54 Questions
What is directly adjacent to the sternal angle?
3rd rib and its costal cartilage
Which muscle is responsible for respiration?
Diaphragm
How many lobes does the right lung have?
3
What does the inability to speak in full sentences before stopping to take a breath suggest?
Increased respiratory drive or impairment of ventilation with reduced vital capacity
What is indicative of increased airways resistance or stiff lungs and/or chest wall?
Supraclavicular retractions, use of accessory muscles of ventilation, and the tripod position
How should the respiratory rate be accurately assessed?
By carefully observing the rate of rise of the chest wall
What is the normal adult respiratory rate?
14-20 times per minute
Which examination technique should focus on identifying dullness and hyperresonance?
Percussion
What should be observed during the general examination of patients with exertional dyspnea?
Signs of hypoxemia, anemia, and extrapulmonary manifestations of lung disease
What is the purpose of examining the abdomen in patients with exertional dyspnea?
To identify paradoxical movement of the abdomen, a sign of diaphragmatic weakness
Which examination is necessary to identify signs of elevated right-sided heart pressures?
Cardiac examination
What should be observed when patients with exertional dyspnea are walking?
To reproduce symptoms and monitor oximetry for desaturation
Which diagnostic measure is used to diagnose obstructive sleep apnea (OSA)?
Polysomnography
What is the leading risk factor for lung cancer?
Cigarette smoking
Which condition is characterized by translucent, white, or gray mucoid sputum and foul-smelling sputum in anaerobic lung abscess?
Cystic fibrosis
What tool can help identify individuals at risk for obstructive sleep apnea (OSA)?
STOP-Bang questionnaire
What is recommended for current or recent heavy smokers as a screening measure?
Annual low-dose computed tomography (LDCT) screening
What is the characteristic sign of Acute Respiratory Distress Syndrome (ARDS)?
Signs of respiratory distress and tachypnea
Which symptom may indicate lower airway obstruction?
Difficulty breathing deeply
What is a diagnostically helpful symptom associated with pneumonia?
Fever
Which condition may be suggested by large volumes of purulent sputum?
Lung abscess
What may indicate the presence of asthma?
Wheezing
What is the most common cause of acute cough?
Viral upper respiratory infections
Where does chest pain from pneumonia usually arise from?
Inflammation of the adjacent parietal pleura
What is the purpose of the muscle responsible for respiration?
To contract and relax to change the volume of the thorax cavity
What is indicative of increased work of breathing?
Use of accessory muscles of ventilation
What does the inability to speak in full sentences before stopping to take a breath suggest?
Impaired ventilation with reduced vital capacity
What is directly adjacent to the sternal angle?
2nd rib and its costal cartilage
How many lobes does the right lung have?
3
What should be observed to accurately assess the respiratory rate?
The rate of rise of the chest wall
Which of the following symptoms may indicate lower airway obstruction?
Musical respiratory sound
What does the presence of foul-smelling sputum may indicate?
Lung abscess
Where does chest pain from pneumonia usually arise from?
Parietal pleura
Which condition may be suggested by large volumes of purulent sputum?
Bronchiectasis
What is the characteristic sound that may indicate lower airway obstruction?
Wheezing
What is the most common cause of acute cough?
Viral upper respiratory infections
Which breath sounds are important to listen for with a stethoscope during a respiratory examination?
Vesicular, bronchial, and bronchovesicular
What may crackles indicate during a respiratory examination?
Abnormalities in lung parenchyma or airways
What do wheezes and stridor indicate during a respiratory examination?
Narrowed airways in conditions like asthma and COPD
What does the absence of wheezes and breath sounds in severe asthma indicate?
A clinical emergency
What does tactile fremitus assess during a respiratory examination?
Symmetric palpable vibrations transmitted through the bronchopulmonary tree
What does forced expiratory time assess during a respiratory examination?
The expiratory phase of breathing, vital in obstructive pulmonary disease
Which examination technique should be direct to skin to avoid altering characteristics of breath sounds?
Auscultation
What is the characteristic sign of diaphragmatic weakness that should be identified during abdominal examination?
Paradoxical movement of the abdomen
What should be observed during the general examination of patients with exertional dyspnea to look for signs of extrapulmonary manifestations of lung disease?
