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Health Assessment > Chapter 19: Thorax & Lung (Exam #2) > Flashcards

Chapter 19: Thorax & Lung (Exam #2) Flashcards

1
Q

Bony structure with a conical shape that is more narrow at the top:

A

Thoracic cage

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2
Q

How many pairs of ribs do we have?

A

12

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3
Q

Number of thoracic vertebrae:

A

12

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4
Q

Name for the floor of the thoracic cage which is a musculotendinous septum that separates the thoracic cavity from the abdomen:

A

Diaphragm

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5
Q

Which ribs attach to the sternum via their costal cartilages?

A

1-7

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6
Q

Which ribs attach to the costal cartilage above?

A

8, 9, & 10

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7
Q

Which ribs are considered “floating” ribs with free palpable tips?

A

11 & 12

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8
Q

Surface landmarks on the thorax are signposts for what?

A

Underlying respiratory structures

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9
Q

What is the name for the non-palpable points at which the ribs join their cartilages?

A

Costochondral junctions

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10
Q

Name for the “breast bone”:

A

Sternum

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11
Q

U-shaped depression just above the sternum between clavicles:

A

Suprasternal notch

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12
Q

By walking your fingers down the manubrium a few centimeters, you can feel a distinct bony ridge called the:

A

Sternal angle

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13
Q

What 3 landmarks are located on the sternum?

A

manubrium, body, & xiphoid process

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14
Q

What is another name for the “Angle of Louis”?

A

Sternal angle

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15
Q

What structure is located at the articulation of the manubrium & body of the sternum? It is also continuous with the 2nd rib.

A

(Angle of Louis)

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16
Q

What is the most useful place to begin counting a patient’s ribs, that can help localize a respiratory finding?

A

Angle of Louis

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17
Q

What marks the site of tracheal bifurcation into the right and left main bronchi?

A

Angle of Louis

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18
Q

The 4 anterior thoracic landmarks are:
- suprasternal notch
- sternum
- sternal angle (angle of louis)
- costal angle

TRUE OR FALSE?

A

True

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19
Q

The right and left costal margins form an angle where they meet at the xiphoid process:

A

Costal angle

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20
Q

Know the location of the posterior thoracic cavity landmarks.

A
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21
Q

The 4 posterior thoracic landmarks are:
- Vertebra prominens
- Spinous processes
- Inferior border of scapula
- 12th rib

TRUE OR FALSE?

A

True

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22
Q

By flexing your head, you can feel the most bony, prominent spur protruding at the base of your neck called:

A

Vertebra prominens

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23
Q

End of the cervical spinous processes & beginning of the thoracic spinous processes:

A

Vertebra prominens

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24
Q

After T4, the spinous process angles in which direction from their vertebral body?

A

Downward

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25
Q

Name for the structures that stack together to form the spinal column, & align with their same numbered ribs ONLY down to T4:

A

Spinous processes

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26
Q

The top bone of the vertebra prominens is what:

A

C7

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27
Q

The bottom bone of vertebra prominens is what?

A

T1

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28
Q

Name for the structures located symmetrically in each hemithroax:

A

Scapulae

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29
Q

By palpating midway between the spine and the patient’s side, you can identify the free tip of which rib?

A

12th

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30
Q

What is considered to be the lower tip, usually at the 7th or 8th rib?

A

Inferior border of the scapula

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31
Q

What are anterior chest reference lines used for?

A

Pinpointing a finding vertically on the chest

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32
Q

What are the three anterior chest reference lines?

A

Axillary line, midclavicular line, & midsternal line

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33
Q

Which anterior chest reference line bisects the center of each clavicle at a point halfway between the palpated sternoclavicular and acromioclavicular joints?

A

Midclavicular line

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34
Q

What posterior reference line extends through the inferior angle of the scapula when the arms are at the sides of the body?

A

Scapular line

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35
Q

What are the two posterior chest reference lines?

