Thorax Abdomen Exam

Front 1

Normal respiratory rate

Back 1

14-20 BPM

Front 2

During respiratory effort. Note use of what muscles?

Back 2

Accessory muscles

Front 3

Which 2 things should you check for cyanosis?

Back 3

1) lips

2) nail beds

Front 4

Uncomfortable awareness of breathing disproportionate to activity level?

Back 4

Dyspnea

Front 5

Rapid, shallow breathing

Back 5

Tachypnea

Front 6

Causes of Tachypnea?

Back 6

1) pleurisy

2) rip fracture

Front 7

Rapid, deep breathing

Back 7

Hyperpnea

Front 8

Causes of Hyperpnea?

Back 8

1) exercise

2) anxiety

Front 9

Slow breathing

Back 9

Bradypnea

Front 10

Causes of Bradypnea?

Back 10

1) diabetic coma

2) drug-induced respiratory depression

3) increased intracranial pressure

Front 11

Observe symmetry of respiratory movement. What does unilateral impaired movement suggest?

Back 11

1) lung problem

2) diaphragm problem

3) rib fracture

Front 12

Check the intercostal spaces for abnormal retraction during inspiration. What does abnormal retraction suggest?

Back 12

1) airway obstruction

2) asthma

3) COPD

Front 13

Look for any abnormalities of the skin. Evaluate any lesions for what?

Back 13

SEV COMETS

1) size

2) elevation

3) vascularity

4) color

5) ordor

6) margins,

7) exudate

8) texture

9) shape

Front 14

Structure of normal adult chest?

Back 14

The lateral diameter is larger than the A-P diameter.

Front 15

What is the usual ratio of the normal adult chest?

Back 15

2:1

Front 16

What do you call an altered chest ratio?

Back 16

Barrel chest

Front 17

In whom would you see a barrel chest?

Back 17

1) children

2) elderly

3) COPD

Front 18

Depression of the lower portion of the sternum?

Back 18

funnel chest

Front 19

AKA for funnel chest

Back 19

pectus excavatum

Front 20

The depressed sternum can compress the heart and great vessesl, causing what?

Back 20

murmurs

Front 21

Anterior displacement of the sternum is called what?

Back 21

pigeon chest

Front 22

AKA for pigeon chest?

Back 22

pectus carinatum

Front 23

What do you call tender nodules at the costrochondral junctions?

Back 23

Rachitic rosary

Front 24

Rachitic rosary nodules are found in children with what?

Back 24

ricketts

Front 25

A sharply angled kyphosis due to collapse of a vertebrae from tuberculosis?

Back 25

gibbus formation

Front 26

Collapse of a vertebrae producing a gibbus formation is caused by what?

Back 26

tuberculosis

Front 27

Abnormal spinal curvatures and vertebral rotation?

Back 27

kyphoscoliosis

Front 28

What distorts the underlying lungs and may make interpretation of lung findings difficult?

Back 28

kyphoscholiosis

Front 29

Multiple rib fractures may result in paradoxical movements of the thorax known as what?

Back 29

flail chest

Front 30

With flail chest, on inspiration, the injured area moves ______ and on expiration it moves _______.

Back 30

inward; outward

Front 31

Palpate the entire back for what?

Back 31

1) masses

2) tenderness

Front 32

Arm position when palpating between the scapulae?

Back 32

arms crossed in front

Front 33

Palpate how many areas for tactile fremitus?

Back 33

4 bilaterally

8 areas total

Front 34

When palpating for tactile fremitus, what do you instruct the patient to say?

Back 34

"99" loudly and deeply

Front 35

To palpate for tactile fremitus, which part of your hand touches the patient's back?

Back 35

1) ball

2) knife-edge/ulnar

Front 36

Increased vibration indicates what?

Back 36

Increased density

Front 37

Decreased vibration indicates what?

Back 37

Decreased density.

Decreased transmission to the chest wall.
1) pneumothorax
2) pleural effusion

Front 38

At what level is respiratory expansion performed?

Back 38

T10

Front 39

During respiratory expansion, where are the patient's arms?

Back 39

at their sides

Front 40

To perform respiratory expansion, grab the patient around the rib cage making sure what?

Back 40

There is plenty of loose tissue between your thumbs.

Keep fingers rigid like a clamp.

Front 41

Perform respiratory expansion over how many breaths?

Back 41

3

Front 42

When testing respiratory expansion, ask the patient to inhale and exhale and observe what?

Back 42

the distance between the thumbs and midline

Front 43

What does decreased respiratory expansion suggest?

Back 43

1) pleural effusion
2) pneumothorax
3) pulmonary fibrosis
4) rib fracture
5) diaphragm problem

Front 44

What has a normal FLAT tone?

Back 44

thigh

Front 45

What has a normal DULL tone?

Back 45

liver

Front 46

What has a normal RESONANCE tone?

Back 46

normal lung

Front 47

What has a normal HYPER-RESONANCE tone?

Back 47

none

Front 48

What has a normal TYMPANY tone?

Back 48

abdomen
(puffed out cheek)

Front 49

Pathological flat tone

Back 49

massive pleural effusion

Front 50

Pathological dull tone

Back 50

tumor, lobar pneumonia

Front 51

Pathological resonance tone

Back 51

simple chronic bronchitis

Front 52

Pathological hyper-resonance tone.

Back 52

emphysema

Front 53

Pathological tympany tone.

Back 53

pneumothorax

Front 54

Percuss how many areas on the thorax?

Back 54

7 areas on each side

14 areas total

Front 55

Arm position when performing diaphragmatic excursion?

Back 55

crossed

Front 56

For diaphragmatic excursion, patient holds the ____, mark diaphragm, then patient holds ____, mark diaphragm.

Back 56

Inhale, exhale

Front 57

Distance between the 2 marks of diaphragmatic excursion?

Back 57

3-6 cm