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SPC Cardio Assess
SPC Cardiopulmonary Assessment Unit 1 & 2
| Question | Answer |
|---|---|
| What is Sensorium? | Level of consciousness. Oriented x 3(time, place, person) = normal |
| Decreased sensorium occurs with: | Decreased cerebral perfusion, decrease CaO2, and drug OD |
| Open-ended questions: | Promote rapport, 'why are you here?' |
| Closed-ended questions: | For specific info, 'how many pack of cigs do you smoke/day?' |
| Types of info contained in Pt hx: | Demographic: name, age, race, gender. Pt hx: review of systems, hx of present illness, past medical hx, family hx, occupational/environmental hx |
| What is ROS? | Review of Systems: detailed questionaire pt fills out - subjective |
| What is HPI? | History of Present Illness: detailed report by pt re: present condition |
| What is CC? | Chief Complaint: primary reason for seeking medical attn |
| What is 'pack years'? | # of packs smoked/day X # of years smoked |
| Sign vs Symptom | Sign: objective - finding by examiner. Symptom: subjective - complaint by pt |
| Acute vs Chronic cough | Acute < 3 weeks. Chronic > 2 weeks or recurrent |
| Mucoid Sputum | Clear, thin = asthma |
| Frothy Sputum | Pulmonary Edema |
| Purulent Sputum | Thick, colored |
| Yellow/Green/Copious Sputum | Cystic Fibrosis w/ pseudomonas infection |
| Rusty Sputum | Streptococcal pneumonia |
| Fetid Sputum | Foul smelling = lung abcess |
| Hypothermia causes | Cold water drowning, head trauma w/ hypothalamus injury |
| Hyperthermia causes | Infection, dehydration |
| Tachycardia causes | > 100/min - hypoxemia, hypertension, fever, anxiety |
| Bradycardia causes | < 60/min - complete heart block, endurance athletes, beta blockers |
| Tachypnea causes | > 20/min - "J" receptor stimulation, metabolic acidemia, anxiety |
| Bradypnea causes | < 10/min - drug o.d., head trauma, hypothermia |
| Hypertension causes | > 150/90 - high SVR |
| Hypotension causes | < 90/60 - hypovolemia, shock, CHF |
| Central Cyanosis | Requires 5g/dl of desaturated Hb, effects lips & oral mucosa |
| Pursed lip breathing seen in | COPD, prevents airway closure |
| What is Perrla? | Pupils become round, reactive to light. |
| What is Mydriasis? Causes? | Pupils become dilated & fixed. Atropine, brain death, cocaine OD |
| What is Miosis? Causes? | Pinpoint pupils. Opiate OD, sunstroke |
| What is Ptosis? Causes? | Drooping eyelids. Myasthenia Gravis |
| What is JVD? Common cause? | Jugular Venous Distention: method quantifying R heart pressure. Cor Pulmonale |
| Suprasternal Notch | Groove at the top of the Manubrium. Palpate to check for tracheal shifts. |
| Sternal Angle | Angle of Louis - ridge at the junction of Manubrium & top of Sternum |
| Right Lung Fissures | Horizontal(minor): RUL - RML Oblique(major): RML - RLL |
| Left Lung Fissures | Oblique(major): LUL - LLL |
| Barrel Chest occurs | With COPD pts |
| Flail Chest | Double fracture of 3 or more adjacent ribs |
| Paradoxical Movement | Chest wall goes in w/ inspiration, out w/ expiration |
| Restrictive Breathing | Rapid, shallow, decreases WOB |
| Obstructive Breathing | 'Pursed Lips', prolonged exhalation, active neck accessories w/ 'clavicular lift' |
| Abdominal Paradox | Abdomen sinks in w/ inspiration, seen in COPD pts w/ impending ventilatory failure |
| Acrocyanosis | Peripheral - nailbeds, due to poor perfusion, low CO, often in COPD pts |
| Central Cyanosis | Oral mucosa, due to severe shunting |
| Vocal Fremitus | Vibrations from vocal cords |
| Tactile Fremitus | Palpation to assess vocal fremitus, pt repeats '99' |
