Clinical Examination Lines and Digital Clubbing

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18 Questions

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?

It is an indication of a localized problem

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

Supine with head and neck at an angle of 45 degrees

What is the maneuver used to assess digital clubbing?

Pt positions 2 opposing fingers held back to back against each other

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

To identify intercostal spaces and successive ribs

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

It serves as a superficial marking for where the trachea divides into right and left main stem bronchi.

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

It allows for the numbering of thoracic vertebrae.

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

It is formed by the joining of the costal margins with the sternum, and normally should not exceed 90 degrees.

Why are the midclavicular lines important in chest examination?

They help in locating specific anatomical structures and reference points.

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

It serves as a vertical reference line bisecting the sternum.

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

Lobar pneumonia, scoliosis, muscle weakness, paralysis, surgical incision

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

Hands placed with palm distal to the nipple line, thumbs meeting in the midline, fingers lying in the posterior axillary fold

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

PT stands behind the patient with hands placed flat on the patient's posterior chest wall at the level of the 10th rib.

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

T2: Sternal notch/axilla (upper lobe), T4: Nipple line (middle lobe), T10: Xiphoid process (lower ribs)

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

To determine the density of the underlying lung and thoracic cavity.

How does a physical therapist perform tactile fremitus assessment?

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.

Learn about different clinical examination lines such as axillary and midscapular lines, along with the technique of visual inspection for digital clubbing. Understand the theories behind the cause of clubbing in patients.

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