Respiratory Assessment: Abnormal Retraction and Palpation
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Questions and Answers

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?

<p>Severe asthma (A)</p> Signup and view all the answers

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

<p>Gently displace the breasts if needed (A)</p> Signup and view all the answers

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

<p>Localized musculoskeletal origin of chest pain (D)</p> Signup and view all the answers

What factors tend to relieve dyspnea in obstructive airway disease?

<p>Sitting up (A)</p> Signup and view all the answers

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

<p>Varied exposure to trigger substances (D)</p> Signup and view all the answers

What is a common manifestation of anxiety in pulmonary disease?

<p>Sighing and lightheadedness (A)</p> Signup and view all the answers

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

<p>Productive cough and recurrent respiratory infections (C)</p> Signup and view all the answers

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

<p>Productive cough (A)</p> Signup and view all the answers

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

<p>It is a series of precordial crackles synchronous with the heartbeat, not with respiration. (B)</p> Signup and view all the answers

What is the best position to hear a mediastinal crunch?

<p>Left lateral position (A)</p> Signup and view all the answers

What is the underlying cause of a mediastinal crunch?

<p>Air entry into the mediastinum causing mediastinal emphysema (pneumomediastinum) (D)</p> Signup and view all the answers

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

<p>Tracheobronchial injury, blunt trauma, pulmonary disease, and use of recreational drugs (A)</p> Signup and view all the answers

What is a common symptom associated with a mediastinal crunch?

<p>Severe central chest pain (C)</p> Signup and view all the answers

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

<p>The table does not provide information on percussion findings for mediastinal crunch (D)</p> Signup and view all the answers

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

<p>Bronchophony (C)</p> Signup and view all the answers

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

<p>Left-sided heart failure (D)</p> Signup and view all the answers

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

<p>Dull (B)</p> Signup and view all the answers

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

<p>Tracheobronchial tree obstruction (A)</p> 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?

<p>Right upper lobe atelectasis (A)</p> Signup and view all the answers

What is a common auscultatory finding associated with bronchophony?

<p>Louder and clearer spoken sounds (A)</p> Signup and view all the answers

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

<p>Fine crackles are heard during mid to late inspiration, while coarse crackles are heard throughout inspiration and expiration. (A)</p> Signup and view all the answers

What is the primary cause of fine crackles?

<p>Sudden inspiratory opening of small airways (A)</p> Signup and view all the answers

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

<p>Interstitial lung diseases (B)</p> Signup and view all the answers

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

<p>Fine crackles are higher pitched and have a shorter duration than coarse crackles. (C)</p> Signup and view all the answers

Which of the following is a characteristic of coarse crackles?

<p>They have a popping sound and are heard throughout inspiration and expiration. (D)</p> Signup and view all the answers

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