A

Scapular line and vertebral (mid spinal) line

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36
Q

By lifting a patient’s arm up 90 degrees, you can divide the lateral chest using three lines, which are called:

A

Anterior axillary, posterior axillary, and midaxillary lines

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37
Q

Located in the middle section of the thoracic cavity containing the esophagus, trachea, heart, and great vessels:

A

Mediastinum

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38
Q

How many lobes does the right lung have?

A

3

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39
Q

How many lobes does the left lung have?

A

2

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40
Q

Located on each side of the mediastinum, containing the lungs:

A

Pleural cavity

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41
Q

Names for the 3 right lobes of the lung:

A

Upper, middle, lower

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42
Q

What structure separates the right upper lobe of the lung with the right middle lobe of the lung?

A

Right horizontal fissure

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43
Q

What structure separates the two left lobes of the lungs?

A

Left oblique fissure

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44
Q

What structure separates the right middle lobe of the lung from the right lower lobe of the lung?

A

Right oblique fissure

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45
Q

Which fissure crosses the 5th rib in the midaxillary line and terminates at the 6th rib in the midclavicular line?

A

Oblique fissure

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46
Q

Name the two lobes of the left lung:

A

Upper & lower

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47
Q

Two other names for the oblique fissures located in each lung?

A

Major or diagonal fissure

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48
Q

Other name for the horizontal fissure in the right lung?

A

Minor fissure

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49
Q

Which fissure extends from the 5th rib in the right midaxillary line to the 3rd intercostal space or the 4th rib at the right sternal border?

A

Minor fissure

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50
Q

What is the most remarkable point about the posterior chest?

A

It is almost all lower lobe

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51
Q

The respiratory system performs several essential functions to support the body’s physiological needs. Which of the following are major functions of the respiratory system? Select all that apply.

A. Supplying oxygen to the body for energy production
B. Removing carbon dioxide as a waste product of energy reactions
C. Producing insulin to regulate blood sugar levels
D. Maintaining homeostasis (acid-base balance) of arterial blood
E. Facilitating nutrient absorption in the intestines
F. Maintaining heat exchange

A

A. Supplying oxygen to the body for energy production
B. Removing carbon dioxide as a waste product of energy reactions
D. Maintaining homeostasis (acid-base balance) of arterial blood
F. Maintaining heat exchange

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52
Q

Why does the respiratory system supply oxygen to the body?

A. To aid in the digestion of food
B. To support the breakdown of carbon dioxide
C. To enable cellular respiration for energy production
D. To maintain the structure of cell membranes

A

C. To enable cellular respiration for energy production

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53
Q

Why does the respiratory system remove carbon dioxide from the body?

A. To increase oxygen levels in the blood
B. To prevent it from accumulating as a waste product of energy reactions
C. To enhance nutrient absorption
D. To stabilize blood pressure

A

B. To prevent it from accumulating as a waste product of energy reactions

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54
Q

How does the respiratory system help maintain homeostasis of arterial blood?

A. By increasing blood glucose levels
B. By regulating the levels of oxygen and carbon dioxide (respiration) to maintain pH balance
C. By absorbing nutrients directly into the bloodstream
D. By stimulating the production of red blood cells

A

B. By regulating the levels of oxygen and carbon dioxide (respiration) to maintain pH balance

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55
Q

In what way does the respiratory system contribute to maintaining heat exchange in the body?

A. By increasing the production of sweat
B. By warming or cooling the air during inhalation and exhalation
C. By regulating blood pressure through vasoconstriction
D. By synthesizing heat-shock proteins

A

B. By warming or cooling the air during inhalation and exhalation

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56
Q

What forms an envelope between the lungs and the chest wall?

A

Slippery pleurae

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57
Q

What cavity normally have a vacuum (negative pressure) to hold the lungs tightly against the chest wall?

A

Pleural cavity

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58
Q

What is considered to be a potential space filled only with a few mL of lubricating fluid?

A

Pleural cavity

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59
Q

Name for the complex lipid substance needed for sustained inflation of the air sacs:

A

Surfactant

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60
Q

The pleurae extend about 3cm below the level of the lungs to form what other potential space?

