Lungs & Heart - Physical Examination
(178).jpg "Lungs & Heart - Physical Examination - Quiz")
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- 1.
Respiratory Examination
- A.
Observation, inspection
- B.
Palpation
- C.
Tapping
- D.
Percussion
- E.
Auscultation
Correct Answer(s)
A. Observation, inspection
B. Palpation
D. Percussion
E. AuscultationExplanation
The given correct answer lists the correct sequence of steps in a respiratory examination. Observation and inspection involve visually assessing the patient's breathing pattern, chest movement, and any visible abnormalities. Palpation involves feeling the chest and assessing for tenderness, masses, or abnormal movements. Tapping, also known as tactile fremitus, involves using the hands to detect vibrations in the chest while the patient speaks. Percussion involves tapping the chest to assess the underlying organs and structures. Auscultation involves using a stethoscope to listen to the breath sounds and any abnormal lung sounds.Rate this question:
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- 2.
Respiration Examination - Observation
- A.
Well or unwell
- B.
Altertness and conscious level
- C.
Body Habitus
- D.
Absconcess
- E.
Signs of Respiratory Distress: Trachea, Tripod position, Use of Accessory Muscles, Pursed Lips, Flared Nostrils
- F.
Ability to whistle
- G.
Breathing Pattern
- H.
Added Breathing Sounds
- I.
Cough: Dry or Productive
Correct Answer(s)
A. Well or unwell
B. Altertness and conscious level
C. Body Habitus
E. Signs of Respiratory Distress: Trachea, Tripod position, Use of Accessory Muscles, Pursed Lips, Flared Nostrils
G. Breathing Pattern
H. Added Breathing Sounds
I. Cough: Dry or ProductiveExplanation
The given answer lists various observations that can be made during a respiratory examination. These observations include assessing whether the person is well or unwell, their level of alertness and consciousness, their body habitus, signs of respiratory distress such as the position of the trachea, tripod position, use of accessory muscles, pursed lips, and flared nostrils. Additionally, the breathing pattern, any added breathing sounds, and whether the cough is dry or productive are also important observations to consider during a respiratory examination.Rate this question:
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- 3.
Which muscles to look for when checking to see if patient is using accessory muscle to breathe.
- A.
Sternocleidomast
- B.
Scalene Trapezius
- C.
Brachials
- D.
Pectorialis Major
- E.
Internal Inter-costals
- F.
Abdominal Muscles
Correct Answer(s)
A. Sternocleidomast
B. Scalene Trapezius
D. Pectorialis Major
E. Internal Inter-costals
F. Abdominal MusclesExplanation
The correct answer includes muscles that are commonly used as accessory muscles during breathing. The sternocleidomastoid, scalene, and pectoralis major muscles are all located in the upper chest and neck area and can be recruited to assist with breathing when the primary respiratory muscles are weakened or compromised. The internal intercostal muscles are located between the ribs and are also involved in forced inhalation. The abdominal muscles, specifically the rectus abdominis and external obliques, can be used during forced exhalation. Therefore, checking for the activation or use of these muscles can help determine if a patient is relying on accessory muscles to breathe.Rate this question:
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- 4.
Accessory Muscle Use / Intercostal RetractionNeck and shoulder muscles used to assist breathing. Muscles between ribs (Blank) [2 words] during inspiration.
Correct Answer(s)
Pull InExplanation
During inspiration, the muscles between the ribs, known as intercostal muscles, contract and pull inwards. This action helps to expand the chest cavity, allowing for the intake of air into the lungs. The term "pull in" accurately describes this movement of the intercostal muscles during the breathing process. Additionally, accessory muscles, including those in the neck and shoulders, may also be recruited to assist with breathing when there is increased demand or difficulty in breathing.Rate this question:
- 5.
Possible Etiology for Accessory Muscle Use while breathing.
- A.
COPD
- B.
Asthma in exacerbation
- C.
Secretion Retention
- D.
