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Lung, Heart, Abdominal Interpretation
| Question | Answer |
|---|---|
| Bronchitis | Percussion is resonant; breath sounds are vesicular; adventitious sounds are crackles in early inspiration & expiration, wheezes or rhonchi |
| Asthma | Respiration is prolonged expiration; percussion is resonant-diffusely hyperresonant; breath sounds are often obscured by wheezes; adventitious sounds are wheezes, possibly crackles; tactile fremitus is decreased |
| COPD | Respiration is prolonged expiration; percussion is diffusely hyperresonant; breath sounds are decreased-absent; adventitious sounds are none or the crackles, wheezes & rhonchi associated with chronic bronchitis |
| Costochondritis | Normal auscultation findings, tenderness to the chest wall and overlying the costochondral junctions |
| RML Pneumonia | Percussion is dull RML; breath sounds are bronchial over RML; adventitious sounds are late inspiratory crackles RML; tactile fremitus is increased over involved area with bronchophony, egophony & whispered pectoriloquy |
| Right Pneumothorax | Percussion is hyperresonant; trachea is shifted to opposite side; breath sounds are decreased-absent on right; adventious sounds are none or possible pleural rub; tactile fremitus is decreased or absent on the right |
| Left Pleural Effusion | Percussion is dull-flat on left; trachea shifted contralateral; breath sounds are decreased-absent, bronchial may be heard; adventitious sounds are none, possible pleural rub; tactile fremitus is absent/dec. may be increased on top of large PE |
| bronchiogenic carcinoma | Abn percussion, breath sounds change, moist rales(pneumonia), endobronchial obstruction may result in localized wheeze, lobar collapse possible in area of decreased breath sounds & dullness to percussion |
| Enlarged Left Heart | S4 heard with bell at mitral valve; lateral, rapid & increased apical impulse observed; large laterally displaced & diffuse PMI palpated; laterally displaced left border on percussion; mitral or tricupsid regurgitation findings |
| Mitral Valve Prolapse | Mid-systolic click at mitral valve, more clearly heard with Valsalva maneuver but lessens with squatting |
| Aortic Stenosis | ASC mnemonic: Angina & Syncope, both exercise related, & Congestive heart failure; murmur is in later systole, with a harsh quality and a crescendo-decrescendo shape; nearly absent S2 |
| Aortic Regurgitation | Lub Pewwww(Blowing Sound); heart at aortic valve in seated position leaning forward |
| S2 Splitting | At left 2nd/3rd interspace's(Pulmonic valve) in inspiration |
| S3 | Opening snap, ken-TUCK-y |
| S4 | TEN-nes-see |
| Appendicitis | Positive rebound tenderness(Rovsing's sign); positive psoas &/or obturator sign, cutaneous hyperesthesia, McBurney's sign, fever |
| Abdominal Aortic Aneurysm | Abdominal aortic bruit; abdominal palpation indicates width of aorta >3cm |
| Cholecystitis | Sharp increase in tenderness with a sudden stop in inspiratory effort constitutes a positive Murphy's sign of acute cholecystitis |
| Liver Cancer | liver bruit & friction rub |
| Diverticulitis | Acute diverticulitis most often involves the sigmoid colon, thus resembling left-side appendicitis |
| Splenomegaly | Positive splnic percussion sign; spleen is palpable |
| Inguinal Hernia | Palpate a pulsion mass in inguinal region when patient lifts head off the exam table & coughs; mass not comparable to the opposite side |
| High Residual Urine in the Bladder | Suprapubic bulge; smooth, round, tense mass; distended bladder will elicit a lower percussion note than the surrounding air-filled intestines |
Created by:
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