A

Costodiaphragmatic recess

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61
Q

What is compromised when the costodiaphragmatic recess abnormally fills with air or fluid?

A

Lung expansion

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62
Q

What lies anterior to the esophagus, begins at the level of the cricoid cartilage in the neck, & bifurnicates right below the sternal angle into the right & left main bronchi?

A

Trachea

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63
Q

At the base of the trachea, there is a ridge of cartilage called:

A

The carina

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64
Q

What two structures transport gases between the environment and the lung parenchyma, and also constitute the dead space?

A

Trachea & bronchi

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65
Q

What is the name for the space that is filled with air but is not available for gaseous exchange?

A

Dead space

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66
Q

Functional respiratory unit that consists of the bronchioles, alveolar ducts, alveolar sacs, and the alveoli:

A

Acinus

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67
Q

Slow, shallow breathing:

A

Hypoventilation

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68
Q

Rapid, deep breathing:

A

Hyperventilation

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69
Q

Increased carbon dioxide in the blood:

A

Hypercapnia

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70
Q

Hypoventilation that results in a state in which there is usually a failure of ventilation and an accumulation of carbon dioxide:

A

Respiratory acidosis

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71
Q

Decreased oxygen in the blood:

A

Hypoxemia

72
Q

Hyperventilation that results in a low level of carbon dioxide in the blood:

A

Respiratory alkalosis

73
Q

Decreased carbon dioxide in the blood:

A

Hypocapnia

74
Q

What is the normal stimulus to breathe for most of us?

A

Hypercapnia

75
Q

ATP (adenosine triphosphate) is essential for many physiological processes in the human body. Which of the following statements describe how ATP is involved in the mechanism of breathing? Select all that apply.

A. ATP provides energy for the contraction of respiratory muscles such as the diaphragm.
B. ATP is synthesized in the lungs during the process of gas exchange.
C. ATP production increases the oxygen demand, influencing the rate and depth of breathing.
D. ATP is used to warm the air as it enters the respiratory tract.
E. ATP formation utilizes oxygen obtained through breathing, supporting cellular respiration.

A

A. ATP provides energy for the contraction of respiratory muscles such as the diaphragm.
C. ATP production increases the oxygen demand, influencing the rate and depth of breathing.
E. ATP formation utilizes oxygen obtained through breathing, supporting cellular respiration.

76
Q

What does ATP stand for?

A

Adenosine triphosphate

77
Q

Occurs when not enough oxygen is reaching the body’s tissues:

A

Hypoxia

78
Q

Physical act of breathing:

A

Ventilation

79
Q

Air rushes into the lungs as the chest size increases. This is known as:

A

Inspiration

80
Q

Air is expelled from the lungs as the chest recoils. This is known as:

A

Expiration

81
Q

Which muscle is primarily responsible for increasing thoracic container size during inspiration?

A) Intercostal muscles
B) Abdominal muscles
C) Diaphragm
D) Sternocleidomastoid

A

C) Diaphragm

81
Q

What causes air to rush into the lungs during inspiration?

A) Positive pressure in the atmosphere
B) Negative pressure in the thoracic container
C) Contraction of the intercostal muscles
D) Relaxation of the diaphragm

A

B) Negative pressure in the thoracic container

82
Q

What is the role of intercostal muscles in inspiration?

A) They depress the ribs and sternum
B) They elevate the ribs and lift the sternum
C) They contract the diaphragm
D) They reduce the AP diameter

A

B) They elevate the ribs and lift the sternum

83
Q

What happens to the pressure within the alveoli during expiration?
A) It decreases, drawing air in
B) It remains constant
C) It becomes relatively positive, pushing air out
D) It becomes negative, retaining air

A

C) It becomes relatively positive, pushing air out

83
Q

What does “respiration” involve at the cellular level?

A) Movement of air into and out of the lungs
B) Exchange of oxygen and carbon dioxide across membranes
C) Contraction of the diaphragm
D) Elevation of the rib cage

A

B) Exchange of oxygen and carbon dioxide across membranes

84
Q

Is expiration an active or passive process, and why?

