BME 302 FINAL COMPREHENSIVE
EXAMINATION 2026 QUESTIONS WITH
SOLUTIONS GRADED A+
◉ Paroxysmal nocturnal dyspnea. Answer: awakening at night with
sudden shortness of breath and needing to be upright to achieve
comfort
◉ Shape and configuration of the chest wall. Answer: Spinous
process should appear in a straight line
Thorax is symmetric, in an elliptical shape with downward sloping
ribs, about 45 degrees relative to the spine
Scapulae are placed symmetrically in each hemithroax
◉ Anteroposterior diameter. Answer: Should be less than the
transverse diameter
Ratio of AP to transverse diameter is about 0.70 to 0.75 in adults,
and increases with age
◉ Barrel chest. Answer: AP is equal to transverse diameter
Chest appears as if it held in continuous inspiration
Occurs in COPD from hyperinflation of the lungs
,◉ Tactile fremitus. Answer: Sounds generated from the larynx are
transmitted through patent bronchi and the lung parenchyma to the
chest wall, where you feel them as vibrations
-Use palmar base of the fingers or the ulnar edge of hand
-"ninety-nine" or "blue moon"
-Start over lung apices and palpate from one side to another
◉ Factors that affect the intensity of tactile fremitus. Answer: -Most
prominent between scapulae and around sternum where major
bronchi are closest to chest wall -- decreases as you progress down
because more tissue impedes sound transmission
-Feels greater over thin chest wall than over obese or heavily
muscular one where thick tissue damps the vibration
-Loud, low-pitched voice generates more fremitus than soft, high-
pitched one
◉ Decreased fremitus. Answer: Occurs with obstructed bronchus,
pleural effusion or thickening, pneumothorax, or emphysema
-Any barrier that comes between sound and palpating hand
decreases fremitus
◉ Increased fremitus. Answer: Occurs with compression or
consolidation of lung tissue (lobar pneumonia)
-Present only when the broncus is patent and the consolidation
extends to the lung surface
,-Only gross changes increase fremitus
-Small areas of early pneumonia do not significantly affect it
◉ Ronchal fremitus. Answer: Palpable with inflammation of the
pleura
◉ Crepitus. Answer: Coarse, crackling sensation palpable over the
skin surface
-Occurs in subcutaneous emphysema when air escapes from the
lungs and enters the subcutaneous tissue (after open thoracic injury
or surgery)
◉ Resonance. Answer: Low-pitched, clear, hollow sound that
predominates in healthy lung tissue in the adult
-No constant standard
-May be duller in an athlete with heavily muscular chest wall or in
heavily obese
◉ Hyperresonance. Answer: Lower-pitched, booming sound found
when too much air is present such as in emphysema or
pneumothorax
◉ Pneumothroax. Answer: Air in the pleural cavity caused by a
puncture of the lung or chest wall
, ◉ Resonance: Dull note. Answer: Signals abnormal density in the
lungs
-Pneumonia
-Pleural effusion
-Atelectasis
-Tumor
◉ Pleural effusion. Answer: Accumulation of fluid in the pleural
cavity
◉ Bronchial breath sounds. Answer: High pitch
Loud
Inspiration < expiration
Harsh, hollow tubular
Location: trachea and larynx
◉ Bronchovesicular breath sounds. Answer: Moderate pitch
Moderate amplitude
Inspiration = expiration
Mixed
Over major bronchi where fewer alveoli are located:
EXAMINATION 2026 QUESTIONS WITH
SOLUTIONS GRADED A+
◉ Paroxysmal nocturnal dyspnea. Answer: awakening at night with
sudden shortness of breath and needing to be upright to achieve
comfort
◉ Shape and configuration of the chest wall. Answer: Spinous
process should appear in a straight line
Thorax is symmetric, in an elliptical shape with downward sloping
ribs, about 45 degrees relative to the spine
Scapulae are placed symmetrically in each hemithroax
◉ Anteroposterior diameter. Answer: Should be less than the
transverse diameter
Ratio of AP to transverse diameter is about 0.70 to 0.75 in adults,
and increases with age
◉ Barrel chest. Answer: AP is equal to transverse diameter
Chest appears as if it held in continuous inspiration
Occurs in COPD from hyperinflation of the lungs
,◉ Tactile fremitus. Answer: Sounds generated from the larynx are
transmitted through patent bronchi and the lung parenchyma to the
chest wall, where you feel them as vibrations
-Use palmar base of the fingers or the ulnar edge of hand
-"ninety-nine" or "blue moon"
-Start over lung apices and palpate from one side to another
◉ Factors that affect the intensity of tactile fremitus. Answer: -Most
prominent between scapulae and around sternum where major
bronchi are closest to chest wall -- decreases as you progress down
because more tissue impedes sound transmission
-Feels greater over thin chest wall than over obese or heavily
muscular one where thick tissue damps the vibration
-Loud, low-pitched voice generates more fremitus than soft, high-
pitched one
◉ Decreased fremitus. Answer: Occurs with obstructed bronchus,
pleural effusion or thickening, pneumothorax, or emphysema
-Any barrier that comes between sound and palpating hand
decreases fremitus
◉ Increased fremitus. Answer: Occurs with compression or
consolidation of lung tissue (lobar pneumonia)
-Present only when the broncus is patent and the consolidation
extends to the lung surface
,-Only gross changes increase fremitus
-Small areas of early pneumonia do not significantly affect it
◉ Ronchal fremitus. Answer: Palpable with inflammation of the
pleura
◉ Crepitus. Answer: Coarse, crackling sensation palpable over the
skin surface
-Occurs in subcutaneous emphysema when air escapes from the
lungs and enters the subcutaneous tissue (after open thoracic injury
or surgery)
◉ Resonance. Answer: Low-pitched, clear, hollow sound that
predominates in healthy lung tissue in the adult
-No constant standard
-May be duller in an athlete with heavily muscular chest wall or in
heavily obese
◉ Hyperresonance. Answer: Lower-pitched, booming sound found
when too much air is present such as in emphysema or
pneumothorax
◉ Pneumothroax. Answer: Air in the pleural cavity caused by a
puncture of the lung or chest wall
, ◉ Resonance: Dull note. Answer: Signals abnormal density in the
lungs
-Pneumonia
-Pleural effusion
-Atelectasis
-Tumor
◉ Pleural effusion. Answer: Accumulation of fluid in the pleural
cavity
◉ Bronchial breath sounds. Answer: High pitch
Loud
Inspiration < expiration
Harsh, hollow tubular
Location: trachea and larynx
◉ Bronchovesicular breath sounds. Answer: Moderate pitch
Moderate amplitude
Inspiration = expiration
Mixed
Over major bronchi where fewer alveoli are located:
