1JO2 Unit 7 Final exam

Question 1

What are the 4 key functions of the respiratory system?

Answer 1

Supplying oxygen to the body for energy production
Removing carbon dioxide as a waste product
Maintains acid-base balance
Maintaining heat exchange ( not as important)

Question 2

What does the pleural cavities contain?

Answer 2

The lungs

Question 3

What does the mediastinum contain?

Answer 3

The esophagus, trachea, heart, and the great vessels

Question 4

Where is the trachea located in relation to the esophagus?

Answer 4

Anteriorly to the esophagus. (In front of it)

Question 5

Where does the trachea part into bronchi?

Answer 5

At the T4 - T5

Question 6

Where does gas exchange occur?

Answer 6

Alveoli, bronchioles, alveolar ducts, alveolar sacs.

Question 7

Where does gas exchange not happen?

Answer 7

The bronchi

Question 8

What lung is shorter? Why?

Answer 8

The right lung is shorter because it is competing for space with the liver.

Question 9

Which lung is narrower? Why?

Answer 9

The left lung because it is competing for space with the heart.

Question 10

Which lung has 3 lobes?

Answer 10

the right lung

Question 11

Where is the 3rd lobe of the lung located?

Answer 11

In the Right Middle Lobe and is only present on the anterior of the chest.

Question 12

Where is the apex of the lung? (Anteriorly)

Answer 12

It is 3 - 4 cm above the clavicles.

Question 13

Where is the base of the lung ?(Posteriorly)

Answer 13

It sits on the diaphragm at around the 6th rib.

Question 14

How much do the lungs inflate? (from what rib to what rib)?

Answer 14

The base of the lung moves from the T10- T12

Question 15

(actual question on the slideshow)
The apex of each lung is located at the:
a) Level of the diaphragm
B) Area slightly over the clavicle
c) Level of the sixth rib
d) Left oblique fissure

Answer 15

B

Question 16

Explain what happens when we breath in.

Answer 16

The pressure inside the lungs drops, which allows air to move inward and then the diaphragm moves downwards and the thoracic cavity expands to allow more air to move in and allows for the lungs to expand more.

Question 17

When are accessory muscles used to breath?

Answer 17

When some one is exercising and has shortness of breath or with a respiratory illness.

Question 18

How is breathing controlled?

Answer 18

It is an autonomic process which is controlled by the brainstem.

Question 19

What is the stimulus that causes us to breath?

Answer 19

The increase of CO2 in the blood, which is called hypercapnia.

Question 20

What is the order of doing a respiratory assesment?

Answer 20

Inspection, palpation, percussion, auscultation - posterior then anterior.

Question 21

What are some questions you can ask when doing a focused respiratory assessment?

Answer 21

What brings you here today?
* Do you have a cough?
* Do you cough up phlegm or sputum? Color?
* Any shortness of breath?
* Difficulty breathing in supine position?
* Any chest pain with breathing?
* Any past history of respiratory infections (pneumonia)
* Any past history of respiratory disease (COPD, asthma)
* Any family history of respiratory disease?
* Assess respiratory risk factors: smoking history
* How many/day? Ever smoked? How long? 2nd & 3rd
hand smoke exposure? Ever tried to quit?
* Environmental exposure to conditions that affect breathing? Work or home environment, etc.
* Potential impact of respiratory system on daily living (participation in leisure activities, exercise, work, chores, sexual activity, sleeping, ADL’s).

Question 22

What position indicates that the client is having trouble breathing?

Answer 22

The tripod position where they are bent over in the chair.

Question 23

What does it mean to be barrel chested?

Answer 23

When the side of the chest is the same width as the front of the chest.

Question 24

What is barrel chested a result of ?

Answer 24

When someone has chronic respiratory disease like COPD. Or where someone has shortness of breath for a long period of time constantly.

Question 25

Where should you asses for symmetric chest expansion?

Answer 25

At the T9 - T10 level. (near the bottom of the rib cage)

Question 26

Where should you asses for tactile fremitus (Posteriorly) ?

Answer 26

Along the spinal column on each side 4 times downwards then lastly once to the side of the back.

Question 27

Where should you feel more vibrations (Posteriorly) ?

Answer 27

At the top of the chest.

Question 28

If someone has decreased fremitus, what does this mean?

Answer 28

It means that they have something that is obstructing the transmission of the vibration, for example an obstructed bronchus, pneumothorax.

Question 29

If someone has increased fremitus what does this mean?

Answer 29

It means they have a later stage of pneumonia.

Question 30

When percussing where should you hear resonance? Dullness?

Answer 30

It should be resonant above the scapula and around it. It should be dull on top of the scapula and it should also be dull above the abdominal organs.

Question 31

Where should you percuss posteriorly?

Answer 31

In 9 locations, the first 3 should be above the scapula, then the 2- 5 should be down the spine, then 6-9 should be in a square shape off to the side. This should be done on both sides of the spine.

Question 32

What is hyper-resonance? and what can it signal?

Answer 32

It is a lower-pitched booming sound when there is to much air present in the lungs like in a pneumothorax.

Question 33

What can a dull note signal?

Answer 33

It signals an abnormal density in the lungs like in pneumonia or a tumor.

Question 34

Where should you auscultate posteriorly?

