Respiratory Assessment: Abnormal Retraction and Palpation

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What is an indication of abnormal retraction during inspiration?

Feeling for tender areas along the costal margin

Local lag in respiratory movement (correct)

Palpation of the anterior chest wall

Normal expansion of the thorax

During physical examination, what is the purpose of sliding hands medially to raise loose skin folds between thumbs?

To evaluate chest expansion (correct)

To assess bruising or skin changes

To observe extent of chest pain

To check for tender pectoral muscles

What does decreased or absent tactile fremitus over the precordium suggest?

Lung consolidation (correct)

Severe chest pain

Normal lung function

Localized musculoskeletal origin of chest pain

In which conditions could abnormal retraction of lower intercostal spaces occur?

Severe asthma Signup and view all the answers

What should be done when examining a female patient regarding tactile fremitus?

Gently displace the breasts if needed Signup and view all the answers

What does the assessment of bruising, sinus tracts, or skin changes help identify during palpation?

Localized musculoskeletal origin of chest pain Signup and view all the answers

What factors tend to relieve dyspnea in obstructive airway disease?

Sitting up Signup and view all the answers

Which environmental condition is often associated with weakness, fatigue, and less common cough in obstructive lung diseases?

Varied exposure to trigger substances Signup and view all the answers

What is a common manifestation of anxiety in pulmonary disease?

Sighing and lightheadedness Signup and view all the answers

What symptoms are often present in individuals with a familial deficiency in α1-antitrypsin?

Productive cough and recurrent respiratory infections Signup and view all the answers

Which symptom is less common in obstructive lung diseases compared to other lung diseases?

Productive cough Signup and view all the answers

What is the main characteristic of a mediastinal crunch (Hamman sign)?

It is a series of precordial crackles synchronous with the heartbeat, not with respiration. Signup and view all the answers

What is the best position to hear a mediastinal crunch?

Left lateral position Signup and view all the answers

What is the underlying cause of a mediastinal crunch?

Air entry into the mediastinum causing mediastinal emphysema (pneumomediastinum) Signup and view all the answers

Which of the following conditions can lead to a mediastinal crunch?

Tracheobronchial injury, blunt trauma, pulmonary disease, and use of recreational drugs Signup and view all the answers

What is a common symptom associated with a mediastinal crunch?

Severe central chest pain Signup and view all the answers

According to the table, what is the typical percussion finding in conditions causing a mediastinal crunch?

The table does not provide information on percussion findings for mediastinal crunch Signup and view all the answers

What is the term used to describe increased tactile fremitus in a patient with left-sided heart failure?

Bronchophony Signup and view all the answers

Which condition may present with late inspiratory crackles in the dependent portions of the lungs?

Left-sided heart failure Signup and view all the answers

What percussion note is likely to be heard over an airless area in the lungs?

Dull Signup and view all the answers

In what condition would you expect to hear whispered pectoriloquy during auscultation?

Tracheobronchial tree obstruction Signup and view all the answers

Which condition would lead to decreased to absent breath sounds with possible bronchial sounds near the top of a large effusion?

Right upper lobe atelectasis Signup and view all the answers

What is a common auscultatory finding associated with bronchophony?

Louder and clearer spoken sounds Signup and view all the answers

What is the primary difference between fine crackles and coarse crackles?

Fine crackles are heard during mid to late inspiration, while coarse crackles are heard throughout inspiration and expiration. Signup and view all the answers

What is the primary cause of fine crackles?

Sudden inspiratory opening of small airways Signup and view all the answers

Which of the following conditions is NOT associated with coarse crackles?

Interstitial lung diseases Signup and view all the answers

How do fine crackles and coarse crackles differ in their frequency and duration?

Fine crackles are higher pitched and have a shorter duration than coarse crackles. Signup and view all the answers

Which of the following is a characteristic of coarse crackles?

They have a popping sound and are heard throughout inspiration and expiration. Signup and view all the answers