Indicates Severe Respiratory distress and Hypoxemia
Correct Answer(s)
A. COPD
B. Asthma in exacerbation
C. Secretion Retention
D. Indicates Severe Respiratory distress and HypoxemiaExplanation
The given answer suggests that the possible etiology for accessory muscle use while breathing includes COPD, asthma in exacerbation, secretion retention, and indicates severe respiratory distress and hypoxemia. This means that in conditions such as COPD and asthma exacerbation, the body may use accessory muscles to help with breathing due to the increased difficulty in getting enough oxygen. Secretion retention can also contribute to the need for accessory muscle use. Overall, the presence of accessory muscle use indicates a severe respiratory distress and low oxygen levels in the body.Rate this question:
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- 6.
Recognizing inadequate breathing.
- A.
Yellow or Cyanotic skin
- B.
Fast or slow rate; Irregular Rhythm
- C.
Abnormal Lung Sounds
- D.
Reduced Tidal Volumes
- E.
Use of Accessory Muscles
- F.
Canary shaped ribs
- G.
Cool, damp, pale or cyanotic skin
Correct Answer(s)
B. Fast or slow rate; Irregular Rhythm
C. Abnormal Lung Sounds
D. Reduced Tidal Volumes
E. Use of Accessory Muscles
G. Cool, damp, pale or cyanotic skinExplanation
The given answer includes a list of symptoms that can indicate inadequate breathing. These symptoms include a fast or slow rate with an irregular rhythm, abnormal lung sounds, reduced tidal volumes, the use of accessory muscles, and cool, damp, pale, or cyanotic skin. These symptoms are commonly observed in individuals who are not breathing properly, and recognizing these signs can help identify inadequate breathing in a person.Rate this question:
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- 7.
Change in pattern of Respiration
- A.
Laboured Respiration (Assess for the use of Accessory muscles f)
- B.
Belly breathing
- C.
Retraction of intercostal spaces during inspiration
- D.
Long expiratory phase of respiration
- E.
Laughing while exhaling
- F.
Use of abdominal muscles to aid in expiration
Correct Answer(s)
A. Laboured Respiration (Assess for the use of Accessory muscles f)
C. Retraction of intercostal spaces during inspiration
D. Long expiratory phase of respiration
F. Use of abdominal muscles to aid in expirationExplanation
The given correct answer includes multiple signs and symptoms associated with laboured respiration. Assessing for the use of accessory muscles and retraction of intercostal spaces during inspiration are both indicators of increased effort in breathing. A long expiratory phase of respiration suggests difficulty in exhaling air. Additionally, the use of abdominal muscles to aid in expiration is another compensatory mechanism seen in laboured breathing. Therefore, all of these signs point towards laboured respiration.Rate this question:
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- 8.
Chest Deformities
- A.
Funnel Chest
- B.
Pigeon Chest
- C.
Canary Chest
- D.
Harrison's Sulcus
Correct Answer(s)
A. Funnel Chest
B. Pigeon Chest
D. Harrison's Sulcus -
- 9.
Wasting of small muscles of hand in (Blank) [2 words].
Correct Answer(s)
Lung CancerExplanation
Lung cancer can lead to wasting of the small muscles of the hand. This is because lung cancer can cause weakness and atrophy in the muscles due to the effects of the cancer on the body. Additionally, lung cancer can spread to other parts of the body, including the muscles, leading to further wasting and weakness.Rate this question:
- 10.
Important Hand signs in Respiration.
- A.
Cyanosis of the nails
- B.
Nail Bed Fluctuation (the first sign in clubbing)
- C.
Hair on fingers
- D.
Clubbing Nails
- E.
CO2 Retention Flap Sign of Hypercapnia (due to abnormally elevated Carbon Dioxide levels)
- F.
Yellow hands
- G.
