A physical therapist completes a respiratory assessment on a patient in an acute
care hospital. The examination reveals decreased breath sounds and decreased
fremitus. This finding is MOST indicative of:
1) pleural effusion
2) pulmonary edema
3) consolidation
4) atelactasis
1) Pleural effusion
Decreased breath sounds and decreased fremitus are most likely caused by?
Pleural effusion or pneumothorax
Decreased breath sounds and increased fremitus are often associated with?
Pulmonary edema, consolidation, and atelactasis
,NPTE CARDIOPULMONARY
What is pleural effusion?
An accumulation of fluid between the layers of the membrane that lines the lungs
and chest cavity
What is pulmonary edema?
An accumulation of fluid in the alveolar spaces
What is consolidation?
Area of the lung that is filled with fluid. This fluid may be edema, inflammatory
exudate, pus, water, or blood.
What is atelectasis?
Absence of gas in part or all of a lung due to a collapse of lung tissue
S1 heart sound
Mitral and tricuspid valve closing
The lub of the lub dub when listening to heart sounds
,NPTE CARDIOPULMONARY
S1 (onset of ventricular systole)
S2 heart sound
Closing of the aortic and pulmonary valves
The dub of the lub-dub
S2 (onset of ventricular diastole)
S3 heart sound
May occur in healthy children and young adults, physiologic third heart sound.
(lub-dub-dub). It also indicates a loss of ventricular compliance in the presence of
heart disease or heart failure. In this case it is called ventricular gallop.
S4 heart sound
Occurs late in diastole just before S1 (la-lub-dub). Associated with atrial
contraction and increased resistance to ventricular filling. This heart sound is
reffered to as atrial gallop.
What population is the S4 heart sound common with?
, NPTE CARDIOPULMONARY
Patients with hypertension, history of MI, and coronary bypass surgery
A physical therapist examines the breath sounds of a 55-year-old male diagnosed
with pulmonary disease. The therapist identifies crackles during both inspiration
and expiration. This finding is MOST representative of:
1) pleural effusion
2) pulmonary fibrosis
3) impaired secretion clearance
4) localized stenosis
3) impaired secretion clearance
What types of sounds are heard with pleural effusion?
Lungs sounds are usually decreased, but a pleural friction rub may be heard if the
pleural surfaces are inflamed
What is pulmonary fibrosis?
Type of restrictive lung dysfunction characterized by changes to the alveoli and
lung architecture from an inflammatory process. The inflammatory changes cause
scarring and fibrotic lesions in the lungs which result in decreased lung
compliance, lung volumes, diffusing capacity, increased pulmonary arterial
pressure, and work of breathing.
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