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NURS 210 > Chest & Lungs > Flashcards

Chest & Lungs Flashcards

1
Q

what are the FOUR FUNCTIONS OF THE RESPIRATORY SYSTEM?

A
  1. SUPPLYING OXYGEN to the body for energy production
  2. REMOVING CARBON DIOXIDE as a waste product
  3. MAINTAINING HOMEOSTASIS within the arterial blood **acid-base balance
  4. MAINTAINING HEAT EXCHANGE
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2
Q

definition of RESPIRATION

A
  • the movement of air BACK & FORTH from the ALVEOLI & the outside environment
  • gas exchange within the ALVEOLAR & PULMONARY CAPILLARY MEMBRANES
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3
Q

what is the PHYSICAL EXAM order for evaluating the chest & lungs?

A
  • INSPECTION/EVALUATION
  • PALPATION
  • PERCUSSION
  • AUSCULTATION
    (posterior - anterior)
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4
Q

describe how the CHEST SIZE CHANGES during RESPIRATION

A

INSPIRATION:
-air begins to rush into the lungs;
DIAPHRAGM – CONTRACTS & goes DOWNWARD
EXPIRATION:
- air is expelled from the lungs as the chest recoils
-

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5
Q

how is RESPIRATION CONTROLLED?

A
  • through the RESP. CENTERS within the BRAIN STEM
  • also asesses the CO2 levels within the blood
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6
Q

which area is the best for assessing the RIGHT MIDDLE LOBE?

A

the MID AXILLARY LINE

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7
Q

describe LUNG ANATOMY

A
  • UNGS:
    • RIGHT LUNG - has 3 lobes
    • LEFT LUNG - has 2 lobes
    • has various fissures for division
    • contains over 300 million within an adult
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8
Q

describe the ANTERIOR ASPECT VIEW OF LUNGS

A
  • indication of RIGHT & LEFT LOBE CAVITIES
  • difficulty to see RIGHT INFERIOR LOBE & LEFT INFERIOR LOBE
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9
Q

describe the POSTERIOR ASPECT VIEW OF THE LUNGS

A
  • clear view of BOTH LOBES IN THE LEFT LUNG
  • clear view of SUPERIOR & INFERIOR RIGHT LOBES
    **not a clear view for the RIGHT MIDDLE LOBE
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10
Q

describe the LATERAL ASPECT VIEW OF THE LEFT LUNG

A
  • clear view of BOTH LOBES of the LEFT LUNG
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11
Q

describe the LATERAL ASPECT VIEW OF THE RIGHT LUNG

A
  • CLEAR VIEW OF ALL THREE LOBES
  • best aspect view to see the RIGHT MIDDLE LOBE
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12
Q

are the LUNGS SYMMETRICAL?

A

NO
- remember they have different amount of lobes; the right lung is more SHORT/ while the left lung is more NARROW
- auscultating the RIGHT MIDDLE LOBE - often on the LATERAL ASPECT/AXILLARY SITE

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13
Q

pleurae

A

thin slippery envelope that between the lungs & chest wall

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14
Q

visceral pleura

A

lining outside of the lungs

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15
Q

parietal pleura

A

lines the inside of the chest wall & diaphragm

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16
Q

what is the PLEURAL SPACE filled with?

A

lubricating fluid - want to reduce friction

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17
Q

where is the TRACHEA LOCATED?

A
  • around 10-11 cm long
  • is ANTERIOR TO the ESOPHAGUS
  • bifuracates at T4/T5
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18
Q

important questions to ask regarding HISTORY OF PRESENT ILLNESS?

A
  • can really vary pertaining between COUGH, SOB, CHEST PAIN
  • onset/duration?
  • dyspnea?
  • location?
  • any a/b factors?
  • different positioning that helps?
  • medications?
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19
Q

what are some RESPIRATORY DISEASES to consider during FAMILY Hx?

A
  • ALLERGIES
  • ASTHMA
  • ATOPIC DERMATITIS (goes in hand in hand with eczema - genetic)
  • CYSTIC FIBROSIS
  • CLOTTING DISORDERS (risk of pulmonary embolism
  • TB
  • EMPHYSEMA/BRONCHITIS/ETC»>
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20
Q

what are some considerations to observe for OLDER ADULTS for respiratory issues?

A
  • can have more difficulty and SOB with ADLs
  • more risk for respiratory diseases/exposure; how does this affect them?
  • any chest pain/coughing/impact on ADLs/weight loss??
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21
Q

describe CHEST INSPECTION

A
  • inspecting landmarks (shape, color, symmetry)
  • inspecting RESPIRATIONS (rate, rhythm)
  • any audible sounds?
    (nasal flaring, accessory muscle use, retraction etc…)
  • PULSE OX
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22
Q

what is a NORMAL A/P DIAMETER vs. an ABNORMAL ONE?

A

NORMAL: 1:2
This means that the distance from the front to the back of the chest is less than the distance from side to side.

ABNORMAL: 1:1
can indicate conditions that cause hyperinflated lungs, such as emphysema or chronic obstructive pulmonary disease (COPD). A 1:1 ratio is also common in children under two years old.

23
Q

describe CHEST PALPATION

A
  • looking for any tenderness, masses, pulsations
  • CREPITUS; a cracking or crinkling sensation–can be heard & palpated
    indication of AIR in the SUBQ TISSUE or rupturing or INFECTION
24
Q

how do we test THORACIC EXPANSION?

