CHapter 8: Thorax and Lungs

Question 1

Structures anterior

Answer 1

Manubrium of sternum
Sternal Angle
2nd rib
2nd intercostal cartilage
Costchondral junctions
Xyphoid process

Question 2

Structures posterior

Answer 2

Spinous process C7
“T1
T7-T8 interspace and inferior angele of scapula

Question 3

Right main bronchus

Answer 3

shallower angle-easier for aspirated material to pass

Question 4

Assessment methods

Answer 4

Inspection
Palpation
Persussion
Auscultation

Question 5

Test chest expansion

Answer 5

thumbs at level of T10-fold skin-pt inhale deeply checking for symmetrical excursion

Question 6

tactile fremitus

Answer 6

palpable vibrations transmitted “ninety-nine”

impeded vibrations in : thick chest wall, obstructed bronchus, COPD, pleural effusion, fibrosis, pneumothorax, tumors

Question 7

Percussion

Answer 7

Flatness: large pleural effusion
Dullness: lobar pneumonia
Resonance: siple, chronic bronchitis
Hyperresonance: COPD, pneumo
Tympany: large pneumo

Question 8

Breath sounds

Answer 8

vesicular: over most of both lungs
bronchovesicular: 1st-2nd interspaces ant or between scapula
bronchial: manubrium
trancheal: trachea

Question 9

Transmitted voice sounds

Answer 9

bronchophony: “ninety-nine”: normally muffled and indistinct. louder and clearer is bronchophony
egophony: when “E” is heard as “ay”. consolidation
whispered pectoriloquy: “ninety-nione” whispered not normally heard-if heard could rep consolidation

Question 10

identify fractured rib

Answer 10

AP compression of chest will distiguish between soft tissue injury and rib fracture