Respiratory Examination Techniques

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Questions and Answers

During tactile vocal fremitus assessment, what indicates a normal finding?

  • Vibrations felt equally on both sides (correct)
  • Absence of vibrations
  • Vibrations felt only on one side
  • Vibrations that increase while coughing

What causes the apical pulsations to be shifted to the opposite side during a chest examination?

  • Pleural effusion (correct)
  • Fibrosis
  • Collapse
  • Normal respiration

Which abnormal breath sound indicates the presence of obstructive lung diseases such as COPD?

  • Diminished intensity
  • Vesicular breathing with prolonged expiration (correct)
  • Vesicular breathing
  • Bronchial breathing

What is the main characteristic of bronchial breathing as observed in certain lung conditions?

<p>Equal intensity during inspiration and expiration (D)</p> Signup and view all the answers

What anatomical landmark does Kronig’s Isthmus represent in a chest examination?

<p>Lung apex (D)</p> Signup and view all the answers

What condition is most likely indicated by a chronic cough persisting for more than 8 weeks?

<p>Pulmonary tuberculosis (A), Asthma (B), Chronic bronchitis (C)</p> Signup and view all the answers

Which of the following can result in a foetid odor in sputum production?

<p>Bronchiectasis (D)</p> Signup and view all the answers

Which term refers specifically to the expectoration of blood from the lower respiratory tract?

<p>True hemoptysis (D)</p> Signup and view all the answers

What abnormal chest shape is characterized by a forward protrusion of the sternum?

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

Which condition is associated with a loss of the typical 45° downward angle of the ribs?

<p>Barrel chest (D)</p> Signup and view all the answers

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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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