| Increased Tactile Fremitus | Denotes increased density(consolidation), pneumonia, atelectasis, fibrosis |
| Decreased Tactile Fremitus | Denotes decreased density(air), pneumothorax, emphysema |
| Thoracic Expansion (Anterior) | Anteriolateral, lower chest, thumbs at costal margins pointing toward xyphoid process |
| Thoracic Expansion (Posterior) | Posteriolateral, thumbs @ T8 @ end-exhalation. At full inspiration movement is equal and approx 3-5cm |
| Thoracic Expansion - Bilateral Decrease causes | COPD, neuromuscular diseases |
| Thoracic Expansion - Unilateral Decrease causes | Lobar consolidation, atelectasis, pneumothorax, pleural effusion |
| Subcutaneous Emphysema | Air w/in subq tissues, noted w/ pneumomediastinum & pneumothorax, feels like bubble wrap & sounds like rice crispies |
| Normal Percussion sound | Easy to hear, low pitch |
| Hyperresonant sound & causes | Louder & lower - sounds like an empty oil barrel. Pneumothorax. Hyperinflation from asthma, emphysema |
| Dullness sound & causes | Muffled & flat - sounds like a full oil barrel. Atelectasis, pleural effusion, consolidation(pneumonia) |
| Vesicular sound | Heard over peripheral lung area - soft & low pitched |
| Bronchial sound & causes | Loud & high pitched. Denotes loss of alveoli - consolidation, atelectasis |
| Diminished sound & causes | Low/quiet. Hypoventilation, hyperinflation, pneumothorax(absent), pleural effusion |
| Adventitious sound & causes | Heard in the airways - crackles - 'velcro'. Fluid in the airways. Small airways = CHF. Large airways = secretions |
| Wheezing sound & causes | Continuous. Small airways - high pitched = bronchospasm, asthma. Large airways - low pitched = obstruction, chronic bronchitis |
| Stridor sound & causes | Continuous, loud, high pitched. Upper airway obstruction - croup, post-extubation |
| Hepatomegaly | Liver girth is > 10cm @ midclavicular line. Assoc w/ Cor Pulmonale |
| Ascites | Serous fluid in the peritoneal cavity. Assoc w/ cirrhosis, malnutrition, CHF |
| Clubbing | Enlargment of terminal phalanges. Assoc w/ CF, bronchogenic cancer, COPD |
| Pedal Edema | Fluid in the subq tissues of the ankles/feet. Assoc w/ CHF, Cor Pulmonale |
| Capillary Refill | Press nailbed until area blanches, release, normal color should return < 3sec |
| Slow Capillary Refill assoc w/ | Hypovolemia, CHF |
| Cold hands, feet assoc w/ | Shock, hypovolemia |
| COPD inspection | JVD, 'pursed lips', active neck accessories w/ 'clavicular lift', barrel chest, hepatomegaly, clubbing, acrocyanosis, pedal edema |
| COPD palpation | Decreased tactile fremitus, thoracic expansion, bilateral decrease |
| COPD percussion & auscultation | Hyperresonant. Diminished, wheeze |
| Consolidation palpation | Increased tactile fremitus, thoracic expansion, unilateral decrease |
| Consolidation percussion & auscultation | Dullness. Bronchial breath sounds |
| Tension Pneumothorax palpation | Thoracic expansion, unilateral decrease, tracheal shift(away) |
| Tension Pneumothorax percussion & ausculation, etc | Hyperresonant. Absent breath sounds. Blood pressure drops, peak vent pressure increases |
| Pleural Effusion palpation | Tactile fremitus, absent, thoracic expansion, unilateral decrease, tracheal shift(away) |
| Pleural Effusion percussion & auscultation | Dullness. Absent breath sounds |
| Cor Pulmonale inspection | JVD, hepatomegaly, pedal edema |
| Shock/Hypovolemia | Slow capillary refill, peripheral skin temp decreased |
Created by:
vgflgirl
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