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300 Cards in this Set
- Front
- Back
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True or false - Women should be screened for intimate partner violence at every health center encounter.
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True
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True or false - Women are more often abused and killed by an intimate partner than anyone else.
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True
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Four basic skills for physical examination.
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Inspection, palpation, percussion, auscultation
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The first skill utilized in a physical exam.
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Inspection
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Nosocomial infections
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Infections acquired during hospitalization
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Normal oral temperature
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37 degrees C or 98.6 degrees F
(range of 35.8 to 37.3 degrees C, or 96.4 to 99.1 degrees F) |
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Normal stroke volume of adult
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70 mL
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Methods of assessing a pulse (normal)
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Rate (adult - 60 - 100 bpm), rhythm (even tempo), force (on scale of 0 - 3+, a 2+ or normal)
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Normal respiration rate (adult)
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10 - 20 respirations per minute
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Normal respiration rate (neonate)
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30 - 40 respirations per minute (much faster than adult)
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Normal ratio of respirations to pulse (adult)
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1:4
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Korotkoff sounds to indicate systolic and diastolic
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1st sound = systolic; 5th sound (last sound before silence) = diastolic
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Normal Pulse Oximetry reading (adult)
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97 - 98% SpO2
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Acromegaly
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Excessive growth hormone, causing overgrowth of bone in face, head, hands, feet but no change in height
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Prehypertension
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120 - 139/80 - 89
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Stage 1 hypertension
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140 - 159/90 - 99
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Nociceptive pain
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Pain deriving from actual or potential tissue damage, starting outside of the nervous system and relaying pain through transduction, transmission, perception, and modulation
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Neuropathic pain
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Pain that does not adhere to typical and predictable phases of nociceptive pain, implying an abnormal processing of the pain from injury to nerve fibers
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Visceral pain
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Pain from larger interior organs
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Deep somatic pain
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Pain from blood vessels, joints, tendons, muscles, and bone
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Cutaneous pain
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Pain from skin surface and/or subcutaenous tissues
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Referred pain
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Pain felt at a particular site but originating from another location
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Acute pain
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Short-term self-limiting pain, as in after an injury or surgery
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Persistent (chronic) pain
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Pain that lasts 6 months or longer, either malignant or nonmalignant
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Breakthrough pain
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Pain that starts again or escalates before next scheduled analgesic dose
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CRIES scale
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Used to assess pain in preterm and neonates
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PAINAD scale
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Used to assess pain in patients with dementia
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Four main headings of mental status assessment
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ABCT
Appearance, Behavior, Cognition, Thought processes |
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Mini-Cog test
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Used to screen cognitive impairment in otherwise healthy older adults
1. 3 item recall test 2. Clock-drawing test |
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Aphasia
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Language disorder secondary to brain damage; patient has true language disturbance, with defect in word choice and grammar or defect in comprehension
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Dysarthria
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Dysfunction in language articulation; patient emits distorted speech sounds; speech may be unintelligible but basic language intact
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Lability
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Rapid shift of emotions - patient expresses various emotions in rapid succession
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Subjective data
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What the patient says about him or herself
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Objective data
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What the nurse observes or the tests indicate
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Traps of interviewing (ten)
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1. False reassurance
2. Giving unwanted advice 3. Using authority 4. Using avoidance language 5. Engaging in distancing 6. Use of jargon 7. Leading/biased questions 8. Talking too much 9. Interrupting 10. Using "why" questions |
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Reflection (in interviewing)
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Echoing the patient's words
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Three major ways of viewing disease causation
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1. Biomedical (cause and effect, body working mechanically)
2. Naturalistic (forces of nature that must be kept in balance, as in yin/yang or hot/cold theories) 3. Magicoreligious (supernatural forces dominate) |
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Symptom
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Subjective sensation that patient feels from a disorder
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Sign
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Objective abnormality that examiner could detect during physical exam or through labs
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PQRSTU
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P: Provocative or Palliative
Q: Quantity or Quality R: Region or Radiation S: Severity (scale from 1 - 10) T: Timing U: Patient Understanding or Perception |
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Four types of clinical databases
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Complete, focused or problem-centered, follow-up, emergency
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Complete (total health) database
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Complete health history and full physical exam
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Focused or problem-centered database
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For limited or short-term problems, concerning mainly one problem or body system.
