2410 thorax&lungs

Question 1

landmarks in anterior thorax 2 important indications

Answer 1

angle of louis

1. tracheal bifurcation
2. upper border of atria

Question 2

landmarks of posterior thorax

Answer 2

c7 & t1 spinous proceses

Question 3

anterior location of (R) lung

Answer 3

apex: 3-4 cm above clavicle
base: 6th rib MCL

Question 4

describe (R) lung fissures

Answer 4

oblique fissure: 5th rib MAL ->6th rib MCL

horizontal fissure: 5th rib MAL -> 4th RSB

Question 5

(L) lung lobe #, describe fissure

Answer 5

2 lobes, 5th rib MAL -> 6th rib MCL

Question 6

differences btw (R) & (L) lungs

Answer 6

(R) lung shorter 3 lobes

(L) narrower 2 lobes

Question 7

posterior position of lungs: apex, base, upper & lower lobe

Answer 7

Apex: c7/t1
base: t10, t12 (inspiration)
upper lobe: t1-.t3/t4
lower lobe: t10 (t12 inspiration)

Question 8

define pleurae

Answer 8

serous membranes btw lungs and chest wall

Question 9

describe 2 types of pleurae

Answer 9

visceral: line the lungs
parietal: line chest wall

Question 10

infant/children developmental considerations

1. airways
2. alveoli
3. risk

Answer 10

1. diameter of airways is small
2. less alveoli
3. higher risk for resp. dz

Question 11

pregnancy developmental considerations

1. diaphragm
2. expansion
3. chest
4. o2

Answer 11

1. uterus pushes diaphragm up 4cm
2. lungs expand horizontally
3. diameter of chest expands
4. higher o2 needs increased tidal volume

Question 12

elderly develop. considerations

1. cartilage
2. thorax
3. lungs
4. alveoli
5. risk
6. funx

Answer 12

1. coastal cartilage becomes calcified
2. thorax less mobile
3. lungs are less elastic
4. decreased # of alveoli
5. higher risk for atelectasis & infx
6. decreased cough and increased secretions

Question 13

was does a cough indicate when
continuous
afternoon
evening
early morning

Answer 13

1. acute illnes
2. irritants
3. sinusitis, postural drainage
4. brochitis

Question 14

what do these sputum colors indicate
white/clear
yellow/green
rust
pink/frothy

Answer 14

1. whiteclear: colds bronchitis
2. yellow, green: bacterial
3. rust:TB
4. pink,froth: CHF pulmonary embolism

Question 15

normal

1. ap:lateral diameter ratio
2. slope of ribs

Answer 15

1:2 or 5:7

45 degrees

Question 16

abnorm ap:lat diameter ratio & costal angle

Answer 16

ap=lat (barrel chest)

greater than 90 degrees (emphysema copd)

Question 17

define retraction

Answer 17

drawing back of interspaces or bulging of interspaces

Question 18

define cheyne stokes

Answer 18

hyperpnea with apnea

Question 19

2 palpations of posterior thorax

Answer 19

1. respiratory expansion (t9/t10)

2. tactile fremitus (vibrations when pt says 99/blue moon) check for symmetry

Question 20

cause of increased fremitus

causes of decreased fremitus

Answer 20

1. consolidation of lung (pneumonia)

2. obstruction of transmission of vibrations (pleural effusion, pneumothorax, obstruction of bronchus)

Question 21

what is rhoncal fremitus,

Answer 21

thick bronchial secretions

Question 22

what is pleural friction rub

Answer 22

inflammation of pleurae that causes grating sensation

Question 23

what is crepitus

Answer 23

crackling sensation on skin, happens b/c of sub cutaneous emphysema or thoracic surgery or injury