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Health Assessment Theory Exam 1 > Ch. 19- Thorax and Respiratory Assessment > Flashcards

Ch. 19- Thorax and Respiratory Assessment Flashcards

1
Q

Where is the suprasternal notch located?

A

At top of sternum (u-shaped)

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2
Q

Explain the sternum anatomy?

A

“breastbone” has three parts; manubrium, body, xiphoid process

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3
Q

“Angle of Louis” continuous with what?

A

2nd rib

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4
Q

Each intercostal space is numbered by what?

A

rib above it

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5
Q

Where is the costal margin?

A

Bottom of rib cage

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6
Q

What is the measurement of a normal costal angle?

A

70 degrees (gets larger with age?)

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7
Q

When you flex the neck forward, what is that body prominence?

A

C7 (two bumps =C7 and T1)

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8
Q

How do you find the spinous processes?

A

count down knobs on vertebrae, which stack together to form spinal column

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9
Q

What should you check the scapula for bilaterally?

A

symmetry and skin break down

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10
Q

What are the anterior reference lines?

A
  • Anterior axillary line
  • Midsternal line
  • Midcalvicular line
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11
Q

What are the posterior reference lines?

A
  • Scapular line

- Vertebral line

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12
Q

What are the lateral reference lines?

A
  • Anterior axillary line
  • Posterior axillary line
  • Midaxillary line
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13
Q

What respiratory subjective data is important?

A
  • CC
  • HPI
  • Patient ROS
  • Patient past history
  • Patient social history
  • Patient family history
  • Immunization status
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14
Q

In what order do you obtain objective respiratory data?

A
  • Inspect
  • Palpate
  • Percuss
  • Auscultate
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15
Q

What things are you inspecting in a respiratory assessment?

A
  • Position of trachea
  • shape and configuration of chest wall
  • anteroposterior diameter should be less than transverse diameter
  • quality of respirations
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16
Q

What is kyphosis?

A

forward flexion of chest

17
Q

What things are you doing during palpation of a respiratory assessment?

A
  1. Symmetric chest expansion: hands of T9-T10
  2. Tactile fremitus: Sounds generated from larynx are transmitted through lung where you feel vibrations
  3. Entire chest wall: crepitus, temp, tenderness, masses
18
Q

What things are you doing during percussion of a respiratory assessment?

A
  • Start at apices, move side to side at interspaces, 2 inches apart
  • Lungs should sound resonance (clear/low pitched)
19
Q

What things should you instruct patient to do when auscultating during a respiratory assessment?

A

Instruct pt to breath through mouth, a little deeper than usual

20
Q

You should use the diaphragm for auscultation of a respiratory assessment and do what?

A
  • Hold it firmly on persons chest wall; listen at least one full respiration in each location
  • compare side to side
21
Q

What is the procedure of auscultation during a respiratory assessment?

A
  • Anterior from the apices above the clavicle to the 9th rib
  • Laterally from axilla down to 7th or 8th rib
  • posterior from apices at C7 to bases around T10
22
Q

What are normal breaths sounds for adults?

A
  • Bronchial
  • Bronchovesicular
  • Vesicular
  • Diminished
23
Q

Explain bronchial breaths sounds:

A

(tracheal or tubular)

  • harsher, over trachea
  • higher pitch, louder, inspiration and expiration are equal and there is a pause between inspiration and expiration
24
Q

Explain bronchovesicular breath sounds:

A

Over major bronchi
-Bronchovesicular sounds are heard in the posterior chest between the scapulae and in the center part of the anterior chest. Bronchovesicular sounds are softer than bronchial sounds, but have a tubular quality.

25
Q

Explain vesicular breath sounds:

A
  • lower and softer, over majority or peripheral lung tissue

- heard over the thorax, lower pitched and softer than bronchial breathing

26
Q

Explain Diminished lung sounds:

A

not normal but common

27
Q

What are adventitious lung sounds?

A
  • Sounds that are not normally heard
  • moving air colliding with secretions in tracheobronchial passageways
  • popping open of previously deflated airways
28
Q

What are types of adventitious lung sounds?

A
  • Crackles
  • Wheezes
  • Stridor
  • Pleural friction rub
29
Q

Explain crackles:

A

Inspiratory/expiratory or just inspiratory, fine or coarse

  • Crackles are the sounds you will hear in a lung field that has fluid in the small airways.
  • Crackles are abnormal lung sounds characterized by discontinuous clicking or rattling sounds. Crackles can sound like salt dropped onto a hot pan or like cellophane being crumpled or like velcro being torn open.
30
Q

Explain Wheezes:

A

Mostly expiratory, high-pitched or low-pitched
-A wheeze might have a low or higher frequency sound. Higher frequency wheezes are similar to squeezing or whistling. A lower frequency wheeze can seem similar to snoring or gurgling. Low frequency wheezes are sometimes called rhonchi.

31
Q

Explain Stridor:

A

Inspiratory, think croup or foreign object

-a harsh or grating sound.

32
Q

Explain Pleural friction rub:

A

Inspiratory/Expiratory grating sound
-Pleural Rubs. Pleural rubs are discontinuous or continuous, creaking or grating sounds. The sound has been described as similar to walking on fresh snow or a leather-on-leather type of sound.

33
Q

What assessment technique do you use to determine quality of voice sounds or vocal resonance?

A

Auscultation

34
Q

Voice sounds assessed via auscultation is only used when?

A

Pathology is expected

35
Q

Explain bronchophony:

A

pt. repeats a phrase “99” while you auscultate

36
Q

Explain Egophony:

A

pt. repeats a long “e” while you auscultate

37
Q

Explain Whispered Pectoriloquy:

A

pt. whispers “1, 2, 3,” as you auscultate

38
Q

What is commonly seen in an aging adult in relation to a respiratory assessment?

A
  • Kyphosis
  • Chest cage shows increased anteroposterior diameter
  • tend to tire easily during auscultation when deep mouth breathing is required

Health Assessment Theory Exam 1 (8 decks)

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