51 Questions
What is the function of the diaphragm in the respiratory system?
Assisting in respiration by contracting and flattening during inhalation
What does the inability to speak in full sentences before stopping to take a breath suggest?
Increased respiratory drive or impairment of ventilation with reduced vital capacity
What does evidence of increased work of breathing, such as supraclavicular retractions and use of accessory muscles of ventilation, indicate?
Increased airways resistance or stiff lungs and/or chest wall
How should vital signs be assessed to accurately measure respiratory rate?
By carefully observing the rate of rise of the chest wall
What is the purpose of assessing bruising, sinus tracts, and skin changes in a respiratory examination?
To identify potential underlying respiratory conditions
Which breath sounds are important to listen for with a stethoscope during a respiratory examination?
Vesicular, bronchial, and bronchovesicular
What may abnormally located bronchovesicular or bronchial breath sounds indicate during a respiratory examination?
Pneumonia or pleural effusion
What do crackles indicate during a respiratory examination?
Abnormalities in lung parenchyma or airways
What do wheezes and stridor indicate during a respiratory examination?
Narrowed airways in conditions like asthma and COPD
What do rhonchi denote during a respiratory examination?
Sounds from secretions in large airways
Why is the absence of wheezes and breath sounds in severe asthma considered a clinical emergency?
It indicates severe airway obstruction and impending respiratory failure
What does tactile fremitus assess during a respiratory examination?
Palpable vibrations transmitted through the bronchopulmonary tree
What does forced expiratory time assess during a respiratory examination?
The expiratory phase of breathing, vital in obstructive pulmonary disease
Why may elderly individuals have decreased thorax mobility during a respiratory examination?
Due to age-related changes in musculoskeletal structure
What distinct symptoms and presentations do various upper and lower respiratory conditions, such as bronchitis, pneumonia, and tuberculosis, have?
Distinct symptoms and presentations
Which diagnostic measure is used to diagnose obstructive sleep apnea (OSA)?
Polysomnography
What is the leading risk factor for lung cancer?
Cigarette smoking
Which condition is characterized by a barrel chest and increased anteroposterior diameter?
Chronic Obstructive Pulmonary Disease (COPD)
What can help identify individuals at risk for obstructive sleep apnea (OSA)?
STOP-Bang questionnaire
What is the recommended screening method for current or recent heavy smokers for lung cancer?
Annual low-dose computed tomography (LDCT) screening
What is the characteristic sputum presentation associated with cystic fibrosis?
Translucent, white, or gray mucoid sputum
Where is needle insertion recommended for decompression of tension pneumothorax?
2nd intercostal space
What does asymmetric decreased fremitus raise the likelihood of?
Unilateral pleural effusion
What is a key symptom in assessing cardiac and pulmonary diseases?
Dyspnea
What is characteristic of Acute Respiratory Distress Syndrome (ARDS)?
Signs of respiratory distress and tachypnea
In which conditions can clubbing of the nails occur?
Bronchiectasis, congenital heart disease, pulmonary fibrosis, cystic fibrosis, lung abscess, and malignancy
What is the second leading cause of lung cancer in the US?
Radon exposure
What is the normal adult respiratory rate per minute?
14-20
During a chest examination, what should percussion focus on identifying?
Dullness and hyperresonance
What is the purpose of palpation of the anterior chest wall during a physical examination?
Identify any tender areas
What should auscultation during a chest examination be direct to, to avoid altering characteristics of breath sounds?
Skin
What is the purpose of examining the abdomen during a clinical examination of patients with exertional dyspnea?
Identify paradoxical movement of the abdomen
What should general examination look for in patients with exertional dyspnea?
Signs of hypoxemia, anemia, and extrapulmonary manifestations of lung disease
What is the purpose of cardiac examination during a clinical examination of patients with exertional dyspnea?
Identify signs of elevated right-sided heart pressures, left ventricular dysfunction, and valvular disease
What does inspection during a physical exam of patients with exertional dyspnea focus on?
Visualizing underlying lobes, chest shape, chest movement, deformities, and chest expansion
What are the physical exam techniques that include client positioning, equipment, and order of examination?
Client positioning, equipment (stethoscope, pulse oximetry, peak flow assessment), and order of examination
What is the normal respiratory rate for infants per minute?
Up to 44
What should chest examination focus on during a clinical examination of patients with exertional dyspnea?
Symmetry of movement, percussion, and auscultation for clues to airway or lung parenchyma disorders
What should normal adult respiratory rate be per minute?
14-20
What is a characteristic of wheezes in the context of lower airway obstruction?
They are musical respiratory sounds
What is a possible cause of acute cough according to the text?
Gastroesophageal reflux disease
What is a potential cause of chronic cough mentioned in the text?
Postnasal drip
Where does pain from conditions like pneumonia and pulmonary infarction usually come from?