A) Active, due to muscle contraction
B) Passive, due to elastic forces
C) Active, due to diaphragm contraction
D) Passive, due to rib elevation

A

B) Passive, due to elastic forces

85
Q

Where does actual “respiration” occur?

A) In the alveoli of the lungs
B) At the cellular level
C) In the bronchi and bronchioles
D) In the trachea

A

B) At the cellular level

86
Q

What is the role of the abdominal muscles in forced expiration?

A) To lower the diaphragm
B) To elevate the rib cage
C) To push the abdominal viscera in and up against the diaphragm
D) To stabilize the spine

A

C) To push the abdominal viscera in and up against the diaphragm

87
Q

Altered mental status + confusion is due to what, until proven otherwise?

A

Hypoxia

88
Q

When a patient has sudden onset of altered mental status / confusion, what are the two steps that need to be done immediately?

A

SpO2 & ABG

89
Q

What is the second most commonly diagnosed cancer in humans in the USA?

A

Lung cancer

90
Q

Volume of air inhaled in a single, normal breath:

A

Tidal volume (TV)

91
Q

Amount of air remaining in the lungs after maximum expiration:

A

Residual volume (RV)

92
Q

The greatest volume of air that can be expelled from the lungs after taking the deepest possible breath:

A

Vital capacity

93
Q

Most common chronic disease in childhood, seen in 5.8% of children under the age of 18:

A

Asthma

94
Q

Acute cough lasts less than:

A

2-3 weeks

95
Q

Chronic cough lasts over:

A

2 months

96
Q

Continuous cough throughout the day:

A

Acute illness

97
Q

Afternoon / evening cough:

A

May be exposure to irritants at work

98
Q

Cough occurring at night can be a result of:

A

Post-nasal drip or sinusitis

99
Q

Cough occurring in the early morning:

A

Chronic bronchial inflammation of smokers

100
Q

What sputum color is associated with a bacterial infection:

A

Yellow / green

101
Q

What sputum color is associated with viral infection, bronchitis, and colds?

A

White / clear

102
Q

What sputum color is associated with pneumonia (pneumococcal) or TB?

A

Rust

103
Q

What sputum color is associated with pulmonary edema?

A

Frothy / pink

104
Q

Coughing up blood is otherwise known as:

A

Hemoptysis

105
Q

Type of cough in mycoplasma pneumonia:

A

Hacking

106
Q

Type of cough in early heart failure:

A

Dry

107
Q

Type of cough in croup:

A

Barking

108
Q

Type of cough in colds, bronchitis, & pneumonia:

A

Congested

109
Q

Difficulty breathing when supine:

A

Orthopnea

110
Q

Awakening from sleep with SOB and needing to be upright to achieve comfort:

A

Paroxysmal nocturnal dyspnea

111
Q

SOB episodes associated with night sweats:

A

Diaphoresis

112
Q

What may occur with a specific allergen, extreme cold, or anxiety and is often described as “chest tightness”:

A

Asthma

113
Q

Cyanosis signals what?

A

Hypoxia

114
Q

It is important for us to inquire about a cough, chest pain, respiratory infections, smoking hx, and environmental exposure when determining the risk for what type of cancer?

A

Lung cancer

114
Q

Older adults have a less sufficient respiratory system due to:

A

Decreased vital capacity & less SA for gas exchange

115
Q

What shape does the chest tend to have in a COPD patient?

A

Barrel chest

115
Q

Sharp, stabbing, or burning pain in the chest that worsens when breathing in or out, coughing, or sneezing:

A

Pleuritic pain

115
Q

What type of muscles are typically used when a patient has COPD?

A

Accessory muscles

116
Q

Which of the following conditions could be indicated by evaluating skin quality and color, such as pallor, cyanosis, redness, or a dusky appearance? Select all that apply.

A) Pallor
B) Cyanosis
C) Allergic Reaction
D) Redness
E) Dusky appearance

A

A) Pallor
B) Cyanosis
D) Redness
E) Dusky appearance

117
Q

Respiratory findings that include pallor, cyanosis, redness, and a dusky appearance indicate what?

