Ch. 19 (Thorax & Lungs) Flashcards
What vertebrae is known as the vertebrae prominens?
C7
What is the middle section of the thoracic cavity where the esphogaus, trachea, heart and great vessels are?
mediastinum
What is located on each side of the mediastinum?
pleural cavities
What do pleural cavities hold?
the lungs
What do we call the top region of the lung borders?
apex
highest point of lung tissue
What do we call the bottom region of the lung borders?
base
Where does the base of the lungs rest?
in the pleural cavities, above the diaphragm
What is the separator between the lungs and the abdominen?
diaphragm
The lungs are assymetrical.
Which lung is shorter and why?
right, to make room for the liver
How many lobes does the right lung contain?
3
How many lobes does the left lung contain?
2
Why are the two lobes on the left lung, narrower?
to make room for the heart
What lung has no middle lobe?
left (only two lobes)
Describe the size of the lobes in the lungs when assessing the anterior chest.
- mostly upper and middle lobes
- very little lower lobe is shown
Describe the size of the lobes in the lungs when assessing the posterior chest.
- almost all lower lobe
What thin slippery envelope is located between the lungs and chest wall?
pleurae
Where is the pleural cavity located?
on each side of the mediastinum, inside the pleurae
Air pressure can either be neutral, positive or negative.
The pleural cavity’s air pressure would be described as what?
negative
The pleural cavity’s air pressure is negative.
What does negative air pressure do to the lungs in the pleural cavity?
holds the lungs tightly against the chest wall (keeping them inflated)
When the lungs inspirate, what happens?
air rushes in, diaphragm descends
When the lungs expirate, what happens?
air is expelled, diaphragm relaxs upwards
When assessing the thorax and lungs, what kind of subjective data do you gather?
- cough
- shortness of breath (SOB)
- chest pain w/breathing (burning, stabbing, constant, come & go)
- past Hx respiratory probs/infections
- smoking Hx
- environmental exposure
- self care behaviors
When inspecting the thoractic cage of the posterior chest, what do we inspect?
- spine (nml=symmetrical)
- thorax (nml=symmetrical)
- anterior-posterior/transverse diameter
- skin color, lesions
- ease of breathing/respiratory rate
- position (nml=upright)
When the anterior-posterior diameter of the thoractic cage is the same as the transverse diameter, what would we classify this finding as?
barrel chest
When palpating the thoractic cage of the posterior chest, what do we assess?
- symmetrical chest expansion
- tactile fremitis
- lumps, tenderness
When palpating the thoractic cage of the posterior chest, how do we go about assessing symmetrical chest expansion?
- put hands in w postion on pt’s mid back, 1-2in below scapula
- pinch small fold of skin between thumbs
- ask pt to take a deep breath in
- thumbs should move apart symmetrically
When palpating the thoractic cage of the posterior chest, how do we go about assessing tactile fremitis?
- use ball of your hand and touch pt’s back while he/she says
ninety-nine
- do not palpate over scapula
- vibrations should be symmetrical
When percussing the thoractic cage of the posterior chest, how do we go about percussing?
- start at apex of lungs, above scapula
- down to interspace, side to side, not percussing over the spine
- eventually towards base of lungs, expand outwards when percussing
When percussing the thoractic cage of the posterior chest, what would we hear when percussing over normal healthy, lung tissue?
resonance
When percussing the thoractic cage of the posterior chest, what would we hear when percussing over a lung that holds a lot of air?
hyperresonance
When percussing the thoractic cage of the posterior chest, what would we hear when percussing over a tumor, big area of fluid consolidation, or bone?
dull
When percussing the thoractic cage of the posterior chest, what would we hear when percussing over bone?
flat
How would we go about auscultating the thoractic cage of the posterior chest?
- auscultate over clothes
- pt leans forward slightly
- breaths in and out through mouth
- auscultate starting superior and moving inferiorly
What are the three different types of nml breath sounds?
- bronchial
- branchovesicular
- vesicular
There are three different types of nml breath sounds.
What type of breath sound would you hear over the trachea and be described as loud?
bronchial
There are three different types of nml breath sounds.
What type of breath sound would you hear over the major bronchi, upper sternum and would be described as moderate in volume?
bronchovesicular
There are three different types of nml breath sounds.
What type of breath sound would you hear over lower portions of the lungs (base) and would be described as a soft, low pitched sound?
vesicular
There are three different types of nml breath sounds.
The majority of breath sounds would sound like what type of nml breathing?
vesicular
When auscultating the thoractic cage of the posterior chest, and you hear abnormal breathing, what kind of sound would this be classified as?
adventitious sound
There are many different types of adventitious sounds emitted from the thoractic cage of the posterior chest. When auscultating the thoractic cage of the posterior chest, what abnormal sound would be emitted in separate incremenets instead of a complete sound?
discontinuous sounds
There are many different types of adventitious sounds emitted from the thoractic cage of the posterior chest. When auscultating the thoractic cage of the posterior chest, what abnormal sound would be emitted when aveoli has collapsed or become filled with fluid?
rales/crackles
on inhalation
There are many different types of adventitious sounds emitted from the thoractic cage of the posterior chest. When auscultating the thoractic cage of the posterior chest, what abnormal sound would be described as a low-pitched, rattling sound, similar to snoring?
rhonchi
