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Health Assessment - Lecture > Assessment of the Respiratory System > Flashcards

Assessment of the Respiratory System Flashcards

1
Q

Complete examination of the thorax and lungs consists of ___________________________________________________________ of the posterior and anterior thorax to evaluate functioning of the lungs.

A

history taking, inspection, palpation, percussion, and auscultation

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2
Q

Complete examination of the thorax and lungs consists of history taking, inspection, palpation, percussion, and auscultation of the _______________________________ to evaluate functioning of the lungs.

A

posterior and anterior thorax

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3
Q

Difficulty breathing

A

Wheezing

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4
Q

a mixture of saliva and mucus coughed up from the respiratory tract, typically as a result of infection or other disease and often examined microscopically to aid medical diagnosis.

A

sputum

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5
Q

cough acute

A

3 weeks

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6
Q

lasting 3 to 8 weeks

A

subacute (cough)

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7
Q

more than 8 weeks

A

chronic (cough)

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8
Q

coughing up blood from some part of the lungs

A

hemoptysis

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9
Q

A clenched fist over the sternum (Levine sign)

A

angina pectoris

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10
Q

a finger pointing to a tender spot on the chest wall

A

musculoskeletal pain

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11
Q

a hand moving from the neck to the epigastrium

A

heartburn

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12
Q

defined as breathing cessation for ≥10 seconds

A

apneas

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13
Q

These symptoms, especially daytime sleepiness and snoring, are hallmarks of

A

obstructive sleep apnea

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14
Q

Commonly seen in patients with obesity, posterior malocclusion of the jaw (retrognathia), treatment-resistant hypertension, heart failure, atrial fibrillation, stroke, and type 2 diabetes.

A

obstructive sleep apnea

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15
Q

for needle insertion for tension pneumothorax

A

2nd intercostal space

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16
Q

2nd intercostal space for needle insertion for

A

tension pneumothorax

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17
Q

for chest tube insertion

A

4th intercostal space

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18
Q

4th intercostal space for

A

chest tube insertion

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19
Q

for the lower margin of an endotracheal tube on a chest x-ray

A

T4

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20
Q

T4 for the lower margin of an

A

endotracheal tube on a chest x-ray

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21
Q

symptoms for tension pneumothorax may include

A
  • chest pain
  • shortness of breath
  • rapid heart rate
  • shallow breathing
  • anxiety
  • blue or ashen skin
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22
Q

a landmark for thoracentasis with needle insertion immediately superior to the 8th rib

A

T7-T8 intercostal space

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23
Q

is more common in the right middle and lower lobe because the right main bronchus is more vertical

A

aspiration pneumonia

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24
Q

aspiration pneumonia is more common in the _______________________ because the right main bronchus is more vertical

A

right middle and lower lobe

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25
Q

Palpate for __________________ using the ball or ulnar edge of one
hand while the client says “ninety-nine”.

A

fremitus

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26
Q

Palpate for fremitus, using the ______________________________ while the client says “ninety-nine”.

A

ball or ulnar edge of one hand

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27
Q

Palpate for fremitus, using the ball or ulnar edge of one
hand while the client says “__________________”.

A

ninety-nine

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28
Q

Palpate for chest expansion. Place hands on the posterior
chest wall with ____________________________________, and
observe the movement of your thumbs as the client takes a
deep breath

A

your thumbs at the level of T9 or T10

29
Q

note that the _______________________________ are not touching the chest wall

A

thumb and 2nd, 4th and 5th fingers

30
Q

is the most important examination technique for assessing air flow through the tracheobronchial tree.

A

Auscultation

31
Q

Before beginning auscultation, ask the patient to cough once or twice to clear _______________________ that
can produce unimportant extra sounds

A

mild atelectasis or airway mucus

32
Q

If “ee” sounds like “A” and has a nasal
bleating quality, an E-to-A change, or
__________________, is present.

A

egophony

33
Q

ask the client to repeat the phrase “ninety-nine”

A

bronchophony

33
Q

ask the client to repeat the letter “E”

A

egophony

34
Q

Normally the sounds transmitted through the chest wall are muffled and indistinct. Louder voice sounds are called ________________________.

A

bronchophony

35
Q

ask the client to whisper the phrase “onetwo-three” or “ninety-nine”

A

whisper pectoriloquy

36
Q

Louder, clearer whispered sounds are
called

A

whispered pectoriloquy

37
Q

ratio of anteroposterior diameter to transverse diameter

A

normally 1:2

38
Q

curvature of the spine (anterior/posterior)

A

Kyphosis

39
Q

curvature of the spine (lateral)

A

Scoliosis

40
Q

increased anterior/posterior chest wall

A

Barrel Chest

41
Q

Abnormal spinal curvatures and vertebral rotation deform the chest. Distortion of the underlying lungs may make
interpretation of lung findings very difficult.