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Follow-up database
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Used to follow-up short term or chronic health problems; evaluates already established problems at regular intervals
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Emergency database
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Rapid collection of data, often concurrent with life-saving measures
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True or false - a full mental status exam is performed during every health assessment.
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False - only when you discover any abnormality in affect or behavior, or when certain abnormalities are suggested; otherwise, ABCT technique is adequate
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AUDIT questionnaire
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Used to assess alcohol use disorders
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The number of drinks per week or occasion that indicates "at-risk drinking"
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Men: > 13 drinks per week or > 3 drinks per occasion
Women: > 7 drinks per week or > 2 drinks per occasion |
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Most commonly used biochemical marker of alcohol drinking
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GGT (gamma glutamyl transferase)
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Dependence (substance)
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Physiologic dependence on substance
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Tolerance (substance)
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Requiring increased amount of substance to produce same effect
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Withdrawal (substance)
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Cessation of substance use produces a syndrome of physiologic symptoms
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Addiction (substance)
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Psychological need or compulsion for a substance (much rarer than dependence, which is physiological need)
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FACES or Oucher scales
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Scales to rank pain based on visualizations of pain; may be introduced at 4 to 5 years
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Marasmus
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Protein-calorie malnutrition; patient has extreme starved appearance (weight less than 80% standard for height)
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Kwashiorkor
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Protein malnutrition; patient may appear normal or even obese due to edematous tissues
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Pellagra
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Pigmented keratotic scaling lesions due to niacin deficiency
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Pruritis
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Itchy skin, occuring with dry skin, aging, drug reactions, allergies, etc.
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Seborrhea
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Oily skin
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Xerosis
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Dry skin
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Striae Gravidarum
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Stretch marks
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Keloids
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Scars that form at site of wound and grow beyond normal boundaries of the wound
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Alopecia
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Significant hair loss
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Hirsutism
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Shaggy or excessive hair
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ABCDE (skin)
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Mnemonic device to assess abnormal characteristics of pigmented lesions:
1. Asymmetry 2. Border irregularities 3. Color variation 4. Diameter (greater than 6 mm) 5. Elevation or Enlargement |
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Pallor
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Whitening of skin, as in high stress situations
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Erythema
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Reddening of skin, as in fever or inflammation
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Cyanosis
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Bluish skin due to decreased perfusion
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Jaundice
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Yellowing of skin, as in hepatitis
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Hypothermia
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Generalized coolness, as with shock; also localized coolness, as in Raynaud's Syndrome
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Hyperthermia
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Generalized or localized excessive heat or warmth, as with fever.
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Diaphoresis
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Profuse perspiration, as with anxiety
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Dehydration (signs from inspection)
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Mucuous membranes appear dry, lips look parched and cracked, skin may appear fissured or cracked
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Pitting scale
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Method of rating edema:
1+ Mild pitting 2+ Moderate pitting 3+ Deep pitting 4+ Very deep pitting |
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Anascaria
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Generalized edema, as in heart failure or kidney failure
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Turgor
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Ability of skin to return to place promptly after being pinched and released; normally tested under clavicle on anterior chest
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Scleroderma
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Chronic connective tissue disorder, characterized by hard skin and decreased mobility
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Cherry angiomas
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Small red dots that appear on trunks of all older adults; not pathologic
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Primary lesion
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Lesion that develops on previously unaltered skin
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Secondary lesion
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Lesion that results when primary lesion changes over time or changes because of a factor such as itching or infection.
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Normal profile of nails
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160 degrees
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Profile of clubbed nails
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180 degrees or more
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Capillary refill (normal)
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Capillary refill (depressing nails to blanch and releasing, noting return of color) should occur in less than 3 seconds. Cyanotic nail beds are suggested when capillary refill takes too long.
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True or false - adults should examine their skin every day.
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False - once a month is usually adequate.
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Mongolian spot
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Black to purple macular area at sacrum or buttocks of darker skinned newborns.
