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Health Assessment > Chapter 19 > Flashcards

Chapter 19 Flashcards

1
Q

Alveoli

A

Functional unit of the lung

Thing-walled chambers surrounded by networks of capillaries that are the site of respiratory exchange of CO2 and 02

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2
Q

Angle of Louis

A

Manubriosternal angle, the articulation of the manubrium and body of the sternum, continuous with the second rib

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3
Q

Apnea

A

Cessation of breathing

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4
Q

Asthma

A

An abnormal respiratory condition associated with allergic hypersensitivity to certain inhaled allergens
Characterized by: Inflammation, bronchospasm, wheezing, and dyspnea

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5
Q

Atelectasis

A

An abnormal respiratory condition characterized by collapsed, shrunken, deflated sections of alveoli

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6
Q

Bradypnea

A

Slow breathing, fewer than 10 breaths per minutes

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7
Q

Bronchiole

A

On of the smaller respiratory passageways into which the segmental bronchi divide

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8
Q

Bronchitis

A

Inflammation of the bronchi with partial obstruction of bronchi due to excessive mucus secretion

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9
Q

Bronchophony

A

The spoken voice sound heard through the stethoscope, which sounds soft, muffled, and indistinct over normal lung tissue

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10
Q

Bronchovesicular

A

The normal breath sound heard over major bronchi

Characterized by: Moderate pitch, an equal duration of inspiration and expiration

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11
Q

Chronic obstructive pulmonary disease (COPD)

A

A functional category of abnormal respiratory conditions

Characterized by: Airflow obstruction

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12
Q

Cilia

A

Millions of hairlike cells lining the tracheobronchial tree

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13
Q

Consolidation

A

The solidification of portions of lung tissue as it fills up with infectious exudate
Ex. pneumonia

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14
Q

Crackles (Rales)

A

Abnormal, discontinuous, adventitious lung sounds heard on inspiration

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15
Q

Dead space

A

Passageways that transport air but are not available for gaseous exchange
Ex. Trachea, bronchi

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16
Q

Dyspnea

A

Difficult, labored breathing

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17
Q

Emphysema

A

Chronic obstructive pulmonary disease

Characterized by: Enlargement of alveoli distal to terminal bronchioles

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18
Q

Fissure

A

The narrow crack dividing the lobes of the lungs

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19
Q

Fremitus

A

A palpable vibration from the spoken voice felt over the chest wall

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20
Q

Friction rub

A

A coarse, grating, adventitious lung sound heard when the pleurae are inflamed

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21
Q

Hypercapnia

A

Increased levels of CO2 in the blood

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22
Q

Hyperventilation

A

Increased rate and depth of breathing

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23
Q

Hypoxemia

A

Decreased level of oxygen in the blood

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24
Q

Intercostal Space

A

Space between the ribs

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25
Q

Kussmaul Respiration

A

type of hyperventilation that occurs with diabetic ketoacidosis

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26
Q

Orthopnea

A

Ability to breathe easily only in an upright position

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27
Q

Paroxysmal Nocturnal Dyspnea

A

Sudden awakening from sleeping, with shortness of breath

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28
Q

Percussion

A

Striking over the chest wall with short, sharp blows of the fingers to determine the size and density of the underlying organ

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29
Q

Pleural Effusion

A

Abnormal fluid between the layers of the pleura

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30
Q

Rhonchi

A

Low-pitch, musical, snoring, adventitious lung sounds caused by obstruction from secretions

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31
Q

Tachypnea

A

Rapid, shallow breathing

More than 24 breaths per minute

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32
Q

Vesicular

A

Refers to soft, low-pitched, normal breath sounds heard over peripheral lung feilds

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33
Q

Wheeze

A

High-pitched, musical, squeaking adventitious lung sounds

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34
Q

Xiphoid process

A

Sword-shaped lower top of the sternum

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35
Q

What subjective thing would you ask about when assessing?

A 
Cough
Chest pain
Respiratory infections
Smoking
Shortness of breath
Environmental exposure
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36
Q

Pleura

A

Thing slippery serous membrane between chest wall and lungs

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37
Q

What structures are composed of dead space?

A

Trachea

Bronchi

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38
Q

What elements would you include in inspection of respiratory system?

A

Shape and configuration
Color
Respiration rate
Use of accessory muscles

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39
Q

What characteristics define barrel chest?

A

Costal angle >90
Appears as if in continuous inspiration
Hyperinflation of the lungs

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40
Q

What condition is barrel chest most common in?