Symmetry of chest movement
What is the normal adult respiratory rate?
14-20 times per minute
What should the focus of percussion be during chest examination to indicate airway obstruction or hyperinflated lungs?
Identifying dullness and hyperresonance
What is the purpose of examining the chest wall for underlying lobes, chest shape, movement, and deformities?
To observe chest expansion
Which diagnostic tool is recommended for identifying individuals at risk for obstructive sleep apnea (OSA)?
STOP-Bang questionnaire
Where is needle insertion recommended for decompression of tension pneumothorax?
2nd intercostal space
Which condition is associated with clubbing of the nails?
Pulmonary fibrosis
What is the leading risk factor for lung cancer?
Cigarette smoking
What is the characteristic sputum associated with cystic fibrosis?
Translucent, white, or gray mucoid sputum
What is the recommended screening measure for current or recent heavy smokers?
Low-dose computed tomography (LDCT) screening
Study Notes
Assessing Dyspnea and Associated Symptoms
- Dyspnea severity is determined by the patient's ability to perform daily activities such as climbing stairs or carrying groceries and its impact on their lifestyle.
- Anxious patients may describe difficulty breathing deeply, a smothering sensation, and tingling sensations, and may experience episodic dyspnea during rest and exercise.
- Wheezing is a musical respiratory sound that may indicate lower airway obstruction from conditions such as asthma or foreign body obstruction.
- The most common causes of acute cough are viral upper respiratory infections and acute bronchitis, while chronic cough can be caused by conditions such as postnasal drip, asthma, and gastroesophageal reflux.
- Cough assessment includes determining if the cough is dry or productive, the volume, color, odor, and consistency of sputum.
- Hemoptysis should be confirmed as originating from the respiratory tract and not from the nose, mouth, or gastrointestinal tract.
- Chest pain can arise from various thoracic and cardiac causes, including the myocardium, pericardium, aorta, trachea, pleura, chest wall, esophagus, and extrathoracic structures.
- Differentiating among the causes of chest pain involves eliciting the location, characteristics, and associated attributes of the pain.
- Lung tissue has no pain fibers, so pain from conditions such as pneumonia usually arises from inflammation of the adjacent parietal pleura.
- The presence of wheezing can indicate asthma, while large volumes of purulent sputum may suggest bronchiectasis or lung abscess.
- Foul-smelling sputum may indicate anaerobic lung abscess, while thick tenacious sputum may suggest cystic fibrosis.
- Diagnostically helpful symptoms associated with a cough include fever and productive cough in pneumonia, and wheezing in asthma.
Respiratory Conditions and Diagnostic Measures
- Risk of latent tuberculosis is higher for individuals born or previously residing in high tuberculosis prevalence countries.
- Chronic Obstructive Pulmonary Disease (COPD) is characterized by a barrel chest and increased anteroposterior diameter.
- Obstructive sleep apnea (OSA) is diagnosed through polysomnography and can be treated with positive airway pressure.
- The STOP-Bang questionnaire can help identify individuals at risk for OSA.
- Cystic fibrosis is associated with translucent, white, or gray mucoid sputum and foul-smelling sputum in anaerobic lung abscess.
- Cigarette smoking is the leading risk factor for lung cancer, with radon being the second leading cause in the US.
- Annual low-dose computed tomography (LDCT) screening is recommended for current or recent heavy smokers.
- Needle insertion for decompression of tension pneumothorax is recommended at the 2nd intercostal space.
- Asymmetric decreased fremitus raises the likelihood of unilateral pleural effusion, pneumothorax, or neoplasm.
- Acute Respiratory Distress Syndrome (ARDS) is characterized by signs of respiratory distress and tachypnea.
- Clubbing of the nails occurs in bronchiectasis, congenital heart disease, pulmonary fibrosis, cystic fibrosis, lung abscess, and malignancy.
- Dyspnea is a key symptom in assessing cardiac and pulmonary diseases.
Test your knowledge of assessing dyspnea and associated symptoms with this quiz. Explore the variety of symptoms related to respiratory distress and learn about their potential causes. This quiz covers topics such as dyspnea severity, wheezing, cough assessment, hemoptysis, and chest pain differentiation.
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