Salbutamol induced tremor (Side effects of using Salbutamol as a treatment)
Correct Answer(s)
A. Cyanosis of the nails
B. Nail Bed Fluctuation (the first sign in clubbing)
D. Clubbing Nails
E. CO2 Retention Flap Sign of Hypercapnia (due to abnormally elevated Carbon Dioxide levels)
G. Salbutamol induced tremor (Side effects of using Salbutamol as a treatment)Explanation
The given answer includes important hand signs in respiration. Cyanosis of the nails is a sign of decreased oxygenation in the blood. Nail bed fluctuation is the first sign in clubbing, which is associated with chronic respiratory conditions. Clubbing nails are another sign of chronic respiratory conditions. CO2 retention flap sign indicates elevated carbon dioxide levels in the blood. Salbutamol induced tremor is a side effect of using Salbutamol, which is commonly used in the treatment of respiratory conditions.Rate this question:
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- 11.
Palpation-posterior positionAssess (Blank) [2 words] — "ninety-nine" Normal lung transmits a palpable vibratory sensation to the chest wall.
Correct Answer(s)
Tactile FremitusExplanation
Tactile fremitus refers to the palpable vibratory sensation felt on the chest wall when the patient says "ninety-nine". This sensation is transmitted through the normal lung tissue. Therefore, assessing tactile fremitus in the posterior position involves feeling for this vibratory sensation while the patient says "ninety-nine".Rate this question:
- 12.
Accentuating normal chest excursion: Place your hands on the patient's back with thumbs pointed towards the spine. Remember to first rub your hands together so that they are not too cold prior to touching the patient. Your hands should lift symmetrically outward when the patient takes a deep breath. Processes that lead to asymmetric lung expansion, as might occur when anything fills the (Blank) [2 words] (e.g. air or fluid), may then be detected as the hand on the affected side will move outward to a lesser degree. There has to be a lot of plerual fluid before this asymmetry can be identified on exam.
Correct Answer(s)
Pleural Space - 13.
Areas of the lungs for percussion
- A.
Anterior Wall - Upper Lobe
- B.
Anterior Wall - Lower Lobe
- C.
Posterior Wall - Upper Lobe
- D.
Posterior Wall - Lower Lobe
- E.
Right Lateral Wall - Middle Lobe
- F.
Left Lateral Wall - Lingula
Correct Answer(s)
A. Anterior Wall - Upper Lobe
D. Posterior Wall - Lower Lobe
E. Right Lateral Wall - Middle Lobe
F. Left Lateral Wall - LingulaExplanation
The answer provided correctly identifies the areas of the lungs for percussion. The anterior wall of the upper lobe, posterior wall of the lower lobe, right lateral wall of the middle lobe, and left lateral wall of the lingula are all areas that can be percussed to assess lung sounds and detect any abnormalities.Rate this question:
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- 14.
A healthy individual breathing through their mouth at normal tidal volumes produces a soft inspiratory sound as air rushes into the lungs, with little noise produced on expiration. These are referred to as (Blank) [3 words].
Correct Answer(s)
Vesicular Breath SoundsExplanation
The given answer, "Vesicular Breath Sounds," accurately describes the soft inspiratory sound produced by a healthy individual breathing through their mouth at normal tidal volumes. These breath sounds are characterized by air rushing into the lungs with little noise on expiration.Rate this question:
- 15.
Ausculation - how to:
- Requesting that the patient exhale forcibly will occasionally help to accentuate abnormal breath sounds (in particular, wheezing) that might not be heard when they are breathing at normal flow rates.
- A.
Ask patient to take slow, deep breaths (increases duration, intensity-thus detestability of abnormal breath sounds)
- B.
Have patient cough DURING auscultation (clears airway secretions and opens small atelactatic areas at lung bases).
- C.
Have patient cough BEFORE beginning auscultation (clears airway secretions and opens small atelactatic areas at lung bases).
- D.
If patient cannot sit up - auscultation can be performed while patient is lying on their side.
- E.
Request patient exhale forcibly - can sometimes help to accentuate abnormal breath sounds (esp.wheezing)
- F.
If patient needs to remain supine - a minimal examination can be performed by listening laterally/posteriorly.
