Physical Diagnosis Block 2
PD Thorax lecture
Questions and Answers
- 1.
The palpable vibrations transmitted through the bronchopulmonary tree to the chest when the patient speaks, often when he says, "Ninety nine"
Explanation
Fremitus refers to the palpable vibrations that can be felt through the chest when a patient speaks, particularly when they say "Ninety nine". These vibrations are transmitted through the bronchopulmonary tree, which includes the bronchi and lungs. Fremitus can be assessed by placing hands on the patient's chest while they speak and feeling for the vibrations. It can provide important information about the condition of the lungs and airways, such as the presence of fluid or consolidation.Rate this question:
- 2.
When would fremitus NOT be decreased or absent?
- A.
Voice is soft
- B.
COPD
- C.
When the transmission of vibrations from larynx to surface of chest is clear
- D.
Thick chest wall
Correct Answer
C. When the transmission of vibrations from larynx to surface of chest is clearExplanation
Fremitus is decreased or absent when the voice is soft or when the transmission of vibrations from the larynx to the surface of the chest is impeded. Causes include obstructed bronchus, COPD, separation of pleural surfaces by fluid (pleural effusion), fibrosis (thickening), air (pneumothorax), infiltrating tumor or thick chest wallRate this question:
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- 3.
What would cause percussion to give a resonance sound?
Correct Answer
Normal, air filled lungExplanation
A normal, air-filled lung would cause percussion to give a resonance sound because when the lung is filled with air, it creates a hollow space that allows sound waves to vibrate and resonate. This resonance sound is characteristic of a healthy lung and indicates that there is no obstruction or abnormality present.Rate this question:
- 4.
When would a lung percussion sound be dull?
Correct Answer
When fluid or solid tissue replaces the air-containing lung
Lobar pneumonia
Hemothorax
TumorExplanation
A lung percussion sound would be dull when fluid or solid tissue replaces the air-containing lung. This can occur in conditions such as lobar pneumonia, hemothorax, or tumor. In these cases, the normal resonance of the lung is replaced by a dull sound due to the presence of fluid or solid tissue, which hinders the transmission of sound waves. This can be detected during a physical examination by tapping on the chest and listening for the resulting sound.Rate this question:
- 5.
Hyperresonance...
- A.
Is when a dull sound replaces the normal, resonant sound
- B.
Can never be heard in a patient with emphysema or asthma
- C.
Is not a reliable sign of emphysema or asthma
Correct Answer
C. Is not a reliable sign of emphysema or asthmaExplanation
Generalized hyperresonance may be heard over the hyperinflated lungs of emphysema or asthma, but is not a reliable sign for them.Rate this question:
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- 6.
Auscultation involves all of the following EXCEPT
- A.
Listening to the sounds generated by breathing
- B.
Listening for any adventitious sounds
- C.
Listening to 4-6 areas posteriorly and 3-5 areas anteriorly and laterally
Correct Answer
C. Listening to 4-6 areas posteriorly and 3-5 areas anteriorly and laterallyExplanation
Auscultation involves listening to 4-6 areas posteriorly and 1-2 areas anteriorly and laterallyRate this question:
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- 7.
A Vesicular breath sound is...
- A.
Normal
- B.
Mixed normal and abnormal
- C.
Abnormal 'breathy' sounds
Correct Answer
A. NormalExplanation
A vesicular breath sound refers to the normal sound heard during breathing. It is a low-pitched, soft, and gentle sound that is heard over most of the lung fields. This sound indicates that the air is flowing freely through the airways and the lungs are functioning properly. Therefore, the correct answer is "Normal."Rate this question:
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- 8.
Bronchovesicular breath sounds...
- A.
Are normal
- B.
Are mixed normal and abnormal
- C.
Are abnormal 'breathy' sounds
Correct Answer
B. Are mixed normal and abnormalExplanation
Bronchovesicular breath sounds are characterized by a mix of normal and abnormal sounds. These sounds are heard during auscultation of the lungs and are produced by the air moving through the larger airways. Normally, bronchovesicular breath sounds are heard in specific areas of the lungs, such as over the main bronchi. However, if these sounds are heard in abnormal locations or if they are altered in intensity or pitch, it may indicate an underlying respiratory condition. Therefore, the correct answer states that bronchovesicular breath sounds are mixed normal and abnormal.Rate this question:
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- 9.
Bronchial breath sounds are...
- A.
Mixed normal and abnormal sounds
- B.
Abnormal 'breathy' sounds
- C.
Normal
Correct Answer
B. Abnormal 'breathy' soundsExplanation
Bronchial breath sounds are abnormal 'breathy' sounds. Normally, breath sounds heard over the bronchial tree are louder and higher pitched than over the lung periphery. However, if these sounds become more audible and have a harsh, blowing quality, it indicates an abnormality. This can occur in conditions such as bronchial obstruction, consolidation of lung tissue, or lung fibrosis. The abnormal 'breathy' sounds suggest a disruption in the normal airflow through the bronchial tree, leading to altered breath sounds.Rate this question:
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- 10.
Vesicular breath sounds are heard through
Correct Answer
inspirationExplanation
Vesicular breath sounds are heard during inspiration. During this phase of breathing, the diaphragm contracts and moves downward, causing the lungs to expand. As the lungs expand, air is drawn in through the airways, creating a gentle and rustling sound known as vesicular breath sounds. These sounds are typically heard over most of the lung fields and are considered normal in healthy individuals.Rate this question:
- 11.