A

Hypoxia

118
Q

What occurs when blood enters your pleural space?

A

Hemothorax

118
Q

Occurs when the patient states “99” or “blue moon”, and is palpated as an impressive vibration:

A

Tactile (Vocal) Fremitus

118
Q

Which condition(s) can be indicated by abnormal chest expansion?

A) Atelectasis
B) Pleural Effusion / Hemothorax
C) Pneumonia (Lobar)
D) Rib Fractures (Trauma)
E) Pneumothorax
F) Pain associated with deep breathing in the setting of pleural
inflammation
G) All of the above

A

G) All of the above

119
Q

Symmetry of tactile fremitus across bilateral lung fields is expected.

TRUE OR FALSE?

A

True

120
Q

Consider consolidation of the lung such as pneumonia:

A

Increased fremitus

121
Q

Consider obstruction such as pleural effusion / hemothorax / pneumothorax:

A

Decreased fremitus

122
Q

Clear, defined, low-pitched, hollow sound that predominates in healthy lung tissue in the adult patient:

A

Resonance

123
Q

So-called booming sound with substantial amount of air present:

A

Hyperresonance

124
Q

So-called muffled, soft thud sound:

A

Dull sound finding

124
Q

Normal high-pitched, loud, harsh, hallow, and tubular sound located in the trachea and larynx where inspiration is less than (<) expiration:

A

Bronchial (Tracheal)

125
Q

Normal moderate sound located over major bronchi, where inspiration = expiration:

A

Bronchovesicular

126
Q

Normal low-pitched, soft, rustling-like-the-trees sound located over peripheral lung fields, where inspiration is greater than (>) expiration:

A

Vesicular

127
Q

What normal lung sounds are no heard posteriorly?

A

Bronchial (tracheal)

128
Q

Name for abnormal sounds:

A

Adventitious sounds

129
Q

High-pitched, short, discontinuous, popping sounds heard during inspiration that are not cleared by coughing:

A

Fine crackles

130
Q

Low-pitched, discontinuous, bubbling & gurgling sounds that start in early inspiration and may be present in expiration:

A

Course crackles

131
Q

Adventitious sound associated with pulmonary edema & pulmonary fibrosis:

A

Course crackles

132
Q

Adventitious sound associated with pneumonia & HF:

A

Fine crackles

133
Q

Discontinuous, sounds like fine-crackles, are not pathologic, & tend to disappear after the first few breaths:

A

Atelectatic crackles

134
Q

Superficial, course, low-pitched sound heard both on inspiration and expiration:

A

Pleural friction rub

135
Q

High-pitched, continuous, musical squeaking sounds that sound like multiple notes in a music chord, & predominate in expiration:

A

High-pitched wheezes (sibilant)

136
Q

Low-pitched, continuous, single-note, musical snoring, & moaning sounds that are heard throughout the cycle and are more prominent on expiration - May also somewhat clear by coughing:

A

Low-pitched wheezes (Sonorous rhonchi)

137
Q

High-pitched, continuous, monophonic, inspiratory, crowing sounds that are louder in the neck than over the chest wall:

A

Stridor

138
Q

What adventitious sound can be considered a medical emergency and should be assessed immediately?

A

Stridor

139
Q

Number of seconds it takes for the person to exhale from total lung capacity to residual volume:

A

Forced expiratory time

140
Q

What piece of handheld equipment is seen after surgery and is also used to measure lung health in chronic conditions?