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Erythema toxicum
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Common rash on infants during first 3 to 4 days; called the flea bite rash; not pathologic
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Acrocyanosis
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Bluish color around lips, hands, fingernails, feet and toenails of newborns; usually not pathologic
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Carotenemia
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Yellow-orange coloring of skin in light-skinned individuals, due to ingesting large amounts of foods containing carotene (vitamin A precursor)
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Storkbite (salmon patch)
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Common irregular red or pink patch on forehead of infants; usually fades during first year and not pathologic
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Senile lentigines
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Liver spots (aging adults); not malignant
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Seborrheic keratosis
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Dark, greasy "stuck-on" lesions (aging adults); not malignant
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Acrochordons
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"Skin tags" - overgrowths of normal skin that form a stalk and are polyp-like. Not malignant
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Confluent lesions
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Lesions that run together
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Zosteriform lesions
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Lesions that are arranged linearly along unilateral nerve
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Macules
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Lesion that is the result solely of color change; flat and circumscribed, less than 1 cm (ex. freckles, flat moles, measles, petechiae, etc).
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Papules
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Lesion that is the result of increased elevation; solid, elevated, circumscribed, less than 1 cm (ex. elevated moles, warts, etc)
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Nodules
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Lesions that are solid, hard or soft, larger than 1 cm
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Mosquito bites and allergic reactions result in what kind of lesions?
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Wheals (superficial, raised, erythematous, irregular)
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Vesicle
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Elevated lesion containing free fluid, up to 1 cm (ex. a blister)
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Cyst
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Lesion of encapsulated fluid in dermis or subcutaneous layer (ex. sebaceous cyst)
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Pustule
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Lesion containing turbid fluid (pus) in cavity, as in acne
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Crust (lesion)
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Dried out exudate left when vesicles/pustules burst or dry up
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Fissure (skin)
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Cracked skin, as in cheilosis (cracks at corners of mouth)
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Stage 1 Pressure Ulcer
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Skin is red but intact; localized redness in light skin will blanch (dark skin appears darker and does not blanch)
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Stage 2 Pressure Ulcer
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Partial thickness skin erosion with loss of epidermis or dermis; open wound but not deep with red-pink wound bed
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Stage 3 Pressure Ulcer
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Full-thickness wound extending into subcutaneous tissue and resembling crater; may see fat but no muscle, bone, or tendon
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Stage 4 Pressure Ulcer
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Full-thickness wound involving all skin layers and extending into supporting tissue; visible muscle, bone, tendons, possible slough and eschar
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Hematoma
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Bruise you can feel (skin is elevated and seen as swelling)
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Contusion
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Bruise -- caused by mechanical injury, resulting in hemorrhage of tissues but skin is intact
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True or false - it is possible to date a bruise or contusion by using its color.
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False
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Petechiae
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Tiny hemorrhages, 1 to 3 mm, round and discrete, red or purple, caused by bleeding of superficial capillaries
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Lymphatics of the Head, Face, and Neck
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Preauricular, postauricular, occipital, submental, submandibular, jugulodigastric, superficial cervical, deep cervical, posterior cervical, supraclavicular
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Dysphagia
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Difficulty swallowing
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Vertigo
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Feeling of true rotational spinning from neurological disease
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Normocephalic
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Term that denotes round symmetrical skull that is appropriately related to body size
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Lymphadenopathy
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Enlargement of lymph nodes (>1 cm) from infection, allergy, or neoplasm
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Tracheal shift with pneumothorax
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Shift to unaffected side
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Tracheal shift with atelectasis
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Shift to affected side
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If a thyroid is enlarged, it should be auscultated for __
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Bruits
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Bruits indicate __
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Turbulent blood flow
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A face that appears immobile and expressionless, with elevated eyebrows, staring gaze, and drooling may indicate ___
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Parkinson's Syndrome
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The classic appearance of Cushing's Syndrome, which occurs with chronic steroid usage, is ___
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Moon-face
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Bell's Palsy
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Complete paralysis of one side of the face; patient cannot wrinkle forehead, raise eyebrows, close eye, whistle, or show teeth on affected side
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Stroke or Cerebrovascular Accident
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Paralysis of lower facial muscles (upper part of face is unaffected, so patient is able to wrinkle forehead and close eyes)
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Palpebral fissures
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Elliptical open space between eyelids (usually horizontal)
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Pupillary light reflex
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Normal constriction of pupils when bright light shines on the retina
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Direct light reflex
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Constriction of pupil that is directly exposed to light
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Consensual light reflex
