Clinical Examination Lines and Digital Clubbing

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Questions and Answers

What is the significance of bilateral distention of jugular veins during a physical examination?

It is caused by congestive heart failure (CHF)

How is digital clubbing assessed during a physical examination?

Pt positions 2 opposing fingers held back to back against each other and notes for absence of a diamond-shape space

How is chest wall configuration assessed during a physical examination?

By visual inspection

What does unilateral distention of jugular veins indicate?

<p>It is an indication of a localized problem</p> Signup and view all the answers

In what position should a patient be during the assessment of jugular venous distention?

<p>Supine with head and neck at an angle of 45 degrees</p> Signup and view all the answers

What is the maneuver used to assess digital clubbing?

<p>Pt positions 2 opposing fingers held back to back against each other</p> Signup and view all the answers

What is the purpose of palpating the sternomanubrial angle during physical examination of the chest?

<p>To identify intercostal spaces and successive ribs</p> Signup and view all the answers

Why is the suprasternal notch considered an important landmark during chest examination?

<p>It serves as a superficial marking for where the trachea divides into right and left main stem bronchi.</p> Signup and view all the answers

What is the significance of the vertebral prominens in the physical examination of the chest?

<p>It allows for the numbering of thoracic vertebrae.</p> Signup and view all the answers

How is the costal angle formed and what is considered normal?

<p>It is formed by the joining of the costal margins with the sternum, and normally should not exceed 90 degrees.</p> Signup and view all the answers

Why are the midclavicular lines important in chest examination?

<p>They help in locating specific anatomical structures and reference points.</p> Signup and view all the answers

What is the purpose of the midsternal line (MSL) in the visual inspection of the chest?

<p>It serves as a vertical reference line bisecting the sternum.</p> Signup and view all the answers

What are some conditions that can restrict chest wall movement unilaterally?

<p>Lobar pneumonia, scoliosis, muscle weakness, paralysis, surgical incision</p> Signup and view all the answers

Describe the hand placement for a physical therapist when assessing chest wall motion in a patient with COPD.

<p>Hands placed with palm distal to the nipple line, thumbs meeting in the midline, fingers lying in the posterior axillary fold</p> Signup and view all the answers

How is the measurement of chest wall excursion done at the level of the 10th rib?

<p>PT stands behind the patient with hands placed flat on the patient's posterior chest wall at the level of the 10th rib.</p> Signup and view all the answers

What landmarks are used for measuring chest wall excursion with a tape measure?

<p>T2: Sternal notch/axilla (upper lobe), T4: Nipple line (middle lobe), T10: Xiphoid process (lower ribs)</p> Signup and view all the answers

Explain the purpose of assessing tactile fremitus during a physical examination.

<p>To determine the density of the underlying lung and thoracic cavity.</p> Signup and view all the answers

How does a physical therapist perform tactile fremitus assessment?

<p>PT stands behind the patient and uses either the palmar or ulnar surface of both hands placed on the patient's back on 3 segments.</p> Signup and view all the answers

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