Question

Lab Assignment

Part 1

Discuss the elements of inspection of an anterior and posterior chest wall.

What are three factors that affect tactile fremitus?

Discuss the five (5) factors that can affect auscultation.

Part 2

What are normal heart sounds? Where are they best heard? What do these heart sounds indicate?

What are abnormal heart sounds? What do these heart sounds indicate?

What is a pulse deficit? How is it calculated?

Part 3

Identify the peripheral arterial pulses. Discuss the grading scale for arterial pulses.

Discuss the grading scale for edema. What does the presence of edema indicate?

Discuss the symptoms of Raynaud's disease.

Answer 1

PART 1

Subpart 1

• .kyphosis- abnormal anterior - posterior curvature of spine.
• Scoliosis- Abnormal lateral curvature of spine.
• Barrel chest- bulging out of chest wall
• Pectus carinatum- sternum protruding from the chest.
• Pectus excavatum- sternum sunken in to the chest

Subpart 2

• Thickness of chest wall
• Pitch and intensity
• Relative location of bronchi to the chest wall

Subpart3

1. Shallow breathing
2. Airway obstruction
3. Pneumothorax
4. Pleural effusion
5. Hyperinflation

PART 2

Subpart1

• S1 and S2 are normal heart sounds
• S3 can be normal, but at times it can also be pathological
• S1 is best heard at apex of heart with stethoscope. S2 is also heard , but S1 is louder than S2 at apex.
• S1- first heart sound- lub-- caused by turbulence caused by closure of mitral and tricuspid valve at start of systole.
• S2--dub-- caused by closure of aortic and pulmonary valve at end of systole

Subpart2

• Heart murmurs- most common abnormal heart sound- occours when blood flows faster than normal rate through heart
• Galloping heart sound-includes S3 and S 4-
• noncomplint left ventricle produce s4
• Overly complaint left ventricle produce S 3

Subpart 3

• Pulse deficit is the difference between heart rate and the palpable pulse, seen in atrial fibrillation.
• Pulse deficit-=apical pulse- radial pulse

PART 3

Subpart 1

Peripheral Arterial pulse is detected on femeral, popliteal and dorsalis pedia areas

Preipheral arterial pulse is graded form 0 to + 4

• 0=non palpable pulse
• 1+= faint but detectable pulse
• 2+=slightly more diminished pulse than normal
• 3+= normal pulse
• 4+= bounding pulse

Subpart 2-

• Oedema grading
• Grade 1; 2 mm depth, immediate rebound
• Grade 2; 4 mm depth, rebound in 15 seconds
• Grade 3; 6 mm depth, rebound in 10-39 seconds
• Grade 4; 8 mm depth, rebounds in more than 20 seconds

Presence of oedema is indicative of congestive heart failure, kidney disease, liver disease, and severe lung condition

Subpart 3

Symptoms of RAYNAUD'S DISEASE

• Sensitivity to cold
• Lack of blood supply
• Pallor
• Redness to toes
• Reduced sensation to touch
• Throbbing pain in fingers or toes.