3 Lungs + Thorax

Question 1

lungs

[lobes + size]

Answer 1

R: 3 lobes
L: 2 lobes + larger

Question 2

Points to listen to

Answer 2

Anterior: 6
Posterior: 8
Lateral: 2

Question 3

first bony landmark

Answer 3

sternum

Question 4

landmark for when the trachea bifurcates into L + R main bronchi

Answer 4

anterior: angle of louis
posterior: T3+T5

Question 5

landmark for apices

Answer 5

ant: 2-4cm above clavicle
post: superior to scapula, bw vertebra + midscapula

Question 6

landmark for base

Answer 6

• 6th intercostal @ midclviclr line
• 8th intercostal @ axillary line
• 10th intercostal @ scapular line

Question 7

prevalence of asthma is HIGHEST among

Answer 7

hispanic/puerto rican, native amercn, alaskan, black, filipino,

Question 8

prevalence of asthma is LOWEST among

Answer 8

asian americans + asian pacific islanders

Question 9

cold environment encourages ___ + ____ the need for oxygen

Answer 9

• vasoconstriction

- decreases

Question 10

an environment w incr moisture + humidity has ___ air, individuals will ___ easily and ___ their need for oxygen

Answer 10

• heavy
• tire
• increase

Question 11

as altitude increases, the partial pressure of O decreases. individuals must adapt by…

Answer 11

increasing the rate + depth of resp cycle

Question 12

mouth breathing is assoc w

Answer 12

problems w nose, habit, or air hunger

Question 13

pt who have to prop themselves up or sit up while sleeping may have…

Answer 13

orthopnea: dyspnea while laying down

Question 14

pink reddish mucus may indicate…

Answer 14

tuberculosis

Question 15

questions about nutritional intake is important to determine…

Answer 15

status of production of RBC, hemoglobin

-essential for oxygenation

Question 16

ratio of length of inspiration + expiration

Answer 16

1:2 [I:E]

Question 17

normal costal angle

Answer 17

less than 90 degrees

Question 18

anxiety may demonstrate…

Answer 18

pallor + shallow breathing

Question 19

pt experiencing

• pain
• dyspnea
• restlessness
• anxious
• unable to follow directions

Answer 19

may need immediate medical assistance

Question 20

circumoral cyanosis

Answer 20

bluish/grey mucus membranes in mough

-early sign of resp distress or hypoxia

Question 21

types of abnormal chest configurations

Answer 21

• barrel chest
• pectus carinatum
• pectus excavatum
• scoliosis
• kyphosis

Question 22

barrel chest

Answer 22

anteroposterior diameter=lateral diameter

• ribs are horizontal
• occurs normally w aging or COPD

Question 23

pectus carinatum

Answer 23

forward displacement of sternum w depression of costal cartilage

• congenital deformity
• does not require tx

Question 24

pectus excavatum

Answer 24

depression of sternum + adjacent costal cartilage

-all of sternum may be involved but its usually the lower portion where the body meets the xiphoid process

Question 25

if pectus excavatum is severe,

Answer 25

chest compression may interfere w respiration | -murmurs may be present w cardiac compression

Question 26

kyphosis

Answer 26

exaggerated curvature of THORACIC | -assoc w aging

Question 27

severe kyphosis...

Answer 27

may decr lung expansion + incr cardiac problem

Question 28

scoliosis

Answer 28

lateral curvature + rotation of thoracic + lumbar spines - more frequent in females - shoulders + pelvis may be elevated

Question 29

w scoliosis, deviates greater than ___ may cause distortion of the lungs

Answer 29

45 degrees -results in decr lung volume or difficulty w interpretation of findings in assessment

Question 30

males tend to breathe ___, and females tend to breathe ___

Answer 30

males: abdominally females: thoracically

Question 31

respiratiin in obese pt may be..

Answer 31

shallow + rapid

Question 32

crepitus

Answer 32

- crunchy feeling under skin | - may be causes by air leaking into subcutaneous tissue

Question 33

fremitus is strongest over ___ and diminishes over ___, and is practically absent in the ____

Answer 33

- trachea - bronchi - over alveoli

Question 34

decreased or absent fremitus may result from...

Answer 34

- soft voice - thick chest wall - underlying disease like COPD or pleural effusion

Question 35

increased fremitus may result from...

Answer 35

- fluid in lungs - fibrosis - tumor - infection

Question 36

how to auscultate posterior thorax in obese pt

Answer 36

- skin folds must be moves | - put arms over the head + lean to opposite side

Question 37

tracheal sounds

Answer 37

harsh, high pitches - over trachea - I

Question 38

bronchial sounds

Answer 38

loud, high pitches - next to trachea - E>I

Question 39

bronchovesicular sounds

Answer 39

medium in loudness + pitch - bw scapulae or next to sternum - over major bronchi - I=E

Question 40

vesicular

Answer 40

soft, low pitched | -I>E : only one where I is greater

Question 41

atelectasis breath sounds

Answer 41

- diminished in both lung | - faint popping sounds if alveoli try to expand