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Simultaneous constriction of non-exposed pupil when other pupil is exposed to light
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Presbyopia
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Loss of vision due to aging, normally the loss of near vision
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Scotoma
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Blind spot, occuring with glaucoma or optic nerve disorders
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Photophobia
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Inability to tolerate light
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Strabismus
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Deviation of the axis of the eye
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Diplopia
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Perception of two images of same object (double-vision)
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Lacrimation
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Tearing
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Snellen chart
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Tests visual acuity (CN II) - 20/20 is normal (first number is the number of feet patient is from chart; second number is the distance an average person would have to stand to see the same line the patient sees)
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Jaeger card
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Used to test near vision for patients older than 40 or report problems with reading
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Confrontation test
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Gross measure of peripheral vision (CN II)
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Corneal light reflex
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Assess parallel alignment of eyes by shining a light at eyes about 30 cm away, noting reflection of light on corneas (should appear at same spot on both eyes)
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Cover/Uncover test
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Detects small degrees of deviated alignment of eyes by interrupting fusion reflex that keeps the eyes parallel; patient asked to cover eyes while fixed on a far-away object, assessing for any jumps in eye fixation
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Nystagmus
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Fine oscillating movement of eyes, best seen around iris
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Cardinal gazes
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6 main positions used to assess eye movement
All diagonal directions and straight up = CN III Straight down and together = CN IV Lateral Left or Right = CN VI |
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Ptosis
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Drooping of lower lid
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Anisocoria
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Having pupils of different sizes
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Normal pupil accommodation
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Far vision - pupils dilate
Near vision - pupils constrict |
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PERRLA
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Method of assessing pupils
Pupils, Equal, Round, Reactive to Light, Accommodation |
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Color and appearance of optic disc
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Creamy yellow-orange to pink, round or oval, distinct, on nasal side of ocular fundus
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Myopia
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Near-sightedness (cannot see far)
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Hyperopia
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Far-sightedness (cannot see near)
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Location and Size of the Macula (eye)
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1 DD in size; 2 DD away from optic disc
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Pseudostrabismus
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Not true strabismus, seen in infants and caused by epicanthal fold over inner corner of the eye, giving the appearance of crossed-eyes.
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Esotropia
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Inward turning of eyes
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Exotropia
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Outward turning of eyes
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Exophthalmos
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Protruding eyes
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Ectropion
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Lower eye lid is loose and rolling out, occuring in aging as result of atrophy of elastic tissues
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Miosis
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Fixed constricted pupils
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Mydriasis
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Fixed dilated pupils
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Conjunctivitis
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Pink eye - red beefy vessels at periphery but clearer around iris, from infection
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Subconjunctival hemmorhage
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Red patch on sclera due to increased intraocular pressure
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Iritis
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Deep dull red halo around iris and cornea; emergency
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Normal pathway of hearing
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Air conduction
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Conductive hearing loss
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Caused by mechanical dysfunction of external/middle ear, as in cerumen buildup, foreign bodies, etc.
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Sensorineural hearing loss
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Caused by pathology of inner ear, CN VIII, or auditory areas of cerebral cortex
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Otitis media
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Middle ear infection, common in children
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Otalgia
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Ear ache
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Otorrhea
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Discharge from the ears
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Presbycusis
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Hearing loss due to aging
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Tinnitus
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Ringing, crackling, or buzzing in the ear
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Objective vertigo
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Person feels like the room is spinning
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Subjective vertigo
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Person feels like he or she is spinning
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Darwin's Tubercle
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Small painless nodule at the helix of the ear
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Pull the pinna __ for adults and __ for children under 3 years of age.
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Up and back; down
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"Normal" appearance of ear drum; normal appearance of cone-shaped light reflex
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Shiny, translucent, pearl gray color; 5 O'clock in right drum - 7 O'clock in left drum
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Whisper test
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Tests hearing ability (CN VIII); placing one finger on tragus and rapidly pushing it in and out, while whispering in opposite ear (mouth covered, asking patient to repeat whispered word or phrase
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If one ear is infected, always examine the __ ear first.
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Unaffected
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How should the pinna be aligned (normal)?
