30 Questions
What does crepitus indicate when palpating the chest?
Presence of subcutaneous air in the chest
Where are painful costochondral joints typically located?
At the mid clavicular line
What may cause pain over a rib or vertebral fracture?
Protracted coughing
What should gentle palpation during assessment of the chest not cause?
Pain
What do palpable vibrations caused by the transmission of air through the bronchopulmonary system refer to?
Tactile fremitus
What is indicated if a small amount of subcutaneous air is found around a chest tube insertion site?
Abnormal condition
What should be the distance between the marks when measuring diaphragm movement?
1 to 2 cm
How can you locate the upper edge of the diaphragm during peak technique measurement?
By asking the patient to exhale
What alters the pitch of breath sounds when auscultating the chest?
Breathing through the nose
What helps determine the condition of the alveoli and surrounding pleura?
Auscultation of breath sounds
What are the four steps involved in a physical examination of the respiratory system?
Inspection, palpation, percussion, auscultation
What should a patient be wearing during a physical examination of the respiratory system?
A gown that allows easy access to the chest
What should be used to listen to a full inspiration and a full expiration at each site during respiratory system assessment?
Stethoscope diaphragm
In what order should the back and front of the chest be examined during a respiratory system assessment?
Back, then front
What changes as air moves from larger airways to smaller airways?
Pitch of breath sounds
Why is it important to compare one side of the chest with the other during a physical examination of the respiratory system?
To check for symmetry and abnormalities
What should be noted about the patient during a respiratory system assessment?
Their level of awareness and general appearance
Why should a well-lit and warm room be ensured before a respiratory system assessment?
To facilitate a comfortable examination environment
What type of sound would you expect to hear when percussing over normal lung tissue?
Resonant sounds
When percussing the chest of a patient with atelectasis before chest physiotherapy, what type of sound would you hear?
High-pitched, dull, soft sounds
What does dullness during percussion indicate?
Decreased air in the lungs
Where would you expect to hear a dull sound when percussing the chest?
Midclavicular line
What is the significance of hearing low-pitched, hollow sounds during percussion?
Increased air in the lungs or pleural space
Where would you hear resonant sounds over normal lung tissue?
Left front chest only
What action should be taken if the patient has abundant chest hair?
Mat down with a damp washcloth
What type of breath sound is tracheal breath sound?
Heard when a patient inhales or exhales
What might cause continuous breath sounds in both lungs?
Atelectasis
Where should the stethoscope be placed to auscultate for breath sounds?
Press firmly against the skin
What does vesicular breath sound indicate?
Prolonged during inhalation and shortened during exhalation
Where should bronchovesicular breath sounds be heard most prominently?
When the patient inhales or exhales
Study Notes
Respiratory System Assessment
- The respiratory system assessment involves four steps: inspection, palpation, percussion, and auscultation.
- Start by inspecting the chest, looking for symmetry, deformities, or signs of respiratory distress.
- Palpate the chest to assess for tenderness, crepitus, and deformities.
- Percuss the chest to detect areas of resonance or dullness, indicating air in the lungs or pleural space.
- Auscultate the chest to listen for breath sounds, noting their intensity, location, pitch, duration, and characteristics.
Percussion
- Percuss the chest to detect areas of resonance or dullness, indicating air in the lungs or pleural space.
- Hyperresonance indicates increased air in the lungs or pleural space.
- Dullness indicates decreased air in the lungs.
- Use percussion sequences to assess the chest, starting from the sixth intercostal space.
Palpation
- Palpate the chest to assess for tenderness, crepitus, and deformities.
- Crepitus indicates subcutaneous air in the chest, an abnormal condition.
- Gentle palpation should not cause pain, and areas of tenderness should be noted.
Auscultation
- Auscultate the chest to listen for breath sounds, noting their intensity, location, pitch, duration, and characteristics.
- There are four types of breath sounds: tracheal, bronchial, bronchovesicular, and vesicular.
- Listen for breath sounds in different areas of the chest, using the diaphragm of the stethoscope.
- Abnormal breath sounds may indicate respiratory disorders, such as emphysema or atelectasis.
Measuring Diaphragm Movement
- Measure diaphragm movement by asking the patient to exhale and then inhale deeply.
- Percuss the back to locate the upper edge of the diaphragm and mark its position.
- Measure the distance between the marks to determine diaphragm movement.
Test your knowledge on assessing the respiratory system and detecting respiratory disorders through systematic evaluation. This quiz covers factors influencing the depth of assessment, patient interaction, and the importance of early detection.
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