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Questions and Answers
Which respiratory pattern is characterized by rapid, deep breaths followed by periods of apnea?
Which respiratory pattern is characterized by rapid, deep breaths followed by periods of apnea?
Which condition is indicated by the use of accessory muscles for breathing?
Which condition is indicated by the use of accessory muscles for breathing?
What is a common physical sign observed in a patient with barrel chest?
What is a common physical sign observed in a patient with barrel chest?
Which of the following describes 'tactile fremitus'?
Which of the following describes 'tactile fremitus'?
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Which type of respiration would be characterized as very slow and regular?
Which type of respiration would be characterized as very slow and regular?
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In which of the following cases would you expect to see tripoding?
In which of the following cases would you expect to see tripoding?
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Which of the following best describes Kussmaul's breathing pattern?
Which of the following best describes Kussmaul's breathing pattern?
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What is characterized by a gap between the ribs due to multiple rib fractures?
What is characterized by a gap between the ribs due to multiple rib fractures?
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Which of the following is NOT a pattern of respiration discussed?
Which of the following is NOT a pattern of respiration discussed?
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Which of the following statements about jugular venous pressure (JVP) is correct?
Which of the following statements about jugular venous pressure (JVP) is correct?
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What is the primary cause of transient loss of consciousness associated with syncope?
What is the primary cause of transient loss of consciousness associated with syncope?
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Which condition is characterized by episodes of dyspnea that awaken a patient 1 to 2 hours after falling asleep?
Which condition is characterized by episodes of dyspnea that awaken a patient 1 to 2 hours after falling asleep?
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S3 and S4 heart sounds are indicative of which of the following conditions?
S3 and S4 heart sounds are indicative of which of the following conditions?
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What characteristic distinguishes pitting edema from other types of edema?
What characteristic distinguishes pitting edema from other types of edema?
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What does the term 'dyspnea' refer to in a health context?
What does the term 'dyspnea' refer to in a health context?
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Which of the following is NOT an anatomical descriptor of the thorax?
Which of the following is NOT an anatomical descriptor of the thorax?
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What might chest pain originating from the esophagus indicate?
What might chest pain originating from the esophagus indicate?
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Which key examination component is NOT typically performed during a thorax examination?
Which key examination component is NOT typically performed during a thorax examination?
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What does 'hemoptysis' specifically refer to?
What does 'hemoptysis' specifically refer to?
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What anatomical location does 'supraclavicular' refer to?
What anatomical location does 'supraclavicular' refer to?
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Which of the following is commonly associated with disordered sleep that may indicate disorders of ventilation?
Which of the following is commonly associated with disordered sleep that may indicate disorders of ventilation?
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What is the normal range for diaphragmatic excursion during percussion?
What is the normal range for diaphragmatic excursion during percussion?
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Which condition is indicated by the absence of diaphragmatic descent?
Which condition is indicated by the absence of diaphragmatic descent?
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What type of breath sounds are classified as soft and relatively low in pitch?
What type of breath sounds are classified as soft and relatively low in pitch?
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Which instrument should be used for detecting high frequency sounds during auscultation?
Which instrument should be used for detecting high frequency sounds during auscultation?
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Which of the following is true regarding crackles (rales) during auscultation?
Which of the following is true regarding crackles (rales) during auscultation?
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What sound is described as sinusoidal, musical, and prolonged during auscultation?
What sound is described as sinusoidal, musical, and prolonged during auscultation?
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What does transmitted voice sounds testing involve when instructing a patient?
What does transmitted voice sounds testing involve when instructing a patient?
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Which of the following descriptions best fits bronchial breath sounds?
Which of the following descriptions best fits bronchial breath sounds?
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What is the best positioning for the pleximeter finger during percussion?
What is the best positioning for the pleximeter finger during percussion?
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What type of lung sounds may be indicative of fluid in the alveoli?
What type of lung sounds may be indicative of fluid in the alveoli?
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What is the primary indication of consolidation in the lung based on auscultation findings?
What is the primary indication of consolidation in the lung based on auscultation findings?
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Which condition is primarily associated with a high-pitched inspiratory sound?
Which condition is primarily associated with a high-pitched inspiratory sound?
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What symptom is common in patients with COPD?
What symptom is common in patients with COPD?
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What is the condition called when there is a collection of pus in the pleural space?
What is the condition called when there is a collection of pus in the pleural space?
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Which of the following describes the sound produced during expiration associated with narrowed airways?
Which of the following describes the sound produced during expiration associated with narrowed airways?
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What characterizes the cough associated with lung cancer?