Vesicular breath sounds...
- A.
Are soft and low pitched
- B.
Heard through inspiration
- C.
Pause between inspiration and expiration
- D.
Fade away about 1/3 of the way through expiration
- E.
Resemble the quiet sound of a breeze rustling the leaves of a tree
- F.
Represent air blowing through the small airways
- G.
Are abnormal
- H.
Are indicative of pneumonia
Correct Answer(s)
A. Are soft and low pitched
B. Heard through inspiration
D. Fade away about 1/3 of the way through expiration
E. Resemble the quiet sound of a breeze rustling the leaves of a tree
F. Represent air blowing through the small airwaysExplanation
Vesicular breath sounds are soft and low pitched, heard through inspiration, and fade away about 1/3 of the way through expiration. They resemble the quiet sound of a breeze rustling the leaves of a tree and represent air blowing through the small airways. These characteristics are normal and indicate normal lung function. They are not abnormal or indicative of pneumonia.Rate this question:
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- 12.
Bronchovesicular breath sounds...
- A.
Inspiratory and Expiratory sounds can be separated by a slight interval
- B.
Heard in a region of resolving pneumonia
- C.
Differences in pitch and intensity are easily detected during inspiration
Correct Answer(s)
A. Inspiratory and Expiratory sounds can be separated by a slight interval
B. Heard in a region of resolving pneumoniaExplanation
Differences in pitch and intensity are often more easily detected during expiration.Rate this question:
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- 13.
Bronchial breath sounds...
- A.
Are soft and low pitched
- B.
Have a short silence between inspiratory and expiratory sounds
- C.
Represent air flowing through larger bronchi as well as smaller airways
- D.
Can be heard over the trachea
- E.
Can be heard near the angle of Louis
- F.
Can be heard in areas of pneumonic consolidation
- G.
Inspiratory sounds last longer than Expiratory sounds
Correct Answer(s)
B. Have a short silence between inspiratory and expiratory sounds
D. Can be heard over the trachea
E. Can be heard near the angle of Louis
F. Can be heard in areas of pneumonic consolidationExplanation
Bronchial breath sounds are louder and higher in pitch, with a short silence between inspiratory and expiratory sounds, expiratory sounds last longer than inspiratory soundsRate this question:
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- 14.
Continuous whistling sounds heard as air rushes through narrowed airways. Often high pitched, reflecting air movement through smaller airways or bronchioles, they are musical in nature
Correct Answer(s)
EWheezes
Wheeze
WheezingExplanation
Continuous whistling sounds heard as air rushes through narrowed airways. Often high pitched, reflecting air movement through smaller airways or bronchioles, they are musical in nature. This description perfectly matches the symptoms of wheezing, which is the correct answer.Rate this question:
- 15.
Reflect air rushing through narrowed, wider caliber bronchi. Suggests secretions in large airways, and are similar to snoring
Correct Answer(s)
Low-pitched wheeze
RhonchiExplanation
The given correct answer is "Low-pitched wheeze, Rhonchi". This suggests that the sound described in the question is a low-pitched wheeze and rhonchi. A low-pitched wheeze is a sound that occurs when air rushes through narrowed, wider caliber bronchi, indicating secretions in the large airways. Rhonchi are also similar to snoring and can be heard when there are secretions in the large airways. Therefore, the presence of a low-pitched wheeze and rhonchi suggests the presence of secretions in the large airways.Rate this question:
- 16.
Louder, clearer, breath sounds are called
Correct Answer(s)
BronchophonyExplanation
Bronchophony refers to the increased loudness and clarity of breath sounds heard during auscultation. This can occur in conditions such as consolidation of lung tissue, where sound waves are transmitted more efficiently. It is characterized by a clearer and louder transmission of spoken words, indicating an abnormality in the lung. Therefore, bronchophony is the correct term to describe louder, clearer breath sounds.Rate this question:
- 17.
When "EE" is heard as "AY", it is called E to A change, or ...
Correct Answer(s)
Egophany - 18.
Egophany is indicative of lung consolidation, which acts as a great conductor of sounds that travel straight through from bronchi to chest wall to stethoscope
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
Egophany refers to the abnormal transmission of sound from the lungs to the chest wall and stethoscope. It is a characteristic finding in cases of lung consolidation, where the lung tissue becomes solid due to conditions like pneumonia. In lung consolidation, the air-filled spaces in the lungs are replaced with fluid or inflammatory material, which acts as a better conductor of sound. This allows sounds produced in the bronchi to travel directly to the chest wall and can be heard more clearly through a stethoscope. Therefore, the statement is true.Rate this question:
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- 19.
Select the INCORRECT answer. Whispered Pectoriloquy...
- A.
Are louder, whispered sounds
- B.
Are a result of a consolidated lung
- C.
Is due to millions of alveoli that baffle and break up whispers
Correct Answer
C. Is due to millions of alveoli that baffle and break up whispersExplanation
When a patient whispers "one, two, three" the whispered voice is faint and indistinct, if heard at all. Louder, whispered sounds are called whispered pectoriloquy. The millions of alveoli that normally baffle and break up whispered sounds into indistinguishable noises are not able to do so when the lung is consolidated, and the character of the sounds is clearly distinguishable by the stethoscopeRate this question:
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Mar 22, 2023Quiz Edited by
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Nov 02, 2010Quiz Created by
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