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Comprehensive Health Assessments > Chapter 11: Lungs/Respiratory > Flashcards

Chapter 11: Lungs/Respiratory Flashcards

1
Q

Tachypnea

A

rapid, shallow breathing
- fast breathing
- faster then 20 breaths per minute

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2
Q

Bradypnea

A

slow breathing
- slower than 12 breaths per minute

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3
Q

Occupational Hazards

A

hazards that include the air-borne ones
- exposure to irritants, asbestos, smoke, etc that affects your lung health

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4
Q

Dyspnea

A

shortness of breath

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5
Q

Orthopnea

A

difficulty breathing when lying down
- propping yourself up with pillows helps alleviate this

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6
Q

Pursed Lip Breathing

A

when you inhale with the nose and then exhale with pursed lips very slowly
- seen in chronic obstructive pulmonary disease (COPD) or asthma

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7
Q

What is Kussmauls ?

A

distressing, paroxysmal dyspnea
- patten of respiration that is rapid, deep, and labored
- also known as air hunger
- affects both inspiration and expiration
- body’s compensation to alleviate the high levels of acidosis

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8
Q

Cyanosis

A

bluish discoloration, especially of the skin and mucous membranes
- can be a sign of inadequate oxygenation of tissues

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9
Q

Auscultate

A

listen to the sounds within the body
- usually with a stethoscope

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10
Q

Barrel-Shaped Chest

A

rounded, bulging chest with abnormal increase in AP diameter
- AP diameter of 1:1
- can be due to chronic air trapping in the alveoli
- can be caused by emphysema
- shows little movement on respiration

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11
Q

Bronchovesicular

A

sounds heard over the main stem bronchi
- intensity of sound is moderate
- I=E
- moderate pitch sound

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12
Q

Adventitious

A

means involuntary/abnormal
- examples of these types of sounds are wheezing, crackles, rhonchi

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13
Q

Pectus Carinatum

A

occurs when abnormal cartilage growth causes the sternum to protude from the chest
- when the breast bones is pushed outwards
- also called pigeon chest

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14
Q

Pectus Excavatum

A

when the breast bones is sunken into the chest

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15
Q

Anterior-Posterior Diameter

A

where the front to back dimension of the chest is smaller than its lateral dimension
- normal is about 1:2 ratio to lateral diameter

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16
Q

Crepitus

A

unusual popping or cracking, etc
- indicates air in the subcutaneous tissue

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17
Q

Pleural Friction Rub

A

Superficial, low-pitched, coarse rubbing or grating sound
- sounds like two surfaces rubbing together
- heard throughout inspiration and expiration
- caused by pericardial pleura rubbing together

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18
Q

Vesicular Sounds

A

heard over the periphery (outside portions of lungs) of lungs
- I>E
- intensity of sound is soft because it’s the furthest site from the airway
- low pitch sound

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19
Q

Rhonchi

A

low-pitched wheezing sounds (can sounds like snoring or moaning)
- usually heard during expiration
- continuous
- can be heard if you have bronchitis, asthma, COPD

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20
Q

Bronchitis

A

inflammation of the bronchial tubes
- may become productive with sputum (muscus)
- can cause coughing, wheezing, etc

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21
Q

Asthma

A

hyperreactive airway disease characterized by bronchoconstriction, airway obstruction, and inflammation

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22
Q

Emphysema

A

Destruction of the alveolar walls causes permanent abnormal enlargement of the air spaces
- causes increased AP (anterior posterior) diameter

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23
Q

Pneumothroax

A

air or gas in the cavity between the lungs and the chest wall, causing collapse of the lung
- decreased chest wall movement on side of injury can occur
- breath sounds over affected area are absent
- tracheal deviation (moves away from the midline and must be seen immediately)

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24
Q

Retraction

A

when the area between the ribs and in the neck sinks in when a person with asthma tries to inhale
- Ex.) intercostal muscles are drawn inward between the ribs
- indicates airway obstruction
- may occur during pneumonia

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25
Q

Asymmetry

A

abnormal finding where the abnormal side of the chest expands less and lags behind the normal side

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26
Q

Pitch

A

how high or low the respiration sound is

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27
Q

Intensity

A

characteristic of the breath sound that is loud, moderate, or soft

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28
Q

Sputum

A

a mixture of saliva and mucus produced by the lungs in viral or bacterial infections

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29
Q

What does greenish/yellow sputum mean ?

A

bacterial infections

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30
Q

What does clear/whiteish sputum mean ?

A

viral infection
- like a cold or bronchitis

31
Q

What does black sputum mean ?

A

smoke or coal dust inhalation

32
Q

What does Rust/Red sputum mean ?

A

TB or pneumococcal pneumonia

33
Q

What does foul smelling sputum mean ?

A

bacterial pneumonia, lung abscess, or bronchietasis

34
Q

What does frothy sputum mean ?

A

pulmonary edema

35
Q

What does thick sputum usually mean ?

A

cystic fibrosis

36
Q

How do we document tobacco use ?

A

using pack-years
- # packs per day X # yrs smoked
- or # cigs per day X # yrs smoked/ 20

37
Q

What does a Normal Lung Inspection look like ?

A
  • Eupneic (easy, free respirations)
  • no nasal flaring
  • no lip, buccal mucosa cyanosis
  • AP diameter of 1:2
  • pink nail beds, capillary refill <3 secs, no clubbing
  • chest wall symmetrical and mobile
38
Q

Why does clubbing occur ?