What characterizes the cough associated with lung cancer?
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What is an expected finding in a patient diagnosed with pneumonia?
What is an expected finding in a patient diagnosed with pneumonia?
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Which term describes coughing up blood?
Which term describes coughing up blood?
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In what condition is forced expiratory time typically prolonged?
In what condition is forced expiratory time typically prolonged?
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How is cyanosis primarily defined in a clinical setting?
How is cyanosis primarily defined in a clinical setting?
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Study Notes
Chapter 15: Thorax - Anatomic Descriptors
-
Chest Anatomy:
- Supraclavicular (above clavicles)
- Infraclavicular (below clavicles)
- Interscapular (between scapulae)
- Infrascapular (below scapulae)
- Apices of lungs (uppermost portions)
- Bases of lungs (lowermost portions)
- Upper, middle, and lower lung fields
Health History and Chest Pain
- Dyspnea: Abnormal or labored breathing
- Wheezing: Expiratory whistling sound
- Cough: Sputum production (e.g., blood-soaked sputum, hemoptysis = coughing up blood)
- Chest pain: Can indicate disorders of the heart, disorders of ventilation, etc.
- Daytime sleepiness, snoring, and sleep disturbances: Symptoms possibly related to ventilation disorders
Sources of Chest Pain and Possible Causes
- Myocardium: Angina pectoris, myocardial infarction, myocarditis
- Pericardium: Pericarditis
- Aorta: Aortic dissection
- Trachea and Large Bronchi: Bronchitis
- Parietal Pleura: Pericarditis, pneumonia, pneumothorax, pleural effusion, pulmonary embolus, connective tissue disease, costochondritis, herpes zoster
- Chest Wall: Costochondritis, musculoskeletal and neurologic systems
- Esophagus: Gastroesophageal reflux disease, esophageal spasm, esophageal tear
Key Examination Components
- Survey respiration: Observation of breathing rate, rhythm, depth, and effort; ability to speak without stopping to breath
- Inspection: Rate, rhythm, depth, and effort of breathing; Cyanosis or pallor; Stridor or tactile fremitus (palpatory); Accessory muscle use; AP ratio, barrel chest
-
Patterns of Respiration:
- Normal Sinusoidal: Even inspirations and expirations.
- Cheyne-Stokes: Alternating periods of rapid deep breaths and apnea.
- Kussmaul: Rapid, deep breaths, frequently seen in diabetic ketoacidosis.
- Bradypnea: Slow breathing.
- Tachypnea: Rapid breathing
- Sighing: Interrupted breaths.
- Apnea: Breathing cessation.
- Ataxic/Biot: Irregular periods of apnea and breathing
- Deformities: Barrel chest, Pectus Carinatum (Pigeon chest), Pectus Excavatum (Funnel chest).
Inspection - Labored Breathing
- Cyanosis: Bluish discoloration of the skin
- Abdominal retractions: Abdomen pokes out during inspiration
- Tachypnea: Increased respiratory rate
- Tripoding: Using arms to lift shoulders to facilitate breathing
- Abnormal position of comfort: Unusual posture indicating potential respiratory distress
- Accessory muscle use: Use of muscles besides the primary breathing muscles
- Intercostal muscle use: Involvement of muscles between the ribs in breathing.
- Dyspnea: Difficulty breathing
- Vocal quality: Raspy or hoarse voice
- Flail chest: Instability of a section of the chest wall
Palpation - Chest Expansion and Tactile Fremitus
- Assess chest expansion (symmetrical expansion with each breath).
- Palpate tactile fremitus (vibrations during speaking).
Percussion
- Sounds like Flat, Dull, Resonant, Hyperresonant, Tympanitic
- Possible causes
- Description
Auscultation - Breath Sounds
- Normal breath sounds
- Abnormal breath sounds: Crackles/rhonchi/wheezes
Diaphragmatic Excursion
- Measure excursion during inspiration and expiration (3-5cm) to assess for changes
- Perform before and after to check whether it changes in inspiration and expiration
Other Important Terms
- Extrathoracic Structures: Neck, gallbladder, and stomach structures influencing chest complaints.
- Pathologic conditions: E.g., Aortic dissection, esophageal reflux, costochondritis, trauma
- Additional diagnostic findings: egophony, bronchophony, whispered pectoriloquy, adventitious sounds and their causes
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Description
Explore the detailed anatomical descriptors of the thorax and understand various health conditions related to chest pain and breathing difficulties. Dive into important terms such as dyspnea, wheezing, and sources of chest pain along with their implications for conditions like angina and bronchitis.