A

COPD

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41
Q

Bronchial lung sound

A

High-pitch
Inspiration < expiration
Harsh, hollow, tubular
Trachea and larynx

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42
Q

Bronchovesicular lung sound

A

Moderate pitch
Inspiration = expiration
Over major bronchioles

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43
Q

Vesicular lung sounds

A

Low pitch
Inspiration > expiration
Rustling sound
Peripheral lung fields

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44
Q

The manubriosternal angle is also called ___

A

Angle of Louis

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45
Q

What is a normal costal angle?

A

90 degrees

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46
Q

Anteroposterior/ Tranverse diameter ratio

A

2:1

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47
Q

Condition if AP diameter is equal to transverse diameter

A

Barrel chest

48
Q

A tripod position is common with which condition?

A

COPD

49
Q

What type of sound is heard when percussing over lungs?

A

Resonance

50
Q

What is the manubriosternal angle?

A

The articulation of the manubrium and the body of the sternum

51
Q

The left lung is ___ compared to the right

A

Narrower

has only 2 lobes

52
Q

The characteristic timing of the cough of chronic bronchitis is described as:

A

Productive cough for at least 3 months of the year for 2 consecutive years

53
Q

How do you note symmetric chest expansion in an assessment?

A

Placing hands on the postriolateral chest wall with thumbs up pinching a small fold of skin

54
Q

How do you correctly assess lung sounds?

A

Hold the diaphragm of the stethoscope against the chest wall

Listen for one full respiration in each location, being sure to do side-to-side compaeisons

55
Q

Patient presenting: Fever, increased respiratory rate, decreases left side chest expansion, Dull percussion over left lower lobe, Fine crackles over left lobe
What is it?

A

Lobular Pneumonia

56
Q

Clubbing and spongy nail bases are indicators of ____

A

COPD

57
Q

You hear a coarse low pitched sound during inspiration and expiration and the patient report pain while breathing. What is this an indicator of?

A

Pleural friction rub

58
Q

While using the technique egophony what would you ask the patient to do?

A

Say “eeee” each time the stethoscope is moved

59
Q

When examining tactile fremitus what is important to do?

A

Palpate the chest symetrically

60
Q

Pulse oxygen measure ___

A

Arterial oxygen saturation in hemoglobin

61
Q

A pleural rub is best detected by what technique?

A

Auscultation

62
Q

What changes occur to the respiratory system in a pregnant woman?

A

Increased estrogen level relaxes chest cage ligaments
Circumference of chest increases
Tidal volume increase by 40%
Physiologic dyspnea

63
Q

Physiologic dyspnea

A

An increased awareness of the need to breathe

64
Q

What changes occur to the respiratory system as we age?

A

Costal cartilages become calcified > thorax less mobile
Barrel chest
Kyphosis

65
Q

Hemoptysis

A

Blood in coughed up sputum

66
Q

Decreased fremitus occurs with:

A

Any barrier that comes between the sound and your palpation

Obstructed bronchus, pleural effusion or thickening, pneumothorax, or emphysema

67
Q

Increases fremitus occurs with:

A

Compression or consolidation of lung tissue

Ex. Lobar pnuemonia

68
Q

Rhonchal Fremitus

A

Palpable with thick bronchial secretion

69
Q

Pleural friction fremitus

A

Palpable with inflammation of the pleura

70
Q

Crepitus

A

A coarse crackling sensation palpable over skin surfaces

71
Q

When is crepitus most likely to happen?

A

After open thoracic injury or surgery

72
Q

When would you hear hyperresonance in the lungs when percussing?

A

When there is too much air present

Ex. Emphysema or Pneumonothorax

73
Q

When would you hear a dull sound in the lungs when percussing?

A

When there is an abnormal density present

Ex. pneumonia, mass, or pleural effusion

74
Q

Decreased/Absent breath sounds occur when:

A

Bronchial tree obstruction
Emphysema - loss of elasticity of lungs
Anything obstructing transmission of sound to stethoscope

75
Q

Increased breath sounds occur with:

A

With consolidation or compression of lung tissue

76
Q

Symptoms of a strained, tired face and pursed-lipped breathing accompany ____

A

COPD

77
Q

What does bulging of the intercostal spaces mean?