A

Thoracic Kyphoscoliosis

42
Q

The lateral diameter of the thorax in the normal adult is greater than its AP diameter. The ratio of its AP diameter to the lateral diameter is normally ∼0.7 up to 0.9 and increases with aging

A

Normal Adult

43
Q

There is an increased AP diameter. This shape is normal during infancy, and often accompanies aging and chronic obstructive pulmonary disease.

A

Barrel Chest

44
Q

Note depression in the lower portion of the sternum.
Compression of the heart and great vessels may cause
murmurs.

A

Funnel Chest (Pectus Excavatum)

45
Q

The sternum is displaced anteriorly, increasing the AP
diameter. The costal cartilages adjacent to the protruding
sternum are depressed.

A

Pigeon Chest (Pectus Carinatum)

46
Q

SIGNS OF RESPIRATORY DISTRESS

A

▪ Tachypneic (>25/bpm)
▪Cyanosis (hypoxia) or pallor (heart failure)
▪ Pursed-lip breathing
▪ Accessory muscle use
▪ Diaphragmatic paradox
▪ Intercostal indrawing

47
Q

Accessory muscles of ventilation:

A
  1. scalene
  2. sternocleidomastoid
  3. pectoralis major
  4. trapezius
  5. external intercostals
48
Q
  • Inspiratory sounds last longer than expiratory sounds.
  • Soft
  • Relatively low
  • Over most of both lungs
A

Vesicular

49
Q
  • Inspiratory and expiratory sounds are almost equal.
  • Intermediate
  • Intermediate
  • Often in the 1st and 2nd interspaces anteriorly and between the scapulae
A

Bronchovesicular

50
Q
  • Expiratory sounds last longer than inspiratory ones
  • Loud
  • Relatively high
  • Over the manubrium, (larger proximal airways)
A

Bronchial

51
Q
  • Inspiratory and expiratory sounds are almost equal.
  • Very loud
  • Relatively high
  • Over the trachea in the neck
A

Tracheal

52
Q
  • Intermittent, nonmusical, and brief
  • Like dots in time
A

Crackles (or Rales)

53
Q

soft, high-pitched (∼650 Hz), very brief (5–10 ms)

A

Fine crackles

54
Q

somewhat louder, lower in pitch (∼350 Hz), brief (15–30 ms)

A

Coarse crackles

55
Q
  • Sinusoidal, musical, prolonged (but not necessarily persisting throughout the respiratory cycle)
  • Like dashes in time
A

Wheezes and Rhonchi

56
Q

relatively high-pitched (≥400 Hz) with hissing or shrill quality (>80 ms)

A

Wheezes

57
Q

relatively low-pitched (150–200 Hz) with snoring quality (>80 ms)

A

Rhonchi

58
Q

is a continuous, high-frequency, high-pitched musical sound produced during airflow through a narrowing in the upper respiratory tract.

A

Stridor

59
Q

is best heard over the neck during inspiration, but can be biphasic. Causes of the underlying airway obstruction
include tracheal stenosis from intubation, airway edema after device removal, epiglottitis, foreign body, and anaphylaxis. Immediate intervention is warranted

A

Stridor

60
Q

is a discontinuous, low-frequency, grating sound that arises from inflammation and roughening of the visceral pleura as it slides against the parietal pleura. This nonmusical sound is biphasic, heard during inspiration and expiration, and often best heard in the axilla and base of the lungs

A

Pleural Rub

61
Q

Before beginning auscultation, ask the patient to ________________________ to clear mild atelectasis or airway mucus that
can produce unimportant extra sounds.

A

cough once or twice

62
Q

Normally the sounds transmitted through the chest wall are _____________________

A

muffled and indistinct

63
Q

Localized bronchophony and egophony are seen in lobar consolidation from

A

pneumonia

64
Q

In patients with fever and cough, the presence of bronchial breath sounds and egophony more than triples the likelihood of

A

pneumonia

65
Q

The lateral diameter of the thorax in the normal adult is greater than its AP diameter. The ratio of its AP diameter to the lateral diameter is normally ________________________________________

A

∼0.7 up to 0.9 and increases with aging.

66
Q

stridor is best heard over?

A

over the neck during inspiration

67
Q

pleural rub is heard during and best heard in?

A

heard during inspiration and expiration; best heard in the axilla and base of the lungs

Health Assessment - Lecture (17 decks)

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