Assessment of the Lungs and Thorax Flashcards

1
Q

When would tactile fremitus increase?

A

when the patient has an advanced case of pneumonia

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2
Q

Subcutaneous Emphysema

A

when gas or air is in the layer under the skin

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3
Q

Bronchovesicular Breath Sounds

A
  • inspiration to expiration periods are equal

- normal sounds in the mid-chest area or in the posterior chest between the scapula

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4
Q

Vesicular Breath Sounds

A
  • heard across the lung surface
  • lower-pitched, rustling sounds with higher intensity during inspiration
  • Inspiration is normally 2-3 times the length of expiration
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5
Q

Broncheal Breath Sounds

A
  • over the trachea
  • higher pitch
  • louder
  • inspiration and expiration are equal and there is a pause between inspiration and expiration
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6
Q

Tracheal Breath Sounds

A
  • sounds heard over the sternum
  • louder and higher-pitched than vesicular sounds
  • expiratory phase is as long as or longer than the inspiratory phase
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7
Q

Crackles

A
  • “rales”
  • occurs on inspiration
  • fine
  • coarse
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8
Q

Wheezes

A
  • “ronchi”

- occurs on expiration

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9
Q

Stridor

A
  • inspiration
  • high-pitched, wheezing sound
  • “musical”
  • caused by block in trachea
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10
Q

Atelectatic Crackles

A

Late inspiratory crackles

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11
Q

How far do the lungs expand?

A

from apex of axilla down to 7th or 8th rib

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12
Q

Developmental Conditions: Aging Adult

A
  • costal cartilages become calcified
  • muscle strength declines
  • decrease elasticity within lungs
  • increased risk of postoperative pulmonary complications
  • increased AP diameter “kyphosis”
  • care with auscultation (allow rest periods)
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13
Q

Developmental Considerations: Infants and Children

A
  • airways are smaller, cartilage is more elastic
  • increased risk for airway obstruction related to disease processes
  • smaller children tend to be abdominal breathers
  • tongue is larger compared their airway (obstruction risk is higher)
  • nasal breathing (mostly neonates)
  • AP 1:1 in neonates
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14
Q

APGARS

A

test after birth to see how baby handled the birthing process

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15
Q

How long should you listen to a child’s resps?

A
  • 1 min (too irregular for 30sec)
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16
Q

Developmental Considerations: Pregnant Women

A
  • thoracic cage may appear wider
  • more “aware” of breathing
  • respirations may be deeper with other changes occurring in the body
  • costal angle increases
  • rib injury
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17
Q

Why do pregnant ladies experience dyspnea?

A

uterus pushes up on diagram

18
Q

Atelectasis

A
  • diaphragm elevates to fill in space left by shrunken section
  • bronchial obstruction causing collapsed area
19
Q

Lobar Pneumonia

A
  • alveoli consolidated with fluid
  • bacteria
  • RBCs
  • WBCs
20
Q

Bronchitis

A
  • inflated primary and secondary bronchi
  • acute bronchitis usually results from an infection such as a cold or flu
  • bronchial inflammation and copious secretions
  • deflated alveoli beyond obstruction
21
Q

Emphysema

A
  • alveoli with emphysema
  • microscopic view of normal alveoli
  • over distended alveoli with destruction of sepia
22
Q

COPD

A
  • easily fatigued
  • frequent respiratory infections
  • use of accessory muscles to breath
  • orthopneic
  • wheezing
  • pursed-lip breahting
  • chronic cough
  • barrel chest
  • dyspnea
  • prolonged espiratory time
  • clubbing
23
Q

Asthma

A

edema of bronchial mucosa/ thick mucus

24
Q

Pleural Effusion

A
  • build-up of excess fluid between the layers of the pleura
25
Pneumothorax
- air in pleural space due to lung wall rupture or leak in chest wall - lung collapse
26
Which is the highest flow of oxygen delivery?
venturi mask
27
What does Pursed-Lip Breathing prevent?
alveolar collapse
28
The trachea is ____ while the mouth is _____.
- sterile | - clean
29
Normal pH
(acidosis)7.35-7.45(alkalosis)
30
Normal PaCO2
(resp alkalosis) 35-45 (resp acidosis)
31
Normal PaO2
(resp acidosis) 80-100 (resp alkalosis)
32
Normal HCO3
(metabolic acidosis) 22-26 (resp alkalosis)
33
METRO
- metabolic together | - respiratory opposite
34
Normal RR
10-18
35
Eupnia
- unlabored breathing
36
Normal Tactile Fremitis
- normal, equal, bilateral | - diminishing towards periphery
37
Normal Diaphoretic Excursion
3-5cm
38
Emphysema Findings
- dead space - barrel chested - decreased tactile fremitis - long expiration
39
Asthma Findings
- wheezing on expiration - increased RR - decreased tactile fremitis - tapychnic - decreased sounds and air movement
40
Pleural Effusion Findings
- hyper resonance
41
Pneumothorax Findings
- increased diaphoretic excretion
42
Pulmonary Embolism Findings
- hypotension | - crackles and wheezes