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NURS351
exam 2-Health assessment-lungs-heart
| Question | Answer |
|---|---|
| anteriorally papalted rib | 10th |
| palapted posterior "floating" ribs | 11th and 12th |
| prominent posterior vertebra | C7 & T1 |
| accessory muscles | abd, sternocleiodmastoid, trapezius, ICs |
| normal anterioposterior diameter | 1:2 to 5:7 |
| kyphosis | humpback |
| lordosis | lumbar curve, occurs during pregnancy |
| scoliosis | lateral curve |
| where palpation of the chest begins | above clavicle |
| palpation feels like bubble wrap | subcutaneous emphysema |
| normal thoracic expansion | 3-5cm |
| posterior placement of hands for thoracic expansion | T10, about 1-3inches apart |
| tactile fremitus/ vocal fremitus best felt here | trachea, 2nd ICS, T1 & T2, less over lung |
| sound over lungs | resonant |
| sound over muscle | dull |
| sound over bone | flat |
| hyperresonant sounds | thin adults, children, asthma, emphysema |
| percussion started here on lateral thorax | directly below axilla |
| normal diaphragmatic excursion | 3-5 cm |
| normal bronchial breath sounds | heard over trachea, longer on exhalation |
| normal bronchovesicular breath sounds | heard over manubrium, equal on inspiration and exhalation |
| normal vesicular breath sounds | heard over base of lungs, longer on inspiration |
| crackles | rales |
| wheezes | musical sounding |
| rhonchi | whistling or snoring sound |
| stridor | harsh vibrating sound |
| pleural friction rub | leathery sounding |
| bronchophony | "99" |
| egophony | "ee" |
| whispered pectoriloquy | whisper "99" |
| retraction | caving in of various regioing of chest |
| Kussmaul's respirations | abnormal, slow ,deep breathing |
| sound producing S1 | closing of mitral and tricuspid valves |
| S1 heard loudest at | apex of heart |
| sound producing S2 | closure of aortic and pulmonic valves |
| split S1 or S2 | valves do not close together |
| S2 heard loudest at | base of heart |
| S3 sound | caused by ventricle filling |
| S4 sound | heard at end of diastole |
| grading of murmurs | intensity, duration, timing, location |
| aortic area | 2nd ICS to right of sternum- aortic valve and S2 sounds best heard here |
| pulmonic area | 2nd ICS to left of sternum- pulmonic valve and split S2 best heard here |
| right ventricular area | 4th ICS left of sternal border- tricuspid valve and S1 best heard here |
| apical/ left ventricular area | 5th ICS medial to the MCL- mitral valve and S1 sounds best heard here |
| nomral JVD | 2cm or less |
| precordium | chest wall situated over the heart |
| normal PMI size | 2cm |
| order of auscultation | A, P, E, R, A |
| S3 sound | "kentucky" seen in CHF, caused by rapid ventricular filling, occurs after S2, heard at apex, "ventricular gallop", use bell to assess, best heard in side lying position |
| S4 sound | "tennessee", heard before S1, caused by a stiff ventricle, seen in HTN and post MI, heard at apex, "atrial gallop". heard best in side lying position |
| murmur | produced by turbulent blood flow |
| pan-systolic/ hollow systolic | heard throughout systole |
| ejection click | abnormal systolic sound due to opening of valve |
| opening snap | abnormal diastolic sound due to opening of valve |
| 5cm | amount added to JVP to calculate CVP |
| pulse pressure | SBP-DBP |
| ausculatory gap | disappearing and reappearing BP sound |
| pulse deficit | apical- radial SBP |
| linea alba | line from sternum to symphisis pubis |
| scaphoid abd | concave |
| protuberant abd | convex |
| Colin's sign | bluish tint around umbilicus, may be blood in abd |
| normal bowel sounds | 5-35 clicks in 1-2min |
| liver dullness span | 6-12cm |
| spleen dullness span | 6-8cm |
| tail of spence | part of breast towards axilla |
| Montgomery Tubercles | sebaceous glands on the nipple that lubricate the area |
| gynecomastia | benign tumor of the breast |
| galactorrhea | secretions from a non-lactating breast |
| position for breast examination | supine, or leaning forward for larger breast |
| prolactin | lactating hormone |
Created by:
rsg175
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