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Top of pinna should be aligned with the imaginary line that extends from corner of the eye to the occiput and should be within 10 degrees of vertical
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The most common location of sebaceous cysts on the ear
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Behind lobule, in the postauricular fold
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Furuncle
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Extremely painful reddened infected hair follicle, often on tragus on the cartilaginous part of ear canal
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Early sign of acute otitis media
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Absence of light reflex when examining ear drum
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Dense white patches on the ear drum indicate __
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Repeated ear infections but do not necessarily affect hearing
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The two pairs of sinuses that can be palpated and examined.
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Frontal and maxillary
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Epistaxis
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Nosebleed
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Xerostomia
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Dry mouth
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Appearance of deviated septum
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Hump or shelf in one nasal cavity
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Stensen's Duct
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Opening of parotid salivary gland, appearing as a small dimple opposite upper second molar (buccal mucosa)
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Leukodema
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Benign milky bluish white, opaque area on tongue, more common in dark skinned individuals
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Torus palatinus
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Nodular bony ridge down middle of hard palate, more common in American indians, Inuits, and Asians
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Fordyce granules
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Small isolated white or yellow papules on mucosa of cheek, tongue, and lips - not pathologic
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How to rate tonsils?
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0 No tonsils
1+ Visible tonsils 2+ Halfway between tonsillar pillars and uvula 3+ Touching the uvula 4+ Touching each other |
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Epstein pearls
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Small whitish papules along hard palate and gums of newborns; look like teeth; not pathologic and disappear after few weeks
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Rhinorrhea
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Clear watery discharge
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Sinusitis
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Facial pain after upper respiratory infection, with red swollen mucosa, swollen turbinates, and purulent discharge
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Color of turbinates during allergic rhinitis
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Usually pale
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Color of turbinates during acute rhinites
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Dark red
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Gingival hyperplasia
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Painless enlargement of gums, occuring with puberty, pregnancy, and leukemia
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Leukoplakia
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Chalky white thick raised patch on tongue that does not scrape off
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Candidiasis
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White cheesy curdlike patch on buccal mucosa and tongue that can be scraped off, often resulting in bleeding; aka "thrush"
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When examining the toddler, how long should the parent be present?
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The entire duration of the exam; the toddler should always be on the parent's lap
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How old should a child be before asking if parental accompaniment is desired during a physical exam?
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At least 11 or 12. Before this age, the parent should be present
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The __ nervous system includes the brain and spinal cord.
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Central
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The __ nervous system includes all the nerve fibers outside the brain and spinal cord.
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Peripheral
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What are the four types of reflexes?
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1. Deep tendon
2. Superficial (ex. corneal, abdominal reflex) 3. Visceral (ex. pupillary accommodation) 4. Pathologic (ex. Babinski) |
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Cranial Nerve 1 (type and function)
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Olfactory - Sensory; smell
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Cranial Nerve 2 (type and function)
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Optic - Sensory; vision
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Cranial Nerve 3, 4, and 6 (type and function)
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Oculomotor - 3 = Mixed; most EOM movement; pupil constriction and lens shape
Trochlear and Abducens, 4 and 6 = motor; movement of eye (4 = down and together; 6 = lateral) |
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Cranial Nerve 5 (type and function)
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Trigeminal - mixed; muscles of mastication (jaw), etc.
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Cranial Nerve 7 (type and function)
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Facial - Mixed; facial muscles, etc.
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Cranial Nerve 8 (type and function)
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Acoustic - Sensory; hearing and equilibrium
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Cranial Nerve 9 and 10 (type and function)
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Glossopharyngeal and Vagus - Mixed - swallowing; taste; gag reflex, etc.
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Cranial Nerve 11 (type and function)
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Spinal Accessory - Motor; movement of trapezius and sternomastoid muscles
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Cranial Nerve 12 (type and function)
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Hypoglossal - Motor; movement of tongue
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Syncope
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Sudden loss of strength, and temporary loss of consciousness
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Paresis
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Partial or incomplete paralysis
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Paresthesia
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Abnormal sensation of tingling or burning
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CN 1 - test
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Test familiar scent from each side of nose
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CN 2 - test
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Snellen test; confrontation (peripheral vision) test
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CN 3,4,6 test
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6 Cardinal Gazes
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CN 5 test
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Palpate temporal and masseter muscles as person clenches teeth; try to separate jaws as patient clenches teeth
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CN 7 test
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Facial nerve test - ask patient to smile, puff cheeks, frown, lift eyebrows
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CN 8 test
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Whispered voice test
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CN 9 and 10 test
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With tongue blade, press down on tongue; patient says "ahh" - uvula and soft palate should rise midline
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CN 11 test
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Patient attempt to turn head against resistance; patient attempts to raise shoulders against resistance
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CN 12 test
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Patient extends tongue and moves it side to side; patient says "light, tight, dynamite."