A
  • putting thumbs lined up on the posterior aspect of the patient
  • looking at expansion & symmetry - through MOVEMENT OF THE HANDS
  • thumbs at level of the TENTH RIB
25
Q

what are the PERCUSSION TONE INDICATORS FOR THE LUNGS?

A
  • RESONANCE; NORMAL
  • HYPERRESONANCE; HYPERINFLATION
  • DULLNESS; DIMINISHED AIR EXCHANGE
26
Q

diaphragm vs. bell

A

DIAPHRAGM;
used to hear HIGH-PITCHED SOUNDS
(often for lungs and heart)

BELL;
used to hear LOW-PITCHED SOUNDS
(often for heart - **murmurs)

27
Q

what are the BREATH SOUNDS?

A
  • BRONCHIAL
  • BRONCHOVESICULAR
  • VESICULAR
28
Q

describe BRONCHIAL BREATH SOUNDS

A
  • these are the HIGHEST IN PITCH & INTENSITY
  • often heart only over the TRACHEA
29
Q

describe BRONCHOVESICULAR BREATH SOUNDS

A
  • these are heard over the MAJOR BRONCHI
  • often are MODERATE IN PITCH & INTENSITY
30
Q

describe VESICULAR BREATH SOUNDS

A
  • these are LOW PITCHED & LOW INTENSITY
  • heard over HEALTHY LUNG TISSUE
31
Q

what are some ADENTITIOUS BREATH SOUNDS?

A
  • CRACKLES/RALES
  • RHONCHI (SONOROUS WHEEZES)
  • WHEEZES
  • FRICTION RUB
32
Q

crackles

A
  • often heard more during INSPIRATION
  • known to be DISCONTINUOUS
  • can be EITHER FINE (h. pitched/short) OR COARSE (l. pitched/longer)
33
Q

rhonchi (sonorous wheezes)

A
  • has a DEEP RUMBLING PRONOUNCED SOUND during EXPIRATION
  • more PROLONGED & CONTINUOUS
  • caused by OBSTRUCTION (thick secretions, spasm, tumor, pressure)
  • can sound like a SNORE
    ex. asthma
34
Q

wheezes

A
  • described as a CONT. HIGH-PITCHED MUSICAL SOUND (almost a WHISTLE)
  • can be heard in both INSPIRATION & EXPIRATION
  • often due to a HIGH-VELOCITY AIRFLOW through narrow/obstructed airway
  • can be caused by a BRONCHOSPASM of asthma/bronchitis
35
Q

friction rub

A
  • happens OUTSIDE RESPIRATORY TREE
  • has a DRY/CRACKLING/LOW-PITCHED SOUND
  • caused by inflamed & roughed surfaces rubbing together
36
Q

asthma

A
  • characterized by SMALL AIRWAY OBSTRUCTION
  • can have AIRWAY INFLAMMATION + EXCESSIVE MUCUS
    **conditions can worsen if irregular use of inhalers – expensive to buy; many patients are conservative with their means
37
Q

atelectasis

A

the incomplete expansion of the lung at birth
collapse of the lung at any age

38
Q

bronchitis

A

inflammation of the large airways

39
Q

pneumonia

A

the inflammatory response of the BRONCHIOLES & ALVEOLI to an infective agent
- can be either bacterial, fungal, or viral

40
Q

influenza

A
  • viral infection of the lung; a SECONDARY BACTERIAL INFECTION
41
Q

covid 19

A

type of VIRAL INFECTION; caused by SARS COV-2 virus

42
Q

TB

A

is an infectious disease that most commonly
affects the lungs. TB is caused by a bacteria called Mycobacterium tuberculosis!

43
Q

common symptoms and findings of TB

A

symptoms;
- prolonged cough
- fatigue/weakness
- chest pain
- weight loss

**antibiotic recovery is long; takes around 4 - 6 months/no alcohol allowed

44
Q

pneumothorax

A

presence of AIR or GAS in the PLEURAL CAVITY

45
Q

hemothorax

A

presence of BLOOD in the pleural cavity
- this is often due to LUNG TRAUMA

46
Q

lung cancer

A

type of BRONCHOGENIC CARCINOMA–malignant tumor
- cells grow out of control; form tumors that begin to damage healthy lung tissue

47
Q

common symptoms/findings of lung cancer

A
  • voice hoarse
  • dyspnea
  • chest pain
  • persistant coughing
  • often can hear WHEEZING
  • some tenderness, masses, etc…
48
Q

pulmonary embolism

A

an EMBOLIC OCCULSION of pulmonary arteries
- can be considered a MEDICAL EMERGENCY

49
Q

epiglottitis

A
  • type of ACUTE + LIFE-THREATENING INFECTION that involves the epiglottis & surrounding tissue
  • can be serious and increase with crying
  • consideration of intubation
50
Q

COPD

A
  • mixture of various resp. issues - coughing, sputum production, dyspnea
  • greatest at risk; SMOKERS
51
Q

emphysema

A

where lungs lose ELASTICITY; alveoli begin to enlarge

52
Q

chronic bronchitis

A

large airway inflammation

53
Q
A

NURS 210 (15 decks)

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