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CMN 568 Exam With Complete Solutions Latest Update
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CMN 568 Exam With Complete Solutions LatestUpdate 2024-2025
components of physical respiratory exam - Answer IPPA: inspection, palpation,
percussion, auscultation
ratio of time spent in inspiration/expiration - Answer ratio of 2:3
what should you palpate on a respiratory exam? - Answer - trachea at suprasternal
notch
- posterior chest wall to gauge fremitus / transmission of spoken words through lungs
- anterior chest wall (assess cardiac impulse)
what do pulmonary function tests do? - Answer measures:
- air flow rates
- lung volumes
ABILITY OF LUNG TO TRANSFER GAS ACROSS ALVEOLI-CAPILLARY MEMBRANE
should you do a PFT on an asthmatic in exacerbation? NO, PFT IS ABSOLUTELY
CONTRAINDICATED IN ACUTE SEVERE ASTHMA, IN RESPIRATORY DISTRESS,
ANGINA AGGRAVATED BY TEST, PNEUMOTHORAX, ACTIVE TB, AND HEMOPTYSIS
tachypnea-increased rate and decreased tidal volume
kussmauls respirations-increased rate w/LARGE VOLUME breathing due to intense
stimulation of respiratory center from metabolic acidosis
Cheyne-Stokes respirations-Answer rhythmic waxing/waning of rate and TV; regular
periods of apnea; seen in end-stage LV failure, neurologic dx, and sleeping at high
altitude
,BLE edema indicates what?-Answer indirectly measures pulmonary HTN; RV failure
what causes clubbing?-Answer increased amounts of unsaturated Hgb in capillary
blood; not a reliable indicator of hypoxemia since cyanosis in polycythemia only means
mild hypoxia
what does dull percussion indicate? - Answer lung consolidation or pleural effusion
what does hyper resonant percussion indicate? - Answer emphysema or pneumothorax
what does bronchial lung sounds heard over the periphery of the lung indicate? -
Answer consolidation
what does globally diminished lung sounds imply? - Answer significant airflow
obstruction
Continuous adventitious lung sounds - Answer - wheezes
- rhonchi
Discontinuous adventitious lung sounds - Answer - fine crackles
- course crackles
wheezing - Response - high-pitched musical sounds
- bronchospasm, mucosal edema, excessive secretions DUE TO NARROWED AIRWAY
- powerful indicator of obstructive lung disease
rhonchi - Response - lower pitched, snoring, gurgling quality sounds
- encountered with excessive secretions and abnormal airway collapse
, - clears after coughing
fine crackles - Response - soft, high pitched crisp noise associated with interstitial
diagnosis or early pulmonary edema
- fine-late inspiratory crackles indicate pulmonary fibrosis
coarse crackles - Answer - louder and lower pitched, slightly longer in duration
- associated with pneumonia or HF or late pulmonary edema
chest and abdominal wall should expand. - Answer simultaneously
normal lung sounds over periphery are described as. - Answer vesicular, fades in
expiration
normal lung sounds heard over suprasternal notch are described as. - Answer tracheal
or bronchial (louder, high pitched and hollow; louder on expiration)
FEV1-Answer amount of air exhaled during first forced breath
FVC-Answer forced vital capacity; total amount of air exhaled during the entire FEV test
obstructive lung disease results in spirometry-Answer- decreased FEV1/FVC ratio
- seen in asthma, copd, bronchiolitis, upper airway obstruction
- if obstruction is evident, repeat test 10-20min after inhaled bronchodilator to help
assess if dx is reversible
- asthma would improve after bronchodilator, copd would not
examples of restrictive chest dysfuction - Answer - ankylosing spondylitis
- scoliosis
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