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How is a patient's balance assessed?
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Observe patient's gait as she/he walks 10 - 20 feet back and forth; tandem walk; Romberg test
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Kinesthesia
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Patient's ability to perceive passive movements of extremities
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Hyperalgesia
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Increased pain sensation
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Hypoalgesia
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Decreased pain sensation
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Analgesia
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Absent pain sensation
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Hypoesthesia
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Decreased touch sensation
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Anesthesia
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Absent touch sensation
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Hyperesthesia
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Increased touch sensation
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Graphesthesia
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Ability to "read" a number by tracing it on the skin
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Stereognosis
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Tests patient's ability to recognize objects by feeling them
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Two-Point Discrimination
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Patient's ability to distinguish the separation of two simultaneous pin points on the skin
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How is the reflex response graded?
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0 - 4+
2+ = normal 0 = no response 4+ = hyperactive response (pathologic) |
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Clonus
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Set of rapid rhythmic contractions of same muscle
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Three main upper extremity reflexes
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Biceps, triceps, brachioradialis
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Two main lower extremity reflexes
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Quadricep (knee jerk) and achilles
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Babinski Reflex
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Fanning of toes of infant; present at birth and disappears after 24 months of age (variable)
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Plantar Grasp
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Downward curling of infant toes when touching ball of foot, disappears at 8 to 10
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Areas of Glasgow Coma Scale
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Eye opening response, motor response, verbal response
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Tic
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Involuntary compulsive repetitive twitching of a muscle group
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Ataxia
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Lack of voluntary coordination of muscle movements
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Meningitis (definition and symptoms)
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Meningitis is an inflammation of the membranes (meninges) surrounding your brain and spinal cord, usually due to the spread of an infection. The swelling associated with meningitis often triggers the "hallmark" signs and symptoms of this condition, including headache, fever and a stiff neck in anyone over the age of 2
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Headache characterized by severe throbbing, often one-sided and behind the eyes; about 2 per month, lasting 1 - 3 days, with aura; relieved by dark room, sleep, laying down, NSAIDs, or narcotics
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Migraine
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Headache characterized by bandlike tightness, with gradual onset, associated with stress; relieved by rest, massaging muscles in area, and NSAIDs
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Tension
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Headache characterized by burning, piercing, excrutiating pain, always one-sided and always on same side, with abrupt onset, associated with nasal congestion; relieved by pacing the floor
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Cluster
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This is the superior lateral corner of the breast, which projects into the axilla
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Tail of Spence
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The site of most breast tumors
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Upper outer quadrant
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What are the four groups of axillary nodes?
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1. Central axillary
2. Pectoral 3. Subscapular 4. Lateral |
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Supernumerary nipple
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An extra nipple visible along the mammary ridge
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Menarche
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Beginning of menstruation (around 12 years of age)
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What is the appearance of the breast during the second stage of sexual maturity of girls (Tanner staging)?
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Breast bud stage (8 - 13 years old)
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Colostrum
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Thick yellow fluid - precursor for breast milk - made after fourth month of pregnancy
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Gynecomastia
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Development of breast tissue in males
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Mastalgia
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Pain or tenderness in the breasts
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Galactorrhea
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Clear nipple discharge, sometimes due to medications
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How often should women have clinical breast exams?
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Every 3 years for women between 20 - 39; every year with annual mammogram after age 39
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True or false - breasts should always appear symmetrical and of the same size.
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True and False - it is common for the left breast to be slightly larger than the right with some slight asymmetry, but they should look fairly symmetrical
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Retraction signs of the breasts when arms are lifted may indicate __
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Fibrosis of breast tissue, usually caused by growing neoplasms
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True or false - nipple discharge is always normal
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False - except in pregnancy and lactation, discharge is abnormal
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This is a firm transverse ridge of compressed tissue in the lower quadrants of the breast (non pathologic)
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Inframammary ridge
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What should be noted about any lumps found in the breast tissue?
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Location, size, shape, consistency, movable, distinctness, nipple, skin over lump, tenderness, lymphadenopathy
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When is the best time to perform a breast self exam?
