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24 Cards in this Set
- Front
- Back
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Lung boundaries
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Superior: 3-4 cm above medial end of clavicle
Inferiorly: rib 6 at midclavic line, rib 8 at midaxillary, T9-12 posteriorly |
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Sternal angle of louis marks 4 spots
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Rib 2
Bifurcation of trachea Carina T4 |
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Oblique fissure
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Separates lower lobes
Rib 6 @ midclavic to rib 5 @ midaxillary, posteriorly to T3 |
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Horizontal fissure
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Separates upper and middle lobes
Sternal border of rib 4 to midaxillary rib 5 |
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Diaphragm location
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At end of expiration:
Rib 5 anteriorly T9 posteriorly |
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Tactile fremitus (decreased vs increased)
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Place hands on chest to feel vibrations
Increased vibrations -> fluid in lung Decreased vibrations -> pleural fluid |
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Percussion sounds in lungs
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Resonant - air, normal lung
Dullness - fluid (normal liver) Hyperresonant - too much air (emphysemic lung) |
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4 normal breath sounds
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Bronchial - loud/high pitched, over sternum
Vesicular - soft/low pitched, over lung Tracheal - harsh/high pitched, over trachea Bronchovesicular - mix of bronchial/vesicular heard over carina and mainstem bronchi |
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Rales/crackles (when, character, cause)
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Inspiratory
Intermittent, non musical Caused by opening of collapsed distal airways and alveoli |
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Wheezes (when, character, cause)
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Expiratory
Continuous high pitched Caused by narrowing bronchi due to swelling/secretion/foreign body/tumor |
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Stridor (when, character, cause)
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Inspiratory
High-pitched Caused by turbulent upper airway flow due to upper airway obstruction |
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Pleural rubs
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Inspiratory and expiratory
Creaking leather Caused by rough/thick pleura |
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Egophany (indicates?)
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E to A change
Indicates consolidation area (fluid-filled) |
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Whispered pectoriloquy
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Amplification of whisper heard through consolidated lung
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Lung consolidation (differential and a few findings)
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Pneumonia or atelectasis
Increased fremitus Dull Increased bronchial sounds Egophony Increased pectoriloquy Rales |
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Pleural effusion (differential and a few findings)
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Fluid b/w lung and chest
Decreased fremitus Dull Absent breath sounds Pleural rub |
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COPD findings (4)
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Prolonged expiration w/ accessory muscle use
Hoover's sign (lower rib cage pulled in on inspiration) Hyperresonant Decreased bronchial sounds |
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Borborygmi
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Low pitched rumbling sounds created by hyperperistalsis
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Rebound tenderness
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Peritoneal sign, indicator of peritoneal irritation
Bump edge of table Ask patient to touch Should elicit pain |
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Rovsing's Sign
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For appendicitis
Push on LLQ and if pain present on RLQ or at McBurney's point -> positive |
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Obturator sign
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For inflammation, appendicitis, peritoneal irritation
Flex leg at hip with knee bent and rotate internally Pain if positive |
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Psoas sign
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Intra-abdominal inflammation, appendicitis, psoas abscess
Lying on unaffected side, passively extend affected side Pain is positive Appendicitis produces positive right psoas test |
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Murphy's sign
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For acute cholecystitis
Palpate liver head on deep inspiration If patient stops inspiration due to pain -> present sign |
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Testicular pain/masses suggest . .
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Testicular torsion
Epididymitis Hydrocele/varicocele |