Correct Answer(s)
A. Ask patient to take slow, deep breaths (increases duration, intensity-thus detestability of abnormal breath sounds)
C. Have patient cough BEFORE beginning auscultation (clears airway secretions and opens small atelactatic areas at lung bases).
D. If patient cannot sit up - auscultation can be performed while patient is lying on their side.
E. Request patient exhale forcibly - can sometimes help to accentuate abnormal breath sounds (esp.wheezing)
F. If patient needs to remain supine - a minimal examination can be performed by listening laterally/posteriorly.Explanation
To properly auscultate and detect abnormal breath sounds, the healthcare provider should ask the patient to take slow, deep breaths. This helps to increase the duration and intensity of the breath sounds, making them more detectable. Additionally, having the patient cough before beginning auscultation helps to clear airway secretions and open small atelectatic areas at the lung bases, improving the quality of the breath sounds. If the patient is unable to sit up, auscultation can be performed while the patient is lying on their side. Requesting the patient to exhale forcibly can also be helpful in accentuating abnormal breath sounds, especially wheezing. If the patient needs to remain supine, a minimal examination can be performed by listening laterally or posteriorly.Rate this question:
- 16.
(Blank) [2 words] refers to an increased loudness of whispering. Usually spoken sounds of a whispered volume by the patient would not be heard by the clinician auscultating a lung field with a stethoscope EXCEPT in areas of the lung where there is lung consolidation, these whispered spoken sounds by the patient (such as saying 'ninety-nine') will be clearly heard through the stethoscope. This increase in sound exists because sound travels faster and thus with lower loss of intensity through liquid or solid ("fluid mass" or "solid mass," respectively, in the lung) versus gaseous (air in the lung) media. Whispered pectoriloquy is a clinical test typically performed during a medical physical examination to evaluate for the presence of lung consolidation, which could be caused by cancer (solid mass) or pneumonia (fluid mass).
Correct Answer(s)
Whispered PectoriloquyExplanation
Whispered pectoriloquy refers to an increased loudness of whispering. Normally, when a patient speaks in a whispered volume, the clinician auscultating the lung field with a stethoscope would not be able to hear the spoken sounds. However, in areas of the lung where there is lung consolidation (fluid or solid mass), the whispered spoken sounds by the patient, such as saying "ninety-nine," will be clearly heard through the stethoscope. This is because sound travels faster and with lower loss of intensity through liquid or solid media compared to gaseous media. Whispered pectoriloquy is a clinical test used to evaluate for the presence of lung consolidation, which could be caused by cancer or pneumonia.Rate this question:
- 17.
COPD (Blank) [4 words] is an umbrella term used to describe progressive lung diseases including emphysema, chronic bronchitis, refractory (non-reversible) asthma, and some forms of bronchiectasis. This disease is characterized by increasing breathlessness.
Correct Answer(s)
Chronic Obstructive Pulmonary DiseaseExplanation
COPD, which stands for Chronic Obstructive Pulmonary Disease, is an umbrella term used to describe progressive lung diseases including emphysema, chronic bronchitis, refractory (non-reversible) asthma, and some forms of bronchiectasis. This disease is characterized by increasing breathlessness.Rate this question:
- 18.
Chronic Obstructive Pulmonary Disease (COPD) is characterized by increasing breathlessness. COPD is an umbrella term used to describe progressive lung diseases including.
- A.
Some forms of Bronchiectasis
- B.
Emphysema
- C.
Chronic Bronchitis
- D.
Refractory (non-reversible) asthma
- E.
All forms of Bronchiectasis
Correct Answer(s)
A. Some forms of Bronchiectasis
B. Emphysema
C. Chronic Bronchitis
D. Refractory (non-reversible) asthmaExplanation
COPD is a progressive lung disease that is characterized by increasing breathlessness. It is an umbrella term that encompasses various conditions including some forms of Bronchiectasis, Emphysema, Chronic Bronchitis, and Refractory (non-reversible) asthma. This means that individuals with COPD may experience symptoms such as breathlessness due to any of these conditions.Rate this question:
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- 19.
