w3- ECM

Question 1

what are things you want to examine for CV for respiratory?

Answer 1

Voice/tone

Lymphatics

Thorax: Inspection Palpation Percussion Auscultation

carotid

Precordium

pulses

veins

Question 2

differentiate a wheeze vs a crackle

Answer 2

wheeze –> Alveoli and small airways closed during prior expiration are reopened during inspiration

crackle –> •xpired air traveling through narrowed airways acts like a reed instrument

Question 3

differentiate the 3 vocal responses

Answer 3

•Broncophony: voice is much louder than normal; patient’s words not intelligible. Any words, particularly diphthong ‘oy’

•Pectoriloquy: patient’s words are intelligible when spoken or whispered. Any words, particularly with consonants

Egophony: nasal quality to sound of patient’s voice, with intermittency or stuttering. Ask patient to say a long ‘EEE …’ sound

Question 4

describe the heart sounds s1 and s2

Answer 4

• S1 times with closure of the mitral and tricuspid valves; normally it sounds like a single ‘Lub’
• S2 times with closure of aortic and pulmonary valves; normally ‘Dup’ yet can split with respiration

Question 5

what does the s3 sound indicate

Answer 5

• S3 times with rapid, passive filling in early diastole
• Indicates LV failure

Question 6

what is does the s4 sound indicate

Answer 6

•S4 times with rapid, active filling in late diastole from atrial contraction

•Indicates LV stiffness, thickening

Question 7

how do you describe a murmor

Answer 7

crescendo- increasing

decresendo- decreasing