5. Respiratory system thorax Flashcards
How do we examine the thorax?
- inspection
- palpation
- auscultation
- percussion
What are the further examination methods of the thorax?
- 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
What do you look for in a bronchial fluid analysis?
Quality Cytological Bacteriological Mycological Virological Parasitological
How do you take a bronchial fluid sample?
-via endoscope or transtracheal wash
Standpoint of a chest inspection:
- skin
- size, shape
- bilateral symmetry
- local deformities
Standpoint of a respiratory movements (RM)
a) frequency
b) rhythm
c) type
d) depth
Thorax inspection:
- Chest
- Respiratory movements (RM)
What is the frequency of respiratory movements?
30/min!!!!
What is increased respiratory frequency called?
polypnea or tachypnea
What is decreased respiratory frequency called?
olygopnea or bradypnea
How does the respiratory frequency increase normally?
under movement excitement work high temperature, obesity pregnancy
How does the respiratory frequency increase abnormally?
fever, hypoxia, hypercapnia, pain, in respiratory
organs
How does the respiratory frequency decrease abnormally?
CNS diseases, barbiturate toxicosis, shock, agony
How do you describe a normal respiratory rhythm?
Periodic rhythmical inspiration and expiration, inspiration is a little bit longer
How do we describe a normal respiratory types?
costal-costoabdominal in dogs and cats
How do we describe an abnormal respiratory types?
Costal respiration or Abdominal respiration
Describe costal respiration:
- 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
Describe abdominal respiration:
-painy chest diseases and paralysis of intercostal muscles
How can we describe the respiratory rhythm?
-Held inspiration
-Held expiration
-Shorter inspiration or expiration
-Asymmetric breathing
Intermittent inspiration
What can cause held inspiration?
- narrowed upper airway’s
- higher abdominal pressure (pregnancy, ascites, meteorism)
What can cause held expiration?
- decreased lung elasticity
- microbronchitis
What can cause shorter inspiration or expiration?
-inhibition about pain
What can cause asymmetric breathing?
- one main bronchus obstruction
- pain in one chest
What can cause intermittent inspiration?
- normally during excitement, long exhausting work
- abnormally: at painy chest disorder
How should normal respiratory depth be like?
medium deep
How do you describe abnormal respiratory depth?
- Shallow (superficial) respiration
- Deep respiration
Describe shallow respiration?
- cases of severe dyspnea
- painful diaphragm and chest diseases
- respiratory center damage
Describe deep respiration?
- after fast movement
- at hypoxia
- may the characteristic sign of dyspnea
Describe dyspnea:
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
Types of dyspnea?
- Inspiratory dyspnea
- Expiratory dyspnea
- Mixed dyspnea
What can be the cause of INSPIRATORY dysnea?
-narrowed upper airways (stridor) (laryngeal edema, laryngeal paralysis, stenotic nares, etc) -pneumothorax -pleural effusions -diffuse pneumonia
What are the signs of INSPIRATORY dyspnea?
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
What can be the cause of EXPIRATORY dysnea?
- compression or obstruction of lower air passages
- microbronchitis
- (pulmonary emphysema)
- fibrous pleuritis
- rarely neoplasms in larynx and pharynx
What are the signs of EXPIRATORY dyspnea?
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
What can be the cause of MIXED dysnea?
- decreased compliance
- pulmonary edema
- pulmonary emphysema
- neoplasma
- compressed diaphragm
What are the signs of MIXED dyspnea?
Forced inspiration and expiration
Paradoxical breathing: normal respiration
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
Paradoxical breathing: Paradoxical respiration
the diaphragm moves opposite to the normal directions
of its movements..
When palpating the thorax what do you check?
- Temperature
- Fremitus pectoralis
- Painfullness
- Deformities
When can we find fremitus pectoralis?
we can find it during dry pleurisy, bronchitis, fibrinous pericarditis, stenotic
cardial valves or vave insufficiency
