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Ascites - ANSWERS-accumulation of fluid in the abdomen caused by LIVER FAILURE
Venous distention - ANSWERS--occurs with CHF
-seen with obstructive patients (seen in exhalation phase)
stridor - ANSWERS--upper airway obstruction
-supraglottic swelling (epiglottitis) (thumb sign)
-subglottic swelling (croup, postextubation) (steeple sign)
-foreign body aspiration
-Racemic epinephrine
-intubation if MARKED stridor
-Lateral neck Xray for confirmation
Pleural friction rub - ANSWERS--coarse grating or crunching sound
-visceral and parietal pleura rubbing together
-associated with TB, pneumonia, pulmonary infarction, cancer
-steroids and antibiotics
,Heart Sound S₁ - ANSWERS--closure of the mitral and tricuspid valves at the beginning
of ventricular contraction
Heart Sound S₂ - ANSWERS--closure of pulmonic and aortic valves
-occurs when systole ends; ventricles relax
Heart Sound S₃ - ANSWERS--abnormal and may suggest CHF
Heart Sound S₄ - ANSWERS--abnormal and indicative of cardiac abnormality such as
myocardial infarction or cardiomegaly
Heart murmurs - ANSWERS--sounds caused by turbulent blood flow
-heart valve defects or congenital heart abnormalities
-can occur when blood is pushed through an abnormal opening (ASD, PDA)
Bruits - ANSWERS--sounds made in an artery or vein when blood flow becomes
turbulent or flows at an abnormal speed.
-usually heard via stethoscope over the identified vessel (carotid artery)
Blood pressure - ANSWERS--systolic and diastolic pressures
-sphygmomanometer to measure cuff pressures
-↑BP = cardiac stress = hypoxemia
-↓BP = poor perfusion = hypovolemia, CHF
Costophrenic Angle - ANSWERS--angle made by the outer curve of the diaphragm and
the chest wall
-obliterated by pleural effusions and pneumonia
Diaphragm - ANSWERS--dome shaped normally
-flattened with COPD
,-hemidiaphragms may shift downward with pneumothorax
-right hemidiaphragm is level of 6th anterior rib and slightly higher than the left
-right lung: 55% and appear larger than left lung
Lateral decubitus CXR - ANSWERS--patient lying on affected side
-detecting small pleural effusions
End expiratory film - ANSWERS--taken when patient is at end-exhalation
-detecting small pneumothorax/foreign body aspiration (FBA)
Position of ET/Tracheostomy tube - ANSWERS--tip should be positioned below the
vocal chords and no closer than 2 cm or 1 inch above the carina.
-approx same level of the aortic knob/arch
-observation and auscultation will quickly determine adequate ventilation before CXR is
taken
-cuff should not extend over the end of the ET or tracheostomy tube
Pacemaker, catheters, Etc. - ANSWERS--pacemaker should be positioned in the right
ventricle
-PAC should appear in right lower lung field
-central venous catheters are placed in the right or left subclavian or jugular vein and
should rest in the vena cava or right atrium
-chest tubes should be located in the pleural space surrounding the lung
-NG tubes should be in stomach 2-5 cm below the diaphragm
Croup (laryngotracheobronchitis) - ANSWERS--viral disorder
-narrowing subglottic swelling
-steeple/picket fence/pencil sign
-gradual onset
-infants
, -Mist tent, O2, Racemic epi, corticosteroids
-barking cough
Epiglottitis - ANSWERS--bacterial infection
-supraglottic swelling with an enlraged and flattened epiglottis and swollen aryepiglottic
folds
-Thumb sign
-Rapid onset
-pediatrics
-provide airway and antibiotics
Computerized Tomography (CT scan) - ANSWERS--X-ray through a specific plane and
appear as slices of organs/body parts
-diagnosis of bronchiectasis
-spiral CT scan w/ contrast dye for PE
Magnetic Resonance Imaging (MRI) - ANSWERS--2D view without use of radiation
-used for determining thoracic aneurysms, congenital abnormalities of the aorta and
major thoracic vessels esp. the hilar area
-able to locate precise position of tumors
V/Q scan - ANSWERS-Ventilation scan
-Radioisotope (xenon) gas is inhaled
-and obstruction to airflow will allow little gas to enter
Perfusion scan
-albumin, tagged with radioactive iodine is injected into a peripheral vein and lodges in
the pulmonary capillaries
-scanned over chest and shows distribution and volume of perfusion