Question 1

What chest wall abnormality is commonly associated with chronic lung disease due to air trapping and a loss in lung compliance and is commonly associated with COPD?

Accepted Answer

Barrel chest is a configuration resulting from an increase in the AP diameter to greater than normal.This abnormality is commonly associated with chronic obstructive pulmonary disease (COPD)due to air trapping and a loss in lung compliance.

Question 2

Where is (are)the midaxillary line(s)located?

Accepted Answer

The midaxillary line is an imaginary line extending downward from the center of the armpit.

Question 3

What type of skeletal abnormality has an anterior-to-posterior curvature of the upper spine and a lateral curvature that causes the vertebrae in the affected area to rotate,flattening the rib cage anteriorly?

Accepted Answer

Kyphoscoliosis is a combination of kyphosis and scoliosis.This condition can profoundly affect ventilatory volume and the mechanics of respiration.

Question 4

Where is (are)the midclavicular line(s)located?

Accepted Answer

The midclavicular lines are two vertical lines bisecting the clavicles.Each of these lines pass just medial to the nipples.

Question 5

What is the normal diaphragmatic excursion?

Accepted Answer

Normal diaphragmatic excursion may be as much as 8-centimeters in normal subjects.The practitioner can easily assess diaphragmatic excursion on the posterior chest.

Question 6

Which type of breathing pattern is characterized by the diaphragm descending and the ribs moving up and out anteriorly and laterally and is the result of discoordinated motion of various parts of the chest wall and/or abdomen?

Accepted Answer

Paradoxical breathing is the result of discoordinated motion of various parts of the chest wall and/or abdomen.

Question 7

Upon reviewing a patient's admission notes,the history states the patient has a long-standing history of emphysema.What type of percussion note would you expect over the patient's chest?

Accepted Answer

Hyperresonance is an abnormal percussion sound heard over the chest.Percussion produces a loud,low-pitched sound of long duration.Conditions that can cause hyperresonance besides a pneumothorax are COPD and asthma (during an acute exacerbation).

Question 8

What is defined as vibration felt on the palpation of the chest during phonation,or speech?

Accepted Answer

Tactile fremitus is vibration felt on the palpation of the chest during phonation,or speech.

Question 9

A patient had a respiratory rate of 16/minute with an I:E ratio of 1:2.How would you record this in the patient's chart?

Accepted Answer

This normal ventilatory pattern is termed eupnea.In an adult breathing normally at rest,the respiratory rate is between 12 and 20-breaths per minute,with an inspiratory-to-expiratory ratio (I:E)of 1:2.

Question 10

In diabetic acidosis,a condition termed metabolic acidosis is produced.What type of breathing pattern is produced to compensate for this condition?

Accepted Answer

Kussmaul's respiration is an increase in rate and depth and occurs most commonly as a result of diabetic crisis.

Question 11

What is an increase in the depth of respirations to greater than normal?

Accepted Answer

An increase in the depth of respirations to greater than normal is termed hyperpnea.Often hyperpnea is mistakenly called hyperventilation.

Question 12

Resonance is the sound heard in percussing normal lung tissue.Which of the following best describes this percussion note?

Accepted Answer

Resonance is a low-pitched sound of long duration heard in percussing normal lung tissue.This sound is characteristic of areas that contain equal distributions of air and tissue.

Question 13

Where is (are)the midscapulae line(s)located?

Accepted Answer

The left and right midscapular lines are imaginary lines bisecting the scapulae and descending vertically.

Question 14

What is defined as the presence of air beneath the skin in the subcutaneous tissues?

Accepted Answer

Subcutaneous emphysema is the presence of air beneath the skin in the subcutaneous tissues.

Question 15

Which way would the trachea shift if the patient had a tension pneumothorax on the right side?

Accepted Answer

Conditions that cause a tracheal deviation away from the affected side of the chest are a large pleural effusion,a pneumothorax,and a tension pneumothorax or a pneumothorax without a functioning chest tube.

Question 16

What breathing pattern is periodic in nature,with a gradual increase in depth and respiratory rate followed by a tapering of rate and depth with periods of apnea or as a waxing and waning of respirations?

Accepted Answer

Cheyne-Stokes respiration is periodic in nature,with a gradual increase in depth and respiratory rate followed by a tapering of rate and depth with periods of apnea.This abnormality has been described as a waxing and waning of respirations.

Question 17

What is normal I:E ratio?

Accepted Answer

In an adult breathing normally at rest,the respiratory rate is between 12 and 20-breaths per minute,with an inspiratory-to-expiratory ratio (I:E)of 1:2.

Question 18

Immediately lateral to the sternal angle is (are)the _________________.

Accepted Answer

Immediately lateral to the sternal angle is the second rib.The sternal angle is a landmark used to find the second rib.

Question 19

The sternal notch is located where the clavicles join at the top of the sternum-the manubrium.The manubrium joins the body of the sternum at a horizontal ridge.What is this ridge called?

Accepted Answer

This ridge is termed the sternal angle.

Question 20

What is a congenital deformity of the sternum characterized by a depression in the sternum at the level of the lower body and xyphoid process?

Accepted Answer

Pectus excavatum is a congenital deformity of the sternum characterized by a depression in the sternum at the level of the lower body and xyphoid process.It is commonly called funnel chest,a term that visually describes the condition.

Quiz 3: Advanced Patient Assessment: Inspection, Palpation, and Percussion