PA-Week 4 - Thorax/Breast

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Author:
amanda430
ID:
305102
Filename:
PA-Week 4 - Thorax/Breast
Updated:
2015-07-12 12:59:18
Tags:
PA EXAM
Folders:
PA
Description:
Exam 2-Breast/Thorax
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  1. Where is the tail of spence?
    in the upper lateral of the breast
  2. What types of tissue are breast made up of?
    • glandular tissue: 15-20 lobes
    • Fibrous bands, including suspensory ligaments
    • Adipose Tissue
  3. What lymph nodes drain the breasts?
    • central axxillary nodes
    • pectoral nodes
    • subscapular nodes
    • lateral axxillary nodes
  4. What are the Tanner Stages?
    the 5 stages of maturation in a woman
  5. What is gynecomastia?
    swelling of breast tissue in men
  6. What is breast tissue swelling in men called?
    gynecomastia
  7. What are some unchangeable risk factors for breast cancer?
    • Female
    • >50 y/o
    • Hx of breast cancer
    • BRCA 1 or 2 mutation
    • 1st degree relative with breast cancer
    • prior radiation
    • menarch <12
    • menopause >50
  8. What is mastalgia?
    pain in the breast
  9. What is pain in the breast called?
    mastalgia
  10. when is a mammogram recommended?
    after 40 or 60
  11. What is one of the first things you do during a breast examination
    ensure pt's privacy
  12. What is masstitis?
    Swelling of the breast
  13. What is swelling of the breast called?
    masstitis
  14. What is dimpling?
    anything that sticks to the chest wall
  15. What is inframammoryridge?
    tissue under the breast that gets compressed
  16. When is discharge from the breast normal?
    pregnancy, lactating
  17. How do you describe a lump?*
    • Location
    • Size
    • Shape
    • Consistency
    • Movility
    • Distinctness-solitary, multiple
    • Nipple-displace, retracted
    • overlying skin
    • tenderness
    • lymphadenopathy (tender lymph nodes
  18. Where do males tend to get breast cancer
    under the nipple
  19. What is fibroadenobas?
    • a firm lobule, mobile, usually non-tender, shows on US, needs biopsy
    • usually aged 15-25
  20. What is a firm lobule that is mobile, non tender and shows in an US in younger women called?
    Feibroadenombas
  21. Describe Fibrocystic breast disease
    • soft to firm, mobile, often tender, single or multiple
    • Age 30-50
    • Too much caffeine can aggravate it
  22. What is a soft to firm lump that is mobile, often tender, single or multiple and occurs between 30-50 y/o called?
    Fibrocystic breast disease
  23. When is breast cancer most common?
    women >50 y/o
  24. What is invasive breast cancer?
    spread from lobule of milk duct to other tissue
  25. What is non-invasive breast cancer?
    Still inside the lobule or milk duct (INSITO)