Bronchiectasis is a disease in which...
- A.
Permanent enlargement of parts of the airways of the lung.
- B.
Typical symptoms: Chronic Cough with mucous production
- C.
Other Symptoms: Shortness of breath, coughing up blood and chest pain.
- D.
Typical symptoms: Chronic Cough with mucous production; coughing up blood.
Correct Answer(s)
A. Permanent enlargement of parts of the airways of the lung.
B. Typical symptoms: Chronic Cough with mucous production
C. Other Symptoms: Shortness of breath, coughing up blood and chest pain.Explanation
Bronchiectasis is a disease characterized by the permanent enlargement of parts of the airways in the lungs. This condition leads to typical symptoms such as chronic cough with mucous production. Additionally, individuals with bronchiectasis may experience other symptoms including shortness of breath, coughing up blood, and chest pain.Rate this question:
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- 20.
Emphysema is...
- A.
Caused by damage to bronchial root.
- B.
Chronic Lung disease
- C.
Caused by damage to the alveoli
- D.
Damage to Alveoli results in fluid becoming trapped, causing them to expand and rupture.
- E.
Damage to Alveoli results in air becoming trapped, causing them to expand and rupture.
Correct Answer(s)
B. Chronic Lung disease
C. Caused by damage to the alveoli
E. Damage to Alveoli results in air becoming trapped, causing them to expand and rupture.Explanation
Emphysema is a chronic lung disease that is caused by damage to the alveoli. This damage leads to air becoming trapped in the alveoli, causing them to expand and rupture. This condition is characterized by difficulty breathing and can be caused by factors such as smoking or long-term exposure to air pollution.Rate this question:
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- 21.
Pneumonia stages:
- A.
Congestion within first 24 hours; characterized by vascular engorgement, intra-alveolar fluid, small numbers of neutrophils, often numerous bacteria. Grossly, the lung is heavy and hyperaemic.
- B.
Red hepatization or consolidation; vascular congestion persists, with intravasation of red cells into alveolar spaces, along with increased #s of neutrophils and fibrin. The filling of airspaces by the exudate leads to a gross appearance of solidification, or consolidation of the alveolar parenchyma. This appearance has been likened to that of the liver, hence the term "hepatization".
- C.
Red hepatization or consolidation; vascular congestion persists, with extravasation of red cells into alveolar spaces, along with increased #s of neutrophils and fibrin. The filling of airspaces by the exudate leads to a gross appearance of solidification, or consolidation of the alveolar parenchyma. This appearance has been likened to that of the liver, hence the term "hepatization".
- D.
Grey Hepatization: Red cells disintegrate, with persistence of the neutrophils and fibrin. The alveoli still appear consolidated, but grossly the colour is paler and the cut surface is drier.
- E.
Resolution (complete recovery): The exudate is doubled by enzymatic activity, and cleared by macrophages or by cough mechanism. Enzymes produced by neutrophils will liquify exudates, and this will either be coughed up in sputum or be drained via lymph.
- F.
Resolution (complete recovery): The exudate is digested by enzymatic activity, and cleared by macrophages or by cough mechanism. Enzymes produced by neutrophils will liquify exudates, and this will either be coughed up in sputum or be drained via lymph.
Correct Answer(s)
A. Congestion within first 24 hours; characterized by vascular engorgement, intra-alveolar fluid, small numbers of neutrophils, often numerous bacteria. Grossly, the lung is heavy and hyperaemic.
C. Red hepatization or consolidation; vascular congestion persists, with extravasation of red cells into alveolar spaces, along with increased #s of neutrophils and fibrin. The filling of airspaces by the exudate leads to a gross appearance of solidification, or consolidation of the alveolar parenchyma. This appearance has been likened to that of the liver, hence the term "hepatization".
D. Grey Hepatization: Red cells disintegrate, with persistence of the neutrophils and fibrin. The alveoli still appear consolidated, but grossly the colour is paler and the cut surface is drier.