Parietal pleura
What is a correct statement about chest pain and pain fibers?
Lung tissue has no pain fibers
What may cause chest pain in the context of COPD?
Recurrent coughing
What is a key distinguishing feature of hemoptysis according to the text?
It should be confirmed to originate from the respiratory tract
What is a correct statement about dyspnea and spirometry in COPD?
Spirometry is crucial in COPD classification
What is a potential cause of shortness of breath severity in COPD?
Patient's daily activities
What may anxious patients with COPD present with?
Hyperventilation and tachypnea
What is a correct statement about chest pain and its causes?
Seven attributes of chest pain help distinguish its various causes
What is a correct statement about lung tissue and pain fibers?
Lung tissue has no pain fibers
Study Notes
Respiratory Conditions and Diagnostic Measures
- Risk of latent tuberculosis is higher for individuals born or previously residing in high tuberculosis prevalence countries.
- Chronic Obstructive Pulmonary Disease (COPD) is characterized by a barrel chest and increased anteroposterior diameter.
- Obstructive sleep apnea (OSA) is diagnosed through polysomnography and can be treated with positive airway pressure.
- The STOP-Bang questionnaire can help identify individuals at risk for OSA.
- Cystic fibrosis is associated with translucent, white, or gray mucoid sputum and foul-smelling sputum in anaerobic lung abscess.
- Cigarette smoking is the leading risk factor for lung cancer, with radon being the second leading cause in the US.
- Annual low-dose computed tomography (LDCT) screening is recommended for current or recent heavy smokers.
- Needle insertion for decompression of tension pneumothorax is recommended at the 2nd intercostal space.
- Asymmetric decreased fremitus raises the likelihood of unilateral pleural effusion, pneumothorax, or neoplasm.
- Acute Respiratory Distress Syndrome (ARDS) is characterized by signs of respiratory distress and tachypnea.
- Clubbing of the nails occurs in bronchiectasis, congenital heart disease, pulmonary fibrosis, cystic fibrosis, lung abscess, and malignancy.
- Dyspnea is a key symptom in assessing cardiac and pulmonary diseases.
Clinical Examination of Patients with Exertional Dyspnea
- Patients with exertional dyspnea should be observed walking to reproduce symptoms and monitor oximetry for desaturation.
- General examination should look for signs of hypoxemia, anemia, and extrapulmonary manifestations of lung disease.
- Chest examination should focus on symmetry of movement, percussion, and auscultation for clues to airway or lung parenchyma disorders.
- Cardiac examination is necessary to identify signs of elevated right-sided heart pressures, left ventricular dysfunction, and valvular disease.
- Examination of the abdomen is important to identify paradoxical movement of the abdomen, a sign of diaphragmatic weakness.
- Normal adult respiratory rate is 14-20 times per minute, up to 44 in infants.
- Physical exam techniques include client positioning, equipment (stethoscope, pulse oximetry, peak flow assessment), and order of examination.
- Inspection should focus on visualizing underlying lobes, chest shape, chest movement, deformities, and chest expansion.
- Auscultation should be direct to skin to avoid altering characteristics of breath sounds; bronchophony and percussion notes should be carefully observed.
- Percussion should focus on identifying dullness and hyperresonance, which may indicate airway obstruction or hyperinflated lungs.
- Palpation of the anterior chest wall should identify any tender areas, which may suggest localized musculoskeletal chest pain.
- Detailed examination techniques are provided for inspection, auscultation, percussion, and palpation, including examples of normal and pathologic findings.
Understanding Symptoms in Chronic Obstructive Pulmonary Disease (COPD)
- Dyspnea and spirometry are crucial in COPD classification and patient management
- Shortness of breath severity is determined by patient's daily activities
- Anxious patients may present with difficulty taking deep breaths and hyperventilation
- Wheezes are musical respiratory sounds in lower airway obstruction
- Acute cough can be caused by viral infections, bronchitis, pneumonia, heart failure, asthma, and smoking
- Chronic cough can be linked to postnasal drip, asthma, reflux, bronchitis, and bronchiectasis
- Hemoptysis should be confirmed to originate from the respiratory tract
- Chest pain can arise from various thoracic and cardiac causes
- Seven attributes of chest pain help distinguish among its various causes
- Lung tissue has no pain fibers, and pericardium has few pain fibers
- Pain from conditions like pneumonia and pulmonary infarction usually comes from inflammation of the adjacent parietal pleura
- Muscle strain from recurrent coughing or costochondral inflammation may also cause chest pain
Test your knowledge of respiratory conditions, diagnostic measures, clinical examination techniques for exertional dyspnea, and symptoms specific to Chronic Obstructive Pulmonary Disease (COPD) with this informative quiz. Brush up on key facts and enhance your understanding of respiratory health.
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