A

sign of chronic hypoxia

39
Q

What causes Barrel Chest to occur ?

A

COPD

40
Q

Is Chest Retraction a good sign ?

A

no, it indicated airway obstruction that can occur because of an asthma attack or pneumonia

41
Q

How do we check for crepitus ?

A

palpation

42
Q

What is Vocal (tactile) Fremitus ?

A

feeling the vibrations of the anterior or posterior thorax
- should be equal bilaterally
- may be absent in a healthy person with a high-pitched or soft voice

43
Q

Fine Crackles

A
  • high-pitched popping sounds
  • not continuous
  • can occur because of pneumonia, bronchitis, fluid in lungs
44
Q

Coarse Crackles

A
  • low-pitched popping
  • more of a rippling sound
  • not continuous
  • can occur because of pneumonia, fluid overtake
45
Q

Do crackles clear with a cough ?

A

no

46
Q

Wheeze

A

high-pitched snoring sound
- continuous
- musical-like sound
- heard during expiration and inspiration
- occurs during asthma

47
Q

Plural Friction Rub

A

caused by inflamed parietal and visceral pleura rubbing against each other
- sounds like a coarse, grating sound

48
Q

Stridor

A

high-pitched crowing, honking sound
- heard over the larynx
- heard during both inspiration and expiration
- can occur because of respiratory obstruction of larynx or trachea and they aren’t getting enough 02

49
Q

Bronchial

A

heard over the trachea and thorax
- high-pitch sound
- intensity of sound is loud because it’s the closest to the airway
- I<E

50
Q

What are the Chronic Pulmonary Diseases ?

A
  • Asthma
  • COPD (emphysema and chronic bronchitis)
51
Q

Acute Bronchitis

A
  • inflammation of the mucous membrane
  • cough is initially non-productive but after a few days it becomes productive
  • rhonchi heard on auscultation with wheezing heard after coughing
52
Q

Chronic Bronchitis

A
  • long-term cough with mucous (sputum history)
    -chronic, cyanosis, may hear rhonchi, obesity, clubbing, wheezes
53
Q

Is Nasal Flaring a good sign in infants ?

A

infants are abdominal breathers, so a little flaring is okay but if it’s excessive then it’s an emergency

54
Q

Atelectasis

A

collapsed alveoli caused by external pressure from a tumors, fluid, or air in the pleural space
- diminished breath sounds and fremitus, low 02 Sat

55
Q

What are common childhood illnesses ?

A

asthma, acute bronchitis, pneumonia, and cystic fibrosis

56
Q

What are illnesses are associated with Fine Crackles ?

A

pneumonia, bronchitis, fluid in lungs

57
Q

What illnesses are associated with Coarse Crackles ?

A

pneumonia, fluid overtake

58
Q

What illnesses are associated with Wheezes and Rhonchi ?

A

asthma, bronchitis, COPD,

59
Q

What are abnormal findings of Vocal (tactile) fremitus ?

A

Diminished/Absent:
- pneumothorax, pleural effusion, obesity, and bronchial obstruction
Increased:
- pneumonia
- tumor if it’s solid

60
Q

What is the Pitch, Intensity, Duration, and Expected location of Bronchial sounds ?

A
  • high-pitched
  • loud (closest to the airway)
  • Expiration is longer than Inspiration
  • over the trachea and thorax
61
Q

What is the Pitch, Intensity, Duration, and Expected location of Bronchovesicular sounds ?

A
  • moderate pitch
  • moderate
  • Inspiration=Expiration
  • over the main stem bronchi
62
Q

What is the Pitch, Intensity, Duration, and Expected location of the vesicular sounds ?

A

-low pitched
- soft (furthest from the site of airway)
- Inspiration is longer
- periphery of lungs (outside portions of the lungs)

63
Q

What are some symptoms of chronic bronchitis ?

A
  • chronic, productive cough
  • cyanosis (due to hypoxia)
  • crackles, wheezes
  • obese
  • prolonged expiration
  • peripheral edema
64
Q

What are some symptoms of emphysema ?

A
  • dyspnea
  • minimal cough
  • pink skin, pursed-lip breathing
  • accessory muscle use
  • hyperinflation, barrel chest
  • tachypnea
  • increased minute ventilation
  • weight loss (due to work of breathing)
65
Q

What is placement of hands during thoracic expansion ?

A

anterior: costal margin and xiphoid process
posterior: T9 or T10 ; 10th rib

66
Q

How do you calculate pack years ?

A
  • # packs smoked a day x # years smoked
  • # cigs smoked per day x # years smoked/ 20
67
Q

When can wheezes be heard ?

A

during inspiration and expiration

68
Q

When can rhonchi be heard ?

A

expiration

69
Q

When can stridor be heard ?

A

during inspiration and expiration

70
Q

Where is stridor usually heard ?

A

over the larynx

71
Q

What adventitious lung sounds are continuous and be cleared with a cough ?

A

wheezes, and rhonchi

72
Q

What causes stridor ?

A

respiratory obstruction of larynx or trachea
- not getting adequate O2
- associated with croup
- very dangerous and must act quickly

73
Q

What causes fine and coarse crackles ?

A

fluid in lungs
- pneumonia or bronchitis

74
Q

What patient do we prioritize seeing ?

A

ABC
- airway
- breathing
- circulation
- respiratory issues are always a priority

Comprehensive Health Assessments (13 decks)

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