Abnormalities: Thorax and Lungs

Question 1

Barrel Chest

Answer 1

• ribs are horizontal rather than the usual downward slope. AP = Transverse Diameter, costal angle >90 degrees.
• common in COPD patients d/t hyperinflation of the lungs.

Question 2

Pectus Carinatum

Answer 2

(pigeon breast/chest) forward protusion of the sternum

Question 3

Tachypnea

Answer 3

increased RR, rapid shallow breathing

Question 4

Bradypnea

Answer 4

slow breathing pattern

less than 10 respirations/minute

Question 5

cheyne-strokes respirations

Answer 5

• respirations gradually wax and wane, with periods of apnea

- in a regular pattern, usually a sign of a poor prognosis

Question 6

pleural effusion

Answer 6

-collection of excess fluid in the intrapleural space.

Question 7

pneumothorax

Answer 7

free air in pleural space causes lungs to collapse.

Question 8

tuberculosis

Answer 8

• positive PPD and positive chest x-ray
• very contagious
• incidence is on the rise

Question 9

bronchitis

Answer 9

• inflammation of the bronchi

- may have partial obstruction of bronchi from secretions or inflammation causing constriction

Question 10

bronchitis is characterized by

Answer 10

• hacking, mucousy wet cough and often productive cough.

- crackles with auscultation, usually CXR are clear.

Question 11

pneumonia

Answer 11

• infection of the lung parenchyma,

- alveoli become consolidated with bacteria and fluid

Question 12

pneumonia is characterized by

Answer 12

• lung sounds include crackles or are diminished
• dull note
• decreased chest expansion
• SOB, dyspnea, anxiety, malaise
• fever, dry nonproductive cough, tachypnea

Question 13

asthma

Answer 13

reactive airway disease, an allergic response or hypersensitivity to allergens, irritants, microorganisms, and exercise.

Question 14

asthma is characterized by

Answer 14

• bronchospasm

- inflammation and very thick mucous production in the airways

Question 15

What are the most common presenting symptoms for asthma?

Answer 15

• wheezing (usually respiratory)
• dyspnea
• chest tightness or decreased air exchange/movement
• anxiety
• SOB, increased RR
• resonance

Question 16

Atelectasis

Answer 16

• collapsed section of lung or entire lung.
• significantly decreased or absent lung sounds over affected area. lag on expansion
• dull note, increased respiratory rate and pulse

Question 17

tuberculosis is characterized by

Answer 17

a productive cough in which sputum is usually purulent and thick and rust colored or yellow-green; night sweats, low grade fever

Question 18

pectus excavatum

Answer 18

sunken sternum and adjacent cartilages.

Question 19

pectus carinatum

Answer 19

forward protrusion of the sternum, with ribs sloping back at either side and vertical depressions along costochondral junctions.

Question 20

kyphosis

Answer 20

exaggerated posterior curvature of the thoracic spine (humpback)

Question 21

increased tactile fremitus

Answer 21

occurs with conditions that increase the density of lung tissue, thereby making a better conduction medium for vibrations.

Question 22

decreased tactile fremitus

Answer 22

occurs when anything obstructs transmission of vibrations.

Question 23

rhonchal fremitus

Answer 23

vibration felt when inhaled air passes through thick secretions in the larger bronchi. May decrease somewhat by coughing.

Question 24

pleural friction fremitus

Answer 24

produced when inflammation of the parietal or visceral pleura causes a decrease in the normal lubricating fluid.
opposing surfaces make a coarse grating sound when rubbed together during breathing.

Question 25

pulmonary edema is characterized by

Answer 25

Pink, frothy sputum

Question 26

paroxysmal nocturnal dyspnea

Answer 26

awakening from sleep with SOB and needing to be upright to achieve comfort

Question 27

Aging effects on older adults related to the thorax and lungs

Answer 27

• have less efficient respiratory system (decreased vital capacity, less surface area for gas exchange); thus they have less tolerance for activity
• feel pleuritic pain less intensely than younger adults.

Question 28

People with COPD are often seen

Answer 28

in a tripod position, leaning forward with arms braced against their knees, chair or bed.

Question 29

Unequal chest expansion occurs with

Answer 29

marked atelectasis, lobar pneumonia, pleural effusion, thoracic trauma (fractured ribs or pneumothorax)

Question 30

crepitus

Answer 30

• coarse, crackling sensation palpable over the skin surface.
• occurs when air escapes from the lung and enters the SQ tissue, as after open thoracic injury or surgery.

Question 31

hyperresonance

Answer 31

a lower-pitched, booming sound when too much air is present such as emphysema or pneumothorax

Question 32

dull note

Answer 32

signals abnormal density in the lungs as with pneumonia, pleural effusion, atelectasis, or tumor

Question 33

increased breath sounds

Answer 33

• sounds are louder than they should be.
• high-pitched, tubular quality, with a prolonged expiratory phase and a distinct pause between inspiration and expiration

Question 34

crackles are sounds heard over

Answer 34

inspiration

Question 35

wheezes are heard mainly over

Answer 35

expiration

Question 36

consolidation or compression of lung tissue will

Answer 36

enhance the voice sounds, making the words more distinct

Question 37

Common indicators of pleural effusion

Answer 37

• crackles
• increased RR, dyspnea
• dull percussion

Question 38

Common indicators of pneumothorax

Answer 38

• unequal chest expansion
• tachycardia, decreased BP
• hyperresonance