| A | B |
|---|
| Chronic obstructive pulmonary disease - assessment findings on inspection | anteroposterior = transverse diameter (barrel chest) with increased costal angle, accessory muscle hypertrophy, possibly tripod positioning |
| Unequal chest expansion - common causes | marked atelectasis or pneumonia, pneumothorax, hemothorax, hemopneumothorax |
| Skeletal deformities that may compromise breathing by limiting excursion | kyphosis, scoliosis, pectus excavatum (if severe) |
| Decreased fremitus - common causes | anything that obstructed transmission (e.g. obstructed bronchus) or that comes between the sound and palpating hand (e.g. effusion) |
| Increased fremitis - common causes | compression or consolidation of lung tissue (sound conducted better through dense tissue) |
| Inflammed pleura - assessment findings | pleural friction fremitis, pleural friction rub |
| Subcutaneous emphysema - assessment findings | crepitus over area, enlargement of area ("blows up" like balloon depending on amount of air in tissues) |
| Hyperresonance - common causes | too much air in lungs as is found in emphysema or normally in children |
| Dullness on percussion of chest - common causes | percussion is dull over solid tissue such as a mass, consolidated or compressed lung tissue, or an organ (e.g. heart, liver) |
| Increased breath sounds - common causes | anything that increases tissue density such as consolidation |
| Decreased breath sounds - common causes | anything that obstructs movement of air (e.g. obstructed bronchus) or that obstructs transmission of sound by coming between lung and stethoscope (obesity, pleural effusion) |
| Wheeze - common causes | restricted airflow due to partially obstructed lower airway |
| Crackles - common causes | air entering distal bronchioles or alveoli that contain fluid or the sudden inflation of previously deflated alveoli |
| Stridor - common causes | restricted airflow due to partially obstructed upper airway as in epiglottis or foreign body obstruction |
| Lung consolidation or compression - common assessment findings | increased tactile fremitus, increased vocal resonance (i.e. voice sounds clearer on auscultation and with egophony "eeee" sounds like "aaaa") |
| Congestive heart failure - common symptoms | dyspnea, orthopnea, paroxysmal nocturnal dyspnea |
| Congestive heart failure - assessment findings | increased respiratory rate, crackles, and (if right ventricle involvement) dependent edema |
| Atelectasis - common causes | complete airway obstruction can cause absorption of air; compression (e.g. due to mass) can prevent alveolar expansion; lack of surfactant can prevent inflation |
| Atelectasis - assessment findings | over affected area there will be dullness and decreased breath sounds |
| Lobar pneumonia - assessment findings | over affected area there will be dullness, crackle, increased clarity in tests of vocal resonance |
| Chronic bronchitis - assessment findings | barrel chest, cough productive of thick tenacious secretions, dyspnea, fatigue, possible cyanosis and clubbing |
| Emphysema - assessment findings | barrel chest, hypertrophied accessory muscles, dyspnea, hyperresonnance, decreased chest expansion on inspiration, decreased breath sounds |
| Asthma - assessment findings | during an attack - increased resp. rate, wheeze (usually expiratory - if inspiratory and expiratory, much more dangerous), resp. labored and prolonged with use of accessory muscles |
| Pleural effusion - assessment findings | dyspnea, over affected area will have decreased or absent tactile fremitus, dull to percussion |
| Pneumothorax - assessment findings | unequal chest expansion, tachycardia, on affected side will be hyperresonant with decreased breath sounds and decreased fremitus, may have tracheal shift to unaffected side |
| Tuberculosis - common symptoms | cough, night sweats, easy fatigue, anorexia, weight loss |
