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Chest Exam
Significance of findings
62
Health Care
Professional
02/05/2012

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Term
Cheyne-Stokes respiration is seen in patients
Definition
with congestive heart failure or raised intracranial pressure.
Term
Biot’s respiration is seen in patients with
Definition
damage to the medulla such as CVA
Term
Kussmaul’s respiration is seen in patients with
Definition
diabetic ketoacidosis and renal failure.
Term
Kussmaul’s respiration is triggered by
Definition
excess hydrogen ions
Term
Increased Tactile Fremitus seen in patients with
Definition
pneumonia, tuberculosis, pulmonary fibrosis
Term
Decreased Tactile Fremitus seen in patients with
Definition
pleural effusion and pneumothorax
Term
tympanic percussion=
Definition
pneumothorax, emphysema or asthma
Term
dull percussion=
Definition
pneumonia, tuberculosis, pulmonary fibrosis
Term
stony dull or flat percussion=
Definition
pleural effusion
Term
Decreased diaphragmatic excursion is seen in:
Definition
emphysema,
pulmonary fibrosis, &
ankylosing spondylitis
Term
There are three main types of breath sounds:
Definition
a. vesicular
b. bronchovesicular
c. bronchial
Term
Vesicular breathing is characterized by inspiratory sounds that are
Definition
longer than expiratory. These are soft low-pitched sounds and are heard over most of the lungs especially at the base. This is normal.
Term
bronchovesicular breathing, inspiratory and expiratory sounds are
Definition
equal in length and in pitch. These are often heard over the 1st and 2nd intercostal spaces anteriorly and posteriorly between the upper interscapular regions. This is normal.
Term
In bronchial breathing,
Definition
expiratory sounds last longer than inspiratory ones. These sounds are loud and relatively high-pitched.
Term
When bronchial breathing is heard, one should suspect that
Definition
the normal air-filled lung has been replaced by fluid or by consolidated lung tissue like in a pneumonia, tuberculosis or atelectasis.
Term
When bronchial breathing is heard, you must proceed to perform 3 additional tests which are not part of the normal examination:
Definition
bronchophony
egophony
whispered pectoriloquy
Term
Bronchophony:
Definition
when the patient says „99” in a normal voice, it would sound very loud with your stethoscope when listening over the affected area.
Term
Egophony:
Definition
when the patient say “E E” if would sounds like the bleating of a goat “A. A”.
Term
Whispered pectoriloquy:
Definition
when the patient whispers “99” it would sound like the normal “99” with the stethoscope. The sound is barely heard when whispered in the normal patient and very loud in a patient with consolidation of a part of the lung.
Term
Trachea in Asthma
Definition
central
Term
Trachea in Atelectasis
Definition
pulled towards
Term
Trachea in Chronic bronchitis
Definition
central
Term
Trachea in CHF
Definition
central
Term
Trachea in Effusion
Definition
pushed away
Term
Trachea in Emphysema
Definition
central
Term
Trachea in Pneumonia
Definition
central
Term
Trachea in Pneumothorax
Definition
central
Term
Trachea in Tension pneumothorax
Definition
pushed away
Term
Trachea in Tuberculosis
Definition
pulled towards
Term
Percussion in Asthma
Definition
hyper-resonant
Term
Percussion in Atelectasis
Definition
dull
Term
Percussion in Chronic bronchitis
Definition
resonant
Term
Percussion in CHF
Definition
resonant
Term
Percussion in Effusion
Definition
stony dull
Term
Percussion in Emphysema
Definition
hyper-resonant
Term
Percussion in Pneumonia
Definition
dull
Term
Percussion in Pneumothorax
Definition
hyper-resonant
Term
Percussion in Tension pneumothorax
Definition
hyper-resonant
Term
Percussion in Tuberculosis
Definition
normal or dull
Term
Tactile Fremitus in Asthma
Definition
decreased
Term
Tactile Fremitus in Atelectasis
Definition
decreased
Term
Tactile Fremitus in Chronic bronchitis
Definition
normal
Term
Tactile Fremitus in CHF
Definition
normal
Term
Tactile Fremitus in Effusion
Definition
decreased
Term
Tactile Fremitus in Emphysema
Definition
decreased
Term
Tactile Fremitus in Pneumonia
Definition
increased
Term
Tactile Fremitus in Pneumothorax
Definition
decreased
Term
Tactile Fremitus in Tension pneumothorax
Definition
decreased
Term
Tactile Fremitus in Tuberculosis
Definition
increased
Term
Breath Sounds in Asthma
Definition
wheezes
Term
Breath Sounds in Atelectasis
Definition
absent
Term
Breath Sounds in Chronic bronchitis
Definition
wheeze/crackles
Term
Breath Sounds in CHF
Definition
crackles
Term
Breath Sounds in Effusion
Definition
none
Term
Breath Sounds in Emphysema
Definition
decreased
Term
Breath Sounds in Pneumonia
Definition
crackles
Term
Breath Sounds in Pneumothorax
Definition
absent
Term
Breath Sounds in Tension pneumothorax
Definition
absent
Term
Breath Sounds in Tuberculosis
Definition
apical crackles
Term
Pulsus alternans =
Definition
Left Ventricular Failure
Term
Pulsus bisferiens =
Definition
Aortic regurgitation [incompetence]
Term
Pulsus bigeminus =
Definition
Hypertrophic obstructive cardiomyopathy
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