F. Resolution (complete recovery): The exudate is digested by enzymatic activity, and cleared by macrophages or by cough mechanism. Enzymes produced by neutrophils will liquify exudates, and this will either be coughed up in sputum or be drained via lymph.Explanation
The correct answer provides a description of the different stages of pneumonia progression. It starts with congestion within the first 24 hours, characterized by vascular engorgement, intra-alveolar fluid, and small numbers of neutrophils. This is followed by red hepatization or consolidation, where vascular congestion persists and red cells extravasate into alveolar spaces, along with increased neutrophils and fibrin. The next stage is grey hepatization, where red cells disintegrate and the alveoli still appear consolidated but with paler color and drier surface. The final stage is resolution, where the exudate is digested by enzymatic activity and cleared by macrophages or cough mechanism.Rate this question:
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- 22.
A (Blank) is an abnormal collection of air in the pleural space between the lung and the chest wall. Symptoms typically include sudden onset of sharp, one-sided chest pain and shortness of breath.
Correct Answer(s)
PneumothoraxExplanation
A pneumothorax is an abnormal collection of air in the pleural space between the lung and the chest wall. This condition can cause sudden onset of sharp, one-sided chest pain and shortness of breath.Rate this question:
- 23.
A pneumothorax is...
- A.
An abnormal collection of air in the pleural space // the lung and chest wall.
- B.
Symptoms: Typically include a sudden onset of sharp, one-sided chest pain and shortness of breath.
- C.
Symptoms: Typically include a sudden onset of sharp, one-sided chest pain and sneezing.
- D.
Symptoms: Typically include a sudden onset of dull, one-sided chest pain and shortness of breath.
Correct Answer(s)
A. An abnormal collection of air in the pleural space // the lung and chest wall.
B. Symptoms: Typically include a sudden onset of sharp, one-sided chest pain and shortness of breath.Explanation
A pneumothorax is an abnormal collection of air in the pleural space, which is the space between the lung and chest wall. This can cause symptoms such as sudden onset of sharp, one-sided chest pain and shortness of breath. The other options in the question, such as sneezing and dull chest pain, are not associated with a pneumothorax.Rate this question:
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- 24.
Place you hands on chest- at the point of lower ribs--ask to do a deep breath in and out– look for the distance between big thumbs. The distance should be no more then (blank) [2 words - distance] and expansion should be symmetrical.
Correct Answer(s)
5 cmExplanation
The correct answer is 5 cm. This is the maximum distance that should be observed between the big thumbs when placing the hands on the chest at the point of the lower ribs and taking a deep breath in and out. The expansion should also be symmetrical.Rate this question:
- 25.
Place you hands on chest- at the point of lower ribs--ask to do a deep breath in and out– look for the distance between big thumbs. The distance should be no more then 5 cm and expansion should be symmetrical Then place hand on the (blank) [2 words] and ask to breath in and out—look for anterior and posterior expansion of the chest– it should be symmetrical.
Correct Answer(s)
anterior chest - 26.
Place you hands on chest- at the point of lower ribs--ask to do a deep breath in and out– look for the distance between big thumbs. The distance should be no more then 5 cm and expansion should be symmetrical Then place hand on the anterior chest and ask to breath in and out—look for anterior and posterior expansion of the chest– it should be symmetrical Find the apex beat of the heart in the (blank) intercostal space. It can be shifted to the side in patient with pneumothorax.
Correct Answer(s)
5th - 27.
Right ventricular heave (blank) [2 words].
Correct Answer(s)
cor pulmonaleExplanation
Cor pulmonale is a condition characterized by right ventricular enlargement and increased pressure in the pulmonary arteries. It is typically caused by long-term lung disease or pulmonary hypertension. In cor pulmonale, the right ventricle has to work harder to pump blood into the lungs, leading to a visible pulsation or heave. This can be observed as a right ventricular heave on physical examination. Therefore, cor pulmonale is the most likely explanation for the given correct answer.Rate this question:
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Mar 21, 2023Quiz Edited by
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Dec 04, 2017Quiz Created by
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