  26. What is peau d'orange?
    • breast looks like an orange
    • not a good sign
    • can be localized or the whole breast
  27. What are the 3 parts of the sternum?
    manubrium, body, xiphoid process
  28. What is the angle of louis?
    The manubriosternum angle
  29. Where is the costal angle?
    At the bottom of the xiphoid process where the fibs dissect
  30. What are the two different types of pleurae and where are they?
    • Lungs
    • parietal:outer
    • Visceral: inner
  31. What is the pleural sac?
    surrounds the lungs
  32. What does clear stringy sputum indicate?
    viral infection
  33. What does yellow/green sputum indicate?
    bacterial infection
  34. What does rust colored sputum indicate?
    TB, Pneumococcal Pneumonia
  35. What does frothy pink sputum indicate**
    pulmonary edema
  36. What is dyspnea?
    difficulty breathing
  37. What is orthopnea?
    • difficulty lying down
    • symptom of emphysema
  38. What is hemoptysis?
    coughing up blood
  39. What is tactile fremitus?
    resonance
  40. What do you do during a PE of the lungs?
    • inspect
    • check respiratory excursion
    • palpate tactile fremitus
    • percuss for symmetry
    • diaphragmatic excursion
    • auscultate post chest
    • repeat on the anterior
  41. What is the AP to transverse ratio?
    2:1
  42. What is the angle of the costal angle?
    <or = to 90
  43. What is an adult RR
    10-20
  44. Describe barrel chested?
    A:P to transverse ratio is 1:1
  45. What is pectus excavatum?
    breast bone is depressed, only an issue if it interferes with breathing
  46. What is pectus corinatum?
    breast bone protrudes
  47. What is kyphosis?
    hump on back
  48. What is a hump on the back called?
    kyphosis
  49. What is a pink puffer?
    pink complextion, SOB, COPD pt(emphysema, chronic bronchitis)
  50. What is a blue bloater?
    • cyanosis, decreased lung capacity, can be RIGHT side heart failure
    • COPD
  51. What is tachypnea?
    RR >20 per min
  52. What is bradypnea?
    RR < 10 per min
  53. What is Kussmaul?
    Tachypnea with deep breaths
  54. What is Cheyne-Stokes?
    regular breathing w. long pauses
  55. What is Biot's pattern?
    • erradic
    • bad sign
  56. Increased tactile fremitius is an indication of what
    pneumonia
  57. decreased tactile fremitus is an indication of what
    obstructed bronchus
  58. What does dullness in the lungs indicate?
    fluid or blockage
  59. What is thorocentisis?
    Dr drains excess fluid from dull area
  60. Where should resonsance be heard till?
    T 10
  61. What is louder with vesicular sounds?
    inspiration > expiration
  62. What is greater with bronchovesicular?
    inspiration = expiration
  63. What is louder in bronchial?
    inspiration < expiration
  64. Where are vesicular sounds heard?
    most of the lung
  65. What are bronchovesicular sounds heard?
    mid chest anteriorly and between scapula
  66. Where are bronchial sounds heard?
    over trachea
  67. What does rhonca sounds like?
    snoring
  68. What are sibilant wheezes associated with?
    asthma
  69. What is bronchophony?
    hear 99 through stethescope clearly, pneumonia
  70. What is egophony
    E turns to A indicates fluid
  71. Whispered pectoriloquy
    hear whisper distinctly, indicates fluid
  72. What is different about infants?
    • barrel chested until 6 y/o
    • breath through nose mainly until 3 months
    • RR 30-40
  73. Describe normal lung
    • trach- midline
    • tactile fremitus- normal
    • percussion- resonant
    • breath sounds- vesicular except for lg bronchi or tachea
    • adventitiou sounds- non
  74. Describe Atelectasis
    • Trahcea: shifted toward side¬†
    • TM : usually absent
    • Percussion: dull over affected area
    • Breath sounds: absent over obstruction
    • Adventitious sounds: none
  75. Describe Consolidation-Pneumonia
    • trach: midline
    • TM: increased over area with fluid
    • Percussion: dull over airless areas
    • Breath sounds: bronchial over involved area
    • Adventitious sounds: crackles over involved area during late inspiration
  76. Bronchitis
    • Trac: Midline
    • TF: Normal
    • Percussion: Resonant
    • Breath Sounds: Vesicular except over lg bronchi or trach
    • Adventitious sounds: may hear crackles or wheezes or rhoncha
  77. Emphysema (alveoli are distended so pt cannot get air out
    • trach: midline
    • TF: Decreased
    • Percussion: Hyperressonant
    • Breath Sounds: decreased or absent
    • Adventitious sounds: none or scatter crackling during early inspirations or sounds associated with bronchitis
  78. Ashthma
    • Trac: Midline
    • TF: Decreased
    • Percussion: Resonant to Hyper resonant
    • Sounds: wheezes
    • Adventitious Sounds: Wheezes
  79. Pleural Effusion (too much liquid in pleurae)
    • Trach: shifts away from involved side
    • TF: Decreased to absent
    • ¬†Percussion: dull over fluid
    • Breath Sounds: decreased to absent over affected area
    • Adventitious Sounds: None, except for possible rub
  80. Pneumothorax (air leaks out of lung into chest)
    • Trach: Shifted away
    • TF: decreased or absent over pleural air
    • Percussion: hyperressonant over pleural air
    • Sounds: decreased to absent over pleural air
    • Adventitious sounds: none
  81. CHF
    • Trach: Midline
    • TF: Decreased
    • Percussion: Resonant
    • Sounds: Vesicular
    • Adventitious Sounds: late inspiratory crackles in dependent portion of lung, maybe wheezes

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