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Right after menstrual period, or 4th through 7th day of the menstrual cycle, when breasts are smallest and least congested
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When teaching about breast self-exams, female clients should be told to look for lumps - true or false.
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False - women should be taught to note the absence of lumps (not the presence of the them).
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Premature thelarche
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Early breast development with no other hormone dependent signs
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When does adolescent breast tissue begin to develop?
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8 - 10 years
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True or false - the great majority of breast lumps are benign and most women will never get breast cancer.
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True
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Nipple retraction
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Nipple appears flatter and broader, like a crater; recent retraction suggests cancer, which causes fibrosis
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Peau d'Orange
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Edema in breast; lymphatic obstruction causes the edema, thickening the skin and exaggerating hair follicles, giving the skin an orange peel appearance; suggests cancer
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Fixation (breast tissue)
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Asymmetry or distortion with elevated arm movement, suggestive of cancer; fibrosis fixes tissue to underlying pectoral muscles
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What are the different breast palpation techniques?
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Vertical strip pattern; spokes on a wheel pattern; concentric circles pattern
Use pads of first three fingers, in gentle rotary motion |
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The left lung has __ lobes and the right lung has __ lobes
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2; 3
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The normal stimulus to breathe
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Hypercapnia (increase of CO2 in blood)
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Hypoxemia
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Decrease of oxygen in the blood
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Surfactant
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Lipid substance needed for sustained inflation of the air sacs in the alveoli
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Hemoptysis
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Coughing up blood
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Orthopnea
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Difficulty breathing when supine
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Paroxysmal Nocturnal Dyspnea
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Awakening from sleep with shortness of breath and the need to stand upright to breathe
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The low-pitched clear hollow sound that predominates in healthy lung tissue
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Resonance
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The three characteristic normal breath sounds
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Bronchial (Tracheal), Bronchovesicular, Vesicular
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This is the only kind of adventitious sounds that is not pathologic
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Atelectatic crackles - they do not last beyond a few breaths
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Pectus Excavatum
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Sunken Sternum
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Pectus Carinatum
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Forward protrusion of the sternum (Pidgeon Breast)
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Lateral S-shaped curvature of the thoracic and lumbar spine
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Scoliosis
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Kyphosis
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Exaggerated posterior curvature of the thoracic spine (humpback) that causes significant pain and limited mobility
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Tachpnea
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Rapid, shallow breathing (greater than 24 respirations per minute)
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Bradypnea
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Slow breathing (less than 10 per minute)
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Atelectasis
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Collapsed shrunken section of alveoli or entire lung due to airway obstruction, compression of lung, or lack of surfactant; decreased breath sounds, percussion, expansion, and tactile fremitus over affected area; tracheal shift to affected side
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Pneumothorax
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Free air in pleural space, causing lung collapse; unequal chest expansion, decreased tactile fremitus, hyperresonant (percussion), decreased breath sounds; tracheal shift to unaffected side
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Bronchophony
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Asking patient to repeat "99" while you listen with stethoscope; should not be able to distinguish what is being said
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Egophony
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Asking the patient to say "ee-ee-ee-ee" while you listen with stethoscope; you should hear "eeeeeeee" through stethoscope
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Whispered Pectoriloquy
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Asking patient to whisper phrase while you auscultate; response should sound muffled and faint
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Coarse crackles occur with ___
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Pulmonary edema, pneumonia, pulmonary fibrosis, and the terminally ill who have depressed cough reflex
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Wheezing occurs with __
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Airway obstruction, as in acute asthma or chronic emphysema
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Stridor occurs with __
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Croup, acute epiglottitis, and foreign body inhalation
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Breathing pattern characterized by respirations waxing and waning in a regular pattern, increasing in rate and depth and then decreasing, with periods of apnea
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Cheyne-Stokes Respiration
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Barrel Chest
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Equal anteroposterior to transverse diameter of chest, with horizontal ribs; characteristic of normal aging but also of chronic emphysema and COPD
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Crepitus
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Coarse, crackling sensation palpable over skin surface
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Fremitus
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Palpable vibration of lung fields, tested with tactile vocal fremitus test.
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Patients with __ often sit in a tripod position and used pursed-lips breathing.
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COPD (ex. emphysema)
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