Assessment of the Thorax and Lungs - Unit 2 Flashcards
Respiratory History - what does this include?
History of Upper Respiratory Infections, Asthma, COPD, Pneumonia, TB, Dyspnea, Smoking, Weight Loss, activity restrictions, environmental exposure to toxins, etc.
How should we position patients for respiratory assessments?
The upright position - the recumbent position, tho, if too ill!
Respiratory Approach - what do we do? What do compare? What direction do we move? Where do we begin?
We inspect, palpate, percuss, and auscultate.
We compare one side with another.
We work from above-down.
We begin with the posterior chest.
COPD - Changes are fast. T/F?
False! It’s slow changing!
What is included under the COPD umbrella?
Chronic Bronchitis, Emphysema, Asthma
What is emphysema?
Abnormal destruction of lung tissue where air gets trapped.
What happens to the bronchioles during with asthma?
Constriction of the bronchioles.
Control of Respirations - normal stimulus is an increase in ___ ___ or ___.
Normal stimulus is an increase in carbon dioxide or hypercapnia.
A decrease in oxygen (hypoxemia) also stimulates respirations but not as effectively. T/F?
True!!!!
Atelectasis - what is it?
Incomplete expansion of the lung (alveoli collapse) caused by tumors, pneumoniae, etc.
Hypostatic Pneumonia - pneumonia from…
not moving around. Make sure to move patients!
TCDB - what does it mean?
Turn, Cough, Deep Breath
Pleural Effusion - what is it?
Fluid buildup between lining of the lung and lung tissue.
Neumothorax - what is it?
Collapsed lung/extra air in lung.
TB - causes cavitation (like little holes) in the lung. T/F?
True!
What is the normal shape of the thoracic cage?
Symmetric chest, oval. The angle is 1:2. The costal angle is less than 90 degrees.
What is barrel chest?
When the chest is big!
What is “pectus excavatum” ?
The chest dips - like the sternum is deep in!
What is “pectus cariatum”?
This is when the sternum is protruding out!
What are the 4 types of retractions?
Intercostal, Substernal, Suprasternal, Supraclavicular
What is scoliosis?
The spine is like an s!
What is kyphosis?
Think of mam - it’s the hunchback!
What is lordosis?
The spine is bent back!
What can obstruct the bronchial tree?
Mucous plug/foreign body.
What can obstruct sound transmission?
Fluid (pleural effusion), Air (pneumothorax)
Rales/Crackles - inspiration or expiration?
Inspiration!
Alveolar Rales - what are they?
Fine crackles, popping sound.
Rales/Crackles - sound produced by air entering a space that contains…
secretions (or blocked by them). may not be (usually not) cleared by coughing.
Rhonchi/Gurgles - inspiration or expiration?
Expiration!
Rhonchi/Gurgles - info on them
Continuous, but more pronounced during expiration. They are rumbling/low pitched, coarse, gurgling.
Rhonchi/Gurgles - characteristically cleared by ___.
Coughing.
Wheezes - inspiration or expiration?
BOTH!
Wheezes - high or low pitched, squeaky, musical sounds. T/F?
True!
Friction Rub - what is it?
A loud dry, girating sound.
Friction Rub - not altered by coughing. T/F?
True!
Pulse Oximetry - determines what? What is normal?
Determines the percentage of hemoglobin saturated by oxygen.
Normal is above 95%, but the goal is to keep it above 90%!
