Questions and Answers
During tactile vocal fremitus assessment, what indicates a normal finding?
What causes the apical pulsations to be shifted to the opposite side during a chest examination?
Which abnormal breath sound indicates the presence of obstructive lung diseases such as COPD?
What is the main characteristic of bronchial breathing as observed in certain lung conditions?
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What anatomical landmark does Kronig’s Isthmus represent in a chest examination?
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What condition is most likely indicated by a chronic cough persisting for more than 8 weeks?
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Which of the following can result in a foetid odor in sputum production?
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Which term refers specifically to the expectoration of blood from the lower respiratory tract?
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What abnormal chest shape is characterized by a forward protrusion of the sternum?
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Which condition is associated with a loss of the typical 45° downward angle of the ribs?
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Study Notes
Cough and Sputum Production
- Chronic cough lasts over 8 weeks; potential causes include asthma, chronic bronchitis, pulmonary tuberculosis, bronchiectasis, or lung cancer.
- Foetid sputum indicates anaerobic infection; associated with suppurative lung infections such as bronchiectasis and empyema, or lung abscesses.
Hemoptysis
- True hemoptysis refers to blood expectorated from the lower respiratory tract, originating below the vocal cords.
- Pseudo-hemoptysis involves blood from the upper respiratory tract or gastrointestinal tract, often mimicking hemoptysis.
Local Examination Techniques
Inspection
- Evaluates chest shape to assess rib and spine structure; variations can be congenital (e.g., pectus excavatum, pectus carinatum) or acquired (e.g., kyphoscoliosis).
- Barrel chest develops from longstanding obstructive disease, changing the ribs’ angle and chest diameter.
Palpation
- Conducted by examining the chest while the patient is positioned comfortably.
- Pulsations can shift due to:
- Pushing factors: pleural effusion, pneumothorax, space-occupying lesions.
- Pulling factors: collapse, fibrosis.
- Tactile vocal fremitus (TVF) involves assessing vocal vibrations transmitted to the chest wall; should be symmetrical.
Chest Percussion and Resonance Areas
- Traube’s area signifies the fundus of the stomach; defined by specific rib landmarks.
- Kronig’s Isthmus represents lung apex resonance, outlined by defined anatomical points.
Auscultation of Breath Sounds
- Normal breath sounds: vesicular, characterized by longer inspiratory phase, shorter expiratory phase, and equal intensity on both sides.
- Abnormal breath sounds:
- Diminished intensity may result from airway obstruction, lung fibrosis, pleural effusion, pneumothorax, or chest wall obesity.
- Vesicular with prolonged expiration indicates obstructive lung diseases (e.g., COPD, asthma).
- Bronchial breathing is hollow-sounding; inspiratory and expiratory phases are equal, pauses heard in pneumonia.
- Bronchovesicular tones indicate various pathological conditions.
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Description
This quiz covers important aspects of respiratory health, including chronic cough causes, hemoptysis differentiation, and local examination techniques such as inspection and palpation. Test your knowledge on how to evaluate respiratory conditions and recognize related symptoms and abnormalities.
