Untitled Quiz

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Questions and Answers

What can trigger localized pain in the chest wall?

Increased heart rate

Decreased lung capacity

Abdominal pain

Inflammation of the airways (correct)

Which shape change of the chest wall indicates chronic lung disease?

Flat chest

Pigeon chest

Funnel chest

Barrel chest (correct)

What is the typical AP:T ratio of a normal chest wall?

3:2

1:1

2:1

1:2 (correct)

Which of the following is a sign of airway constriction?

Wheezing Signup and view all the answers

What do fine crackles signify about fluid in the airways?

Fluid in smaller airways Signup and view all the answers

What condition is most likely to cause acute cough?

Pneumonia Signup and view all the answers

What characteristic distinguishes coarse crackles from fine crackles?

Pitched frequency Signup and view all the answers

Which of the following options relates to chronic cough pathology?

Inflammation of costal cartilages Signup and view all the answers

What does rhonchi indicate regarding airway conditions?

Partial airway narrowing due to thick mucus Signup and view all the answers

Which symptom is most indicative of central cyanosis?

Bluish color of mucous membranes Signup and view all the answers

What is the significance of diminished breath sounds?

They signify complete obstruction in one or more airways. Signup and view all the answers

Which symptom is NOT typically associated with hypoxemia?

Increased circulation volume Signup and view all the answers

What characterizes stridor in patients with upper airway issues?

Harsh, high-pitched creaking sounds Signup and view all the answers

How is peripheral cyanosis typically identified?

Through capillary refill time and nail bed color Signup and view all the answers

What can prolonged hypoxemia lead to in patients over time?

Development of finger clubbing Signup and view all the answers

Which is the primary cause of stridor?

Obstruction in the upper airway, such as the trachea or larynx Signup and view all the answers

Which of the following conditions can lead to hemoptysis?

Tuberculosis Signup and view all the answers

What is dyspnea commonly associated with?

Reduced pH levels Signup and view all the answers

What characterizes the sputum during a viral acute upper respiratory infection?

Clear and thin Signup and view all the answers

What physical response might be observed in a person experiencing dyspnea?

Sitting upright Signup and view all the answers

Which statement about retractions is true?

They indicate accessory muscle use for inspiration. Signup and view all the answers

What causes pleural pain experienced during deep inspiration?

Inflammatory processes within the pleura Signup and view all the answers

What technique is used to assist with air trapping during exhalation?

Pursed lip breathing Signup and view all the answers

What type of sputum is typically associated with pulmonary edema?

Frothy and blood-tinged Signup and view all the answers

Study Notes

Chest Wall Pain

Costochondritis, inflammation of one or more costal cartilages, is characterized by anterior chest wall pain.
Coughing can trigger costochondritis.
Inflammation of the airways, intercostal muscles, or accessory muscles can also cause localized pain.
Coughing can trigger inflammation.
Chest pain can originate in the lungs, but must be differentiated from cardiac pain to rule out a myocardial infarction.

Barrel Chest

The chest wall is typically oval-shaped, with the anterior-posterior (AP) plane narrower than the transverse (T) plane (AP:T ratio of approximately 1:2).
Chronic dilation and distention of the alveoli, as seen in emphysema, can lead to a barrel chest appearance, where the AP:T ratio becomes 1:1.

Breath Sounds

Adventitious breath sounds are altered lung sounds caused by airway constriction or fluid accumulation.
Wheezing breath sounds are caused by airway constriction.
Crackles, a snapping, popping, or bubbling sound, are caused by fluid accumulation in the airways.
Fine crackles are high-pitched and short, signifying fluid in smaller airways.
Coarse crackles are louder and lower-pitched, indicating fluid in larger airways.
Rhonchi, low-pitched wheezing sounds with a snoring quality, occur when the airway narrowing is in the larger airways.
Rhonchi, high-pitched wheezing sounds with a squeaking quality, occur when the airway narrowing is in the smaller airways.
Rhonchi are caused by thick mucus partially blocking the airways.
Stridor, a harsh, high-pitched, creaking sound, is indicative of upper airway obstruction, particularly in the trachea or larynx.
Diminished breath sounds indicate quieter, barely audible breath sounds, suggesting complete obstruction in one or more airways.
Absent breath sounds indicate no air movement through the lungs.

Systemic Manifestations of Altered Ventilation

Hypoxemia, hypoxia, and hypercapnia can cause systemic manifestations.
Fever, malaise, leukocytosis, and higher levels of circulating plasma proteins can occur with inflammation and issues with altered ventilation and diffusion.
The intensity of hypoxic or hypercapnic responses varies depending on the severity of oxygen deprivation and carbon dioxide retention.
Manifestations may include dusky or cyanotic mucous membrane color, changes in arterial blood gases, mental status changes, and finger clubbing.

Cyanosis

Cyanosis is caused by a high proportion of desaturated hemoglobin in the blood, giving the blood a bluish hue.
Central cyanosis, a problem of low oxygen saturation in arterial blood, can cause color changes in the skin and mucous membranes.
In individuals with dark skin, color changes are often described as ashen or dusky.
In light skin, color changes are often described as pale or bluish.
The most reliable indicator of central cyanosis is a bluish color in the mucous membranes.
Peripheral cyanosis, caused by sluggish blood flow in the fingers and toes, often presents with slow capillary refill and a pale or bluish hue in the nail beds.

Finger Clubbing

Chronic problems with ventilation and diffusion may lead to clubbing of the fingers.

Sputum

A viral acute upper respiratory infection (common cold) often begins with clear, thin mucus.
As phagocytes move into the area of inflammation and die, they are shed off as yellow or green mucus.
Hemoptysis, coughing up blood from the respiratory tract, is caused by the presence of red blood cells in the sputum.
Hemoptysis in the sputum can be caused by heavy exertion during coughing, tuberculosis, a tumor, or trauma.
In the presence of pulmonary edema, the sputum can become blood-tinged, frothy, or foamy.

Dyspnea

Dyspnea, the subjective feeling of shortness of breath or the inability to get enough air, is common in individuals with altered ventilation or diffusion.
Dyspnea is stimulated by hypoxemia, hypercapnia, and the subsequent reduction in pH, but the exact mechanism is often unknown.
Lung receptors or chemoreceptors may stimulate the brain and breathing muscles to induce this sensation.
Dyspnea often leads to physical and emotional responses, such as the need to sit upright or stand to maximize lung expansion (orthopnea).
Individuals with dyspnea may use accessory muscles and demonstrate nasal flaring to assist with breathing.
Retractions, pulling in of accessory muscles in the intercostal, substernal, and supraclavicular spaces, can promote more effective inspiration.
Individuals experiencing air trapping may perform pursed lip breathing to maintain positive airway pressure in the alveoli, minimize air trapping, and promote carbon dioxide expiration.
Emotional manifestations of dyspnea include anxiety, panic, frustration, and anger.

Pleural Pain

Inflammatory processes within the pleura can lead to pleural pain, which is often described as sharp or stabbing and increases with deep inspiration.
Auscultation reveals a grating, scratching sound (pleural friction rub) with inspiration.