5. Respiratory system thorax

Question 1

How do we examine the thorax?

Answer 1

• inspection
• palpation
• auscultation
• percussion

Question 2

What are the further examination methods of the thorax?

Answer 2

• X-ray
• ultrasonography
• endoscopy
• bronchial fluid sample (BAL)
• bronchial fluid analysis
• thoracocentesis, biopsy
• CT, MR, scintigraphy
• thoracotomy
• lung function testing
• blood count, acid-base analysis

Question 3

What do you look for in a bronchial fluid analysis?

Answer 3

Quality
Cytological
Bacteriological
Mycological
Virological
Parasitological

Question 4

How do you take a bronchial fluid sample?

Answer 4

-via endoscope or transtracheal wash

Question 5

Standpoint of a chest inspection:

Answer 5

• skin
• size, shape
• bilateral symmetry
• local deformities

Question 6

Standpoint of a respiratory movements (RM)

Answer 6

a) frequency
b) rhythm
c) type
d) depth

Question 7

Thorax inspection:

Answer 7

• Chest

- Respiratory movements (RM)

Question 8

What is the frequency of respiratory movements?

Answer 8

30/min!!!!

Question 9

What is increased respiratory frequency called?

Answer 9

polypnea or tachypnea

Question 10

What is decreased respiratory frequency called?

Answer 10

olygopnea or bradypnea

Question 11

How does the respiratory frequency increase normally?

Answer 11

under movement
excitement
work
high temperature,
obesity
pregnancy

Question 12

How does the respiratory frequency increase abnormally?

Answer 12

fever, hypoxia, hypercapnia, pain, in respiratory

organs

Question 13

How does the respiratory frequency decrease abnormally?

Answer 13

CNS diseases, barbiturate toxicosis, shock, agony

Question 14

How do you describe a normal respiratory rhythm?

Answer 14

Periodic rhythmical inspiration and expiration, inspiration is a little bit longer

Question 15

How do we describe a normal respiratory types?

Answer 15

costal-costoabdominal in dogs and cats

Question 16

How do we describe an abnormal respiratory types?

Answer 16

Costal respiration or Abdominal respiration

Question 17

Describe costal respiration:

Answer 17

• the function of the diaphragm is lost (abdominal pain caused by inflammation)
• increased abdominal pressure, (pregnancy, meteorism, ascites)
• narrowed upper airways, compression of the lung

Question 18

Describe abdominal respiration:

Answer 18

-painy chest diseases and paralysis of intercostal muscles

Question 19

How can we describe the respiratory rhythm?

Answer 19

-Held inspiration
-Held expiration
-Shorter inspiration or expiration
-Asymmetric breathing
Intermittent inspiration

Question 20

What can cause held inspiration?

Answer 20

• narrowed upper airway’s

- higher abdominal pressure (pregnancy, ascites, meteorism)

Question 21

What can cause held expiration?

Answer 21

• decreased lung elasticity

- microbronchitis

Question 22

What can cause shorter inspiration or expiration?

Answer 22

-inhibition about pain

Question 23

What can cause asymmetric breathing?

Answer 23

• one main bronchus obstruction

- pain in one chest

Question 24

What can cause intermittent inspiration?

Answer 24

• normally during excitement, long exhausting work

- abnormally: at painy chest disorder

Question 25

How should normal respiratory depth be like?

Answer 25

medium deep

Question 26

How do you describe abnormal respiratory depth?

Answer 26

- Shallow (superficial) respiration | - Deep respiration

Question 27

Describe shallow respiration?

Answer 27

- cases of severe dyspnea - painful diaphragm and chest diseases - respiratory center damage

Question 28

Describe deep respiration?

Answer 28

- after fast movement - at hypoxia - may the characteristic sign of dyspnea

Question 29

Describe dyspnea:

Answer 29

The dyspnea caused by difficulties of respiration (compression, obstruction of the air passages, decreased lung compliance). During resting or better at works the muscles working in respiration seem to do their work forcedly

Question 30

Types of dyspnea?

Answer 30

1. Inspiratory dyspnea 2. Expiratory dyspnea 3. Mixed dyspnea

Question 31

What can be the cause of INSPIRATORY dysnea?

Answer 31

``` -narrowed upper airways (stridor) (laryngeal edema, laryngeal paralysis, stenotic nares, etc) -pneumothorax -pleural effusions -diffuse pneumonia ```

Question 32

What are the signs of INSPIRATORY dyspnea?

Answer 32

Prolonged and labored inspiration! Inspiratory phase is longer, extension of the head and neck, nostril dilatation, labial respiration, spreading of the scapules,exaggerated intercostal activity, slack or sunken flanks and sagging belly

Question 33

What can be the cause of EXPIRATORY dysnea?

Answer 33

- compression or obstruction of lower air passages - microbronchitis - (pulmonary emphysema) - fibrous pleuritis - rarely neoplasms in larynx and pharynx

Question 34

What are the signs of EXPIRATORY dyspnea?

Answer 34

prolonged and labored exspiration Expiratory phase is longer, the work of abdominal muscles is more severe, extension of the head and neck, thorax very fasten collapsed during expiration. Expiratory dyspnea is abdominal, duplicate or strongly held

Question 35

What can be the cause of MIXED dysnea?

Answer 35

- decreased compliance - pulmonary edema - pulmonary emphysema - neoplasma - compressed diaphragm

Question 36

What are the signs of MIXED dyspnea?

Answer 36

Forced inspiration and expiration

Question 37

Paradoxical breathing: normal respiration

Answer 37

both the abdomen and chest move in and out together, allowing maximum expansion of the lungs. The diaphragm normally moves downwards during inspiration and upwards during expiration

Question 38

Paradoxical breathing: Paradoxical respiration

Answer 38

the diaphragm moves opposite to the normal directions | of its movements..

Question 39

When palpating the thorax what do you check?

Answer 39

- Temperature - Fremitus pectoralis - Painfullness - Deformities

Question 40

When can we find fremitus pectoralis?

Answer 40

we can find it during dry pleurisy, bronchitis, fibrinous pericarditis, stenotic cardial valves or vave insufficiency