing the lung fields?

    <p>Percussing over the scapulae</p> Signup and view all the answers

    What is the characteristic of resonance in the lung fields?

    <p>Low-pitched and hollow</p> Signup and view all the answers

    What is the purpose of asking the person to repeat the words 'ninety-nine' or 'blue moon' during the assessment?

    <p>To assess the sounds transmitted through bronchi and lung parenchyma to the chest wall</p> Signup and view all the answers

    Why is it important to maintain a room temperature of around 22°C (72°F) during the examination?

    <p>To prevent vasodilation or vasoconstriction</p> Signup and view all the answers

    What is the purpose of lifting both of the person's hands in your hands during the examination?

    <p>To enhance visualizing</p> Signup and view all the answers

    What is the normal time for color to return to the nail beds after depression and blanching?

    <p>Within 1-2 seconds</p> Signup and view all the answers

    What is the purpose of inspecting the skin for turgor during the examination?

    <p>To assess for dehydration</p> Signup and view all the answers

    What equipment is used to measure the circumference of the legs during the examination?

    <p>Paper tape measure</p> Signup and view all the answers

    Why is it important to evaluate the leg veins with the person standing?

    <p>To evaluate the leg veins in a gravity-dependent position</p> Signup and view all the answers

    Study Notes

    Chest and Lung Examination

    • Determine normal chest and lung examination
    • Determine abnormal chest and lung examination
    • Determine other systematic diseases based on assessment of chest and lung examination
    • Demonstrate organized approach in examining the chest
    • Demonstrate approach reflecting safety, infection control, and patient dignity

    Preparation

    • Ask the person to sit upright
    • Ask a man to disrobe to the waist, and a woman to leave the gown on and open at the back
    • Equipment needed: Stethoscope, alcohol wipe, and Pulse Oximeter

    Inspection

    • Inspect the posterior chest: thoracic cage
      • Note the shape and configuration of the chest wall
      • The spinous processes should appear in a straight line
      • The thorax is symmetric
    • Inspect the anterior chest
      • Lift up the gown and drape it on her shoulders rather than removing it completely

    Palpation

    • Palpate the posterior chest
      • Symmetric expansion: place warmed hands sideways on the posterolateral chest wall with thumbs pointing together at the level of T9 or T10
      • Palpate for tenderness, skin temperature and moisture, superficial lumps or masses, and skin lesions
    • Palpate using the fingers, gently palpate the entire chest wall
    • Tactile fremitus: use either the palmar base or the ulnar edge of one hand and touch the person's chest
      • Ask the person to repeat the words “ninety-nine” or “blue moon”
      • Start over the lung apices and palpate from one side to the other, avoiding the scapulae

    Percussion

    • Percuss the posterior chest
      • Determine the predominant note over the lung fields
      • Start at the apices and percuss the band of normally resonant tissue across the tops of both shoulders
      • Percuss in the interspaces, making a side-to-side comparison all the way down the lung region
      • Avoid damping resonance and the effect of the scapulae and ribs

    Additional Assessments

    • Measure the calf circumference with a non-stretchable tape measure
      • To identify any edema or atrophy
    • Palpate for temperature, tenderness
    • Palpate peripheral arteries in both legs
    • Depress the skin over the tibia or the medial malleolus to detect edema
    • Ask the person to stand up to assess the venous system
      • Note any visible, dilated, and tortuous veins
    • Perform a manual compression test

    Pulmonary Function Status

    • Measure pulmonary function status
      • Ask the person to inhale as deeply as possible and then blow all out hard, as quickly as possible
      • Listen with a stethoscope over the sternum
      • Normal time for full expiration is 4 seconds or less
    • Use Pulse Oximeter to assess arterial oxygen saturation (SpO2)
      • Normally SpO2 is 97% to 99%

    Heart and Neck Vessel Examination

    Preparation

    • Ask the person to sit upright
    • Ask a man to disrobe to the waist, and a woman to leave the gown on and open at the back
    • Environmental preparations:
      • Room temperature should be about 22° C (72° F) and draft less to prevent vasodilation or vasoconstriction
    • Equipment:
      • Marking pen
      • Paper tape measure
      • Stethoscope with diaphragm and bell end pieces
      • Doppler ultrasonic probe

    Inspection and Palpation

    • Inspect and palpate the arms
      • Lift both person hands in your hands
      • Inspect the palms of hands for size and shape
      • Turn hands and inspect, then inspect for skin color, nail beds, texture, turgor of skin presence of lesion, edema, clubbing, profile sign

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    Description

    This lab teaches students to examine chests and lungs, identifying normal and abnormal conditions, as well as systematic diseases. Students will learn a safe and dignified approach to examination.

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