A

Trapped air

78
Q

A palpable grating sensation with breathing indicates:

A

Pleural friction fremitus

79
Q

6-Minute Walk Test

A

Recreating the patient’s everyday activities to measure respiratory rehabilitation
Measure of how far patient walks in 6 minutes without exerting themselves

80
Q

A barrel shaped chest in an infant after 6 years may be an indicator of ___ or ___

A

Chronic asthma or Cystic fibrosis

81
Q

What is the highest score on the APGAR scale?

A

10

You can only have 2 in each category

82
Q

An infant with an APGAR score of 6 is considered:

A

Moderately depressed

83
Q

Newborns are predominantly _____ breather until 3 months

A

Nose breathers

84
Q

Normal respiratory range for newborn is:

A

30-40 breaths/minute

85
Q

What type of lung sounds will you hear in the peripheral lung fields in a child until 5-6 years old?

A

Bronchovesicular

86
Q

Crackles in the immediate newborn. Abnormal/Normal

A

Normal

The adaptation of extrauterine life: opening of the airways and clearing of fluid

87
Q

Pectus excavatum

A

Sunken sternum

Congenital defect

88
Q

Pectus carinatum

A

Forward protrusion of the sternum

89
Q

Scoliosis may increase what risks regarding the thorax/lungs?

A

Reduce lung volume

Impair cardiopulmonary function

90
Q

Tachypnea

A

Rapid shallow breathing

More than 24 breaths per minute

91
Q

Bradypnea

A

Slow breathing

Less than 10 breaths per minute

92
Q

Factors that would provoke bradypnea

A

Drug induce depression of the medulla
Increases intracranial pressure
Diabetic coma

93
Q

Cheyne-Stokes Respiration

A

Cyclic pattern of increasing rate and depth then decreasing

94
Q

Causes of Cheyne-Stokes Respiration

A 
Heart failure***
Renal failure
Meningitis
Drug overdose
Increased intracranial pressure
95
Q

Hyperventilation

A

Increase in both rate and depth

96
Q

Kussmaul respirations

A

Hyperventilation that occurs with diabetic ketoacidosis

97
Q

What does hyperventilation cause regarding blood?

A

Alkalosis

Blowing off increase CO2 levels

98
Q

Hypoventilation

A

Irregular shallow pattern

99
Q

Hypoventilation is caused by:

A

Narcotics
Anesthetics
Prolonged bed rest

100
Q

Chronic obstructive breathing

A

Normal inspiration and prolonged expiration to overcome increased airway resistance

101
Q

Atelectatic crackles

A

Sound like fin crackles

Disappears after first few breaths or coughs

102
Q

Wheezes are usually heard inspiration/expiration?

A

Predominate in expiration but could be heard in both

103
Q

Stridor

A

Monophonic, inspiratory, crowing sound

Louder in the neck that over chest wall

104
Q

Broncophony

A

Ask the person to repeat “99” while listening with a stethoscope

105
Q

While using the techniques broncophony, you should hear a clear “99” like they are saying right into your ear. Normal/Abnormal

A

Abnormal

The sound hear through the stethoscope should be soft, muffled, and indistinct

106
Q

Egophony abnormality

A

Hearing an “aaaa” sound instead of “eee”

107
Q

Whispered Pectoriloquy

A

Ask the person to whisper a phrase “one-two-three” as you auscultate
Should be muffled and indistinct

108
Q

Atelectasis

A

Collapsed, shunken lung

Breath sounds decreased, cough, lag on expansion of chest

109
Q

Acute bronchitis is characterized by:

A

Cough lasting up to 3 weeks

110
Q

Emphysema is characterized by:

A 
Permanent enlargement of air sacs distal to terminal bronchioles and rupture of interalveolar walls
Increased expiration resistance
Barrel chest
Tripod position
SOB
Tachypnea
111
Q

What is chronic bronchitis usually caused by?

A

Cigarette smoking

112
Q

Chronic Brontitis

A

Excessive mucus secretion

Inflamed bronchi with partial obstruction

113
Q

Heart Failure causes __ ___

A

Pulmonary congestion

114
Q

What adventitious sounds would you hear on a patient with heart failure

A

Crackles at lung bases

S3 heart sound

115
Q

What adventitious sounds accompany a pulmonary embolism?

A

Crackles

Wheezes

116
Q

Pleural effusion

A

Collection of excess fluid in intrapleural space with compression of overlying lung tissue

117
Q

Symptoms of pleural effusion

A 
Tactile fremitus
Crackles
Wheezing
Breath sounds decreased
Bronchophony
Egophony
Whispered pectoriliquy

Health Assessment (27 decks)

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