Murmur grades - ️️Grade I: barely audible. very faint and may not be heard by
professionals
Grade II: Quiet, soft, and audible.
Grade III: Moderately loud. audible w/o thrill
Grade IV: Loud, but still of intermediate intensity; palpable vibration or thrill; detection of
a palpable thrill i...
AHN 568 Module 1
Murmur grades - ✔️✔️Grade I: barely audible. very faint and may not be heard by
professionals
Grade II: Quiet, soft, and audible.
Grade III: Moderately loud. audible w/o thrill
Grade IV: Loud, but still of intermediate intensity; palpable vibration or thrill; detection of
a palpable thrill indicates a murmur of grade IV or more
Grade V: Very loud, heard with a stethoscope partly off the chest; accompanied by a
palpable thrill
Grade VI: Heard with the stethoscope entirely off the chest and accompanied by
palpable thrill
Lobar Pneumonia (consolidation) assessment findings - ✔️✔️percussion: dull over
airless area
midline trachea
BS: bronchial over the involved area
extra BS: late inspiratory crackles over area
increased tactile fremitus. egophony, bronchophony, whispered pectoriloquy.
Left sided HF respiratory assessment findings - ✔️✔️percussion: resonant
trachea: midline
BS: vesicular
adventitious: late inspiratory crackles in dependent part of lunch; possible wheeze
normal voice sounds and tactile fremitus.
chronic bronchitis - ✔️✔️percussion: resonant
trachea: midline
BS: vesicular
extra BS: scattered coarse crackles in early inspiration and expiration; wheeze, rhonchi
Partial Lobar Obstruction (atelectasis) - ✔️✔️percussion: dull over airless area
trachea shifts TOWARD involved side
Absent breath sounds with bonchial plug except when its a right upper lobe atelectasis
with adjacent tracheal breath sounds transmitted.
no adventitious sounds.
tactile fremitis is absent if bronchial plus, but tactile fremitus and voice sounds might be
increased if it's right upper lobe atelectasis.
atelectasis= - ✔️✔️lobar obstruction from mucus, foreign object ,or organ pressing on
lobe. alveoli collapse. has NO ADVENTITIOUS BREATH SOUNDS.
, Pleural Effusion respiratory assessment - ✔️✔️percussion: dull over the fluid
trachea shifts AWAY from effusion if large
BS: decreased to absent. or bronchial sounds over top of effusion.
no extra BS but maybe a pleural rub.
decreased or absent tactile fremitus, but could be increased at top of large effusion
pneumothorax respiratory assessment - ✔️✔️percussion: hyperresonant or tympany
over pleural air.
trachea shifts away from tension PTX
BS: decreased or absent over the PTX
no extra BS, but many a pleural rub
decreased or absent tactile fremitus over pleural air
COPD respiratory assessment - ✔️✔️percussion: all over hyperressonant
trachea midline
BS: delayed expiration, decreased BS
extra BS: crackles, wheeze, rhonchi or chronic bronchitis
decreased tactile fremitus and voice sounds
Asthma respiratory assessment - ✔️✔️percussion: resonant or diffusely
hyperressonant.
trachea midline
breath sounds are obscured by wheezes. extra BS are wheeze and maybe crackles
decreased tactile fremitus and voice sounds
hyperresonance indicates? - ✔️✔️- Hyper-inflated lungs (too much air)
- like Chronic emphysema
dullness is over - ✔️✔️fluid
tactile fremitus and voice sounds are only increased in what? - ✔️✔️pneumonia
characteristics of GERD chest pain - ✔️✔️retrosternal and may radiate to back. burn or
squeeze. mild to severe. chronic cough in early morning or at night. hoarse. mistaken
for asthma.
characteristics of angina chest pain - ✔️✔️retrosternal radiates to neck, shoulders,
arms, jaw, upper abd. pressing, squeezing, tight, heavy. 1-3 min but as long as 10 min.
can cause dyspnea, nausea, sweating
characteristics of pleuritic chest pain - ✔️✔️sharp and knifelike. severe. persistent. on
deep inspiration, coughing, movements of the trunk. caused from : pleurisy, PNA, pulm
infarct, neoplasm, abcess
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