A

Incentive spirometer

141
Q

Normal chest slope is:

A

Downward

142
Q

A markedly sunken sternum and adjacent cartilages (funnel breast):

A

Pectus excavatum

143
Q

A forward protrusion of the sternum, with the ribs sloping back at either side and vertical depressions along costochondral junctions (pigeon breast):

A

Pectus carinatum

144
Q

Lateral, S-shaped curvature of the thoracic and lumbar spine, usually involved with vertebrae rotation:

A

Scoliosis

145
Q

Exaggerated posterior curvature of the thoracic spine (humpback) that causes significant back pain and limited mobility:

A

Kyphosis

146
Q

250 mL or less on an incentive spirometer:

A

Hypoventilation

147
Q

2000 mL or more on an incentive spirometer:

A

Hyperventilation

148
Q

Fast-paced breathing over 20 breaths per minute:

A

Tachypnea

149
Q

Slow breathing, less than 12 breaths per minute:

A

Bradypnea

150
Q

Occasional ______ punctuate the normal breathing pattern and are purposeful to expand alveoli.

A

Sighs

151
Q

Breathing pattern that involves a cycle of gradually increasing and then decreasing breaths, followed by a pause in breathing called an apnea:

A

Cheyne-Stoke respirations

152
Q

A series of 3-4 normal respirations followd by a period of apnea:

A

Biot respirations

153
Q

The intercostal space number correlates to the rib:

A) Above
B) Below

A

A) Above

154
Q

A patient comes in with rust-colored sputum. What transmission precautions should they be put on?

A. Standard
B. Airborne
C. Droplet
D. Contact

A

B. Airborne

155
Q

What position could indicate that the patient is in respiratory distress:

A

Tripod position

156
Q

Stridor is part of the anaphylactic reaction and is a late response:

TRUE OR FALSE?

A

True

157
Q

Barrel chest is seen in what patient population?

A

COPD

158
Q

Cheyne-stokes & biot respirations are abnormal breathing rhythms associated with dying patients.

TRUE OR FALSE?

A

True

159
Q

Normal inspiration and prolonged expiration to overcome increased airway resistence:

A

Chronic obstructive breathing

160
Q

Increased tactile fremitus would be evident in an individual who has which of the following conditions?

A. Emphysema
B. Pneumonia
C. Crepitus
D. Pneumothorax

A

B. Pneumonia

161
Q

Which of the following is a clinical manifestation in patients with COPD?

A. Periodic breathing patterns
B. Prolonged expiration
C. Unequal chest expansion
D. Hyperventilation

A

B. Prolonged expiration

162
Q

When auscultating lung sounds, it is important for the nurse to do which of the following?

A. Tell the patient to stop the assessment if they begin to feel dizzy.
B. Quickly move through the assessment to decrease risk for fainting or hyperventilation.
C. Complete assessment of right lung fields then move to auscultate the left lung fields.
D. Anterior auscultation should include 9 spots on each side.

A

A. Tell the patient to stop the assessment if they begins to feel dizzy.

163
Q

Inspiration is primarily facilitated by which of the following muscles?

A. Diaphragm and rectus abdominis
B. Trapezius and sternomastoids
C. Internal intercostal and abdominis
D. Diaphragm and intercostal

A

D. Diaphragm and intercostal

164
Q

Which of the following voice sounds would be a normal finding?

A. The voice transmission is distinct and sounds close to the ear.
B. The “eeeee” sound is clear and sounds like “eeeee.”
C. The whispered sound is transmitted clearly.
D. Whispered “1-2-3” is audible and distinct.

A

B. The “eeeee” sound is clear and sounds like “eeeee.”

165
Q

The gradual loss of intra-alveolar septa and a decreased number of alveoli in the lungs of older adults cause:
A. hyperventilation.
B. spontaneous atelectasis.
C. decreased surface area for gas exchange.
D. decreased dead space.

A

C. decreased surface area for gas exchange.

166
Q

Stridor is a high-pitched, inspiratory crowing sound commonly associated with:

A. upper airway obstruction.
B. atelectasis.
C. congestive heart failure.
D. pneumothorax.

A

A. upper airway obstruction.

167
Q

An increase in the transverse diameter of the chest cage in a pregnant woman is due to a(n):

A. compensatory increase in respiratory parenchyma.
B. increase in estrogen.
C. increase in surfactant.
D. increase in tidal volume. Incorrect

A

B. increase in estrogen.

Health Assessment (42 decks)

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