Answer 34

The 9 locations are exactly the same as percussion only instead of listening 3 times above the scapula you only need to listen once.

Question 35

When auscultating posteriorly what part of the stethoscope should you use?

Answer 35

The diaphragm.

Question 36

How long should you auscultate in each location posteriorly?

Answer 36

1 full respiration

Question 37

What are the 3 sounds that we should be able to identify when auscultating?

Answer 37

Vesicular, Bronchial, Bronchovesicular.

Question 38

Where normally should you hear the bronchial sounds? (Posteriorly)

Answer 38

In the neck specifically the trachea and larynx.

Question 39

Where should you hear the Bronchovesicular sounds? (Posteriorly)

Answer 39

Over the bronchi, right next to the spine and between the scapula.

Question 40

Where should you hear vesicular breath sounds? (posteriorly)

Answer 40

Over the lungs. Or everywhere else but the other 2.

Question 41

How should the duration of the Bronchial breath sound like? (Inspiration/Expiration?)

Answer 41

The inspiration should sound shorter then the expiration.

Question 42

How should the duration of the Bronchovesicular breath sound like? (Inspiration/Expiration?)

Answer 42

Inspiration and expiration should sound equal.

Question 43

How should the duration of the vesicular breath sound like? (Inspiration/Expiration?)

Answer 43

Inspiration should sound longer then expiration.

Question 44

Where should you palpate anteriorly?

Answer 44

There are 4 locations, in males and 3 in females. the first location is above the clavicle mid-clavicular, the second is mid-clavicular at the horizontal level of the axilla. Then the 3 is only done on males because you can't do it on females. The the 4th one is around the 5th intercostal space midclavicular.

Question 45

Where should you hear resonance when percussing anteriorly?

Answer 45

Above the clavicle, pretty much the entire chest minus the area closest to the clavicle.

Question 46

Where should you hear dullness? (anteriorly)

Answer 46

In the area around the sternum and overtop of the liver.

Question 47

Where should you hear tympany? (anteriorly)

Answer 47

Over top of the stomach.

Question 48

Where should you auscultate anteriorly?

Answer 48

In the same locations as percussion.

Question 49

What are adventitious breath sounds?

Answer 49

Crackles and wheezes.

Question 50

When are wheezes heard?

Answer 50

On expiration

Question 51

What are wheezes a symptom of?

Answer 51

Bronchitis or asthma.

Question 52

What is stridor?

Answer 52

It is a barking cough

Question 53

When is stridor heard?

Answer 53

On inspiration

Question 54

What is stridor a symptom of ?

Answer 54

Croup, acute epiglottis, foreign body, altered anatomy

Question 55

What do course crackles sound like?

Answer 55

Loud, low pitched, bubbling or gurgling sound.

Question 56

What are course crackles a result of?

Answer 56

Fluid or inflammation in the lungs.

Question 57

Where are fine crackles heard?

Answer 57

The loudest at the base.

Question 58

What are fine crackles a result of?

Answer 58

secretions in the alveoli and it usually happens to bed ridden adults.

Question 59

What are some developmental considerations for pregnant women?

Answer 59

They have a elevated diaphragm to make room for the growing fetus. And then to compensate for the elevated diaphragm their thoracic is wider to make more room to take a breath in.

Question 60

What are some developmental considerations for older adults?

Answer 60

They are more likely to have a barrel chest and less chest expansion. They have fewer alveoli, and have increased shortness of breath on exertion. lastly they have a higher chance of post op complications.

Question 61

What are some developmental considerations for infants and children?

Answer 61

Crying increases tactile fremitus, it is more difficult to localize breath sounds. Nose flaring indicates distress.

Question 62

What is the cause of almost all pediatric arrests?

Answer 62

They are almost always due to respiratory issues.

Question 63

What are the 4 respiratory issues that can cause arrests?

Answer 63

Upper airway obstruction (ex. croup, obstruction) Lower airway obstruction (ex. asthma, bronchitis) Lung tissue disease (ex. pneumonia, pulmonary edema) Disordered control of breathing (ex. seizures, drug overdose)

Question 64

What is an upper airway obstruction caused by?

Answer 64

Croup or any type of obstruction

Question 65

What is a lower airway obstruction caused by?

Answer 65

Asthma and bronchitis.

Question 66

What is lung tissue disease caused by?

Answer 66

Pneumonia and pulmonary edema.

Question 67

What is disordered control of breathing caused by?

Answer 67

Seizures and drug overdoses.

Question 68

What are the signs and symptoms of an upper airwayobstruction?

Answer 68

increased respiratory rate and more effort used, use of accessory muscles, nasal flaring, stridor, barking cough, poor chest rise.

Question 69

What are the signs and symptoms of a lower airway obstruction?

Answer 69

Increased RR, Retractions, flaring, prolonged expiration, wheezing and cough.

Question 70

What are the signs and symptoms of a lung tissue disease?

Answer 70

Crackles and decreased breath sounds.

Question 71

What are the signs and symptoms of disordered control of breathing?

Answer 71

Variable and irregular respiratory rate, shallow breathing and apnea.

Question 72

What is the most common cause of lower respiratory disease in infants worldwide?

Answer 72

RSV (Respiratory syncytial virus)