- midsternal line
- anterior axillary
common and concerning symptoms for respiratory history
- cough, dyspena, wheezing
- chest pain
- blood in sputum(hemoptysis)
- snoring, apnea, and daytime sleepiness
for respiratory history Hpi what are some of the things that you should ask?
- when does breathing worsen
- you think what kind of pain could this be?
- understand the location of the pain ?oneside?
- quantity how respiratory illness has affected the daily life? before and after?
- how would you describe this?
when doing severity for respiratory illness without pain, what should you use?
- how it affect your ADL ( activities of daily life)
- or mild moderate and severe
what affects should you consider in regards to respiratory history ?
is this causing worry?
when starting out a physical exam with respiratory concerns start with ?
what does the Pe for the lungs and thorax look like?
what are you looking for during scoliosis inspection
- how they are breathing? shallow, deep
- the shape of their chest ? the pace ?
- contraction of accessory muscles
- is the traches midlines
- what is their color
- is their breathing sounds !
what is abnormal chest shape ?
how to palpate thorax
- Lay hands over thorax and watch if thumbs move symmetrically in expiration and inspiration
- feel for tenderness, crepitus and amasses
- ensure to go both posterior and anterior
what is tactile fremitus
- palpable vibrations
- you can feel this as the physician using the ball o f your hand or ulnar surface
how many taactile location are there on the front and back ?
- on the front there are 3
- posterior: 4
category of lung songs?
- Breath sounds
- adventitious ( addition noisies)
- transmitted voice sounds
what are the characteristics of breath sounds?
- vesticular =inspiratory last lonnger than exp; stet place over most of both lungs
- bronchiovestibular-insp and exp are about equal ; on the trachea via in btwn the scapula or 1st and 2nd interspace; it is high pitched.
what are continuous adventitous ausculation
what is egophony
when you hear E and it is heard as A via the steth.
when pt says 99 it is transmitted as louder sounds and not muffled 99
whn pt whispers 1-2-3 or 99 and instead of hearing nothing or very fainy sounds you hear clearer whisper sounds
what lobe(s) of the long takes up the most space in the anterior right chest?
The RUL and RML
what lobe(s) of the long takes up the most space in the anterior left chest?
- LUL mostly
- and inferior medially is the LLL
what lobe(s) of the long takes up the most space in the posterior left chest?
LLL more inferiorly
what lobe(s) of the long takes up the most space in the posterior right chest?
RLL more inferiorly
side orientation of the right long
- RML is more anterior axillary
- RUL is more superior
- RLL is more posetrior or moddle axillary
side orientation of the left long
- LUL is more superior and anterior axillary ( in an oblique fashion)
- LL is mor inferior and posterior axillary ( oblique)