Chapter 16—Thorax & Lungs Flashcards
pectus carinatum
pectus excavatum
scoliosis
kyphosis
lordosis
chest expansion assessment
fremitus assessment
lung palpation order
swelling or hardening of normally soft tissue (in lungs)
consolidation
bronchophony
repeat “_”
should be…
will be…. over consolidation
usually caused by… (3)
ask to repeat “99”
should be soft/muffled
will be clear, loud over condolidation - sounds like pt is speaking directly into stethoscope
usually caused by pneumonia, atelectasis, or tumor
egophony
repeat “__”
should be…
will sound like….. over consolidation
ask pt to repeat “E”
should be soft
will sound like an “A” over consolidation
whisper pectoriloquy
repeat “___”
should be…
will sound …. over consolidation
ask pt to repeat “1, 2, 3”
should be faint and muffled
will sound clear over consolidation
fremitus
pt says “__”
use …. surface of hand
where to place hands?
increased by…
decreased by…
vibration palpated when pt says “99”
use palmar or ulnar surface of hands on pt’s upper back
increased by consolidation, will be unequal on each side
decreased by air or fluid, indicating emphysema or pleural effusion
assessing lung expansion
where to place hands?
normal?
abnormal?… indicates what?
decreased expansion indicates…?
place hands on pt’s back level with T9-10 (or on anterior chest)
should expand equally c inspiration
inequality indicates atelectasis, pneumonia, chest trauma, pneumothorax
decreased expansion indicates COPD
biot respiration
regular deep inspirations followed by periods of apnea
normal bronchial sounds
pitch & volume
location
loud, high pitched
found over trachea & larynx
normal bronchovesicular sounds
pitch & volume
location
I & E time?
middle pitch and volume
over major bronchi with fewer alveoli - upper third of chest
equal inspiratory & expiratory time
normal vesicular sounds
pitch, volume
location
soft, low pitched
alveoli of lungs
dividec into fine and coarse sounds
crackles/rales
divided into sibilant (hissing) and sonorous (deep) sounds
wheezing
FLATNESS
intensity, pitch, duration, normal, pathological
soft
high
short
thigh
pleural effusion
DULLNESS
intensity, pitch, duration, normal, pathological
medium
medium
medium
liver
lobar pneumonia
RESONANCE
intensity, pitch, duration, normal, pathological
loud
low
long
healthy lung
chronic bronchitis
HYPERRESONANCE
intensity, pitch, duration, normal, pathological
very loud
lower
longer
no healthy
COPD, pneumothorax
TYMPANY
intensity, pitch, duration, normal, pathological
loud
high
longer
puffed cheek
pneumothorax
crackles
describe?
I or E?
caused by?
cleared by cough?
high pitched popping noises
on inspiration
fluid in lungs
not cleared by cough
fine crackles heard where?
base of lungs
wheezing
describe
caused by?
continuous, musical
narrowing of airways
rhonchi
describe
location
caused by…
elimiated by coughing?
low pitched continuous wheezing - snoring/moaning sound
midline of chest
secretions in airways
usually eliminated by coughing
stridor
describe
volume & location
caused by…
high pitched, musical inspiration
louder over throat than wheezing
caused by partially obstructed upper airway
lung sound like walking on snow
pleural friction rub
pleural friction rub
describe
eliminated by coughing?
creaking or grating
not altered by coughing
