Chest & Lungs Flashcards
what are the FOUR FUNCTIONS OF THE RESPIRATORY SYSTEM?
- SUPPLYING OXYGEN to the body for energy production
- REMOVING CARBON DIOXIDE as a waste product
- MAINTAINING HOMEOSTASIS within the arterial blood **acid-base balance
- MAINTAINING HEAT EXCHANGE
definition of RESPIRATION
- the movement of air BACK & FORTH from the ALVEOLI & the outside environment
- gas exchange within the ALVEOLAR & PULMONARY CAPILLARY MEMBRANES
what is the PHYSICAL EXAM order for evaluating the chest & lungs?
- INSPECTION/EVALUATION
- PALPATION
- PERCUSSION
- AUSCULTATION
(posterior - anterior)
describe how the CHEST SIZE CHANGES during RESPIRATION
INSPIRATION:
-air begins to rush into the lungs;
DIAPHRAGM – CONTRACTS & goes DOWNWARD
EXPIRATION:
- air is expelled from the lungs as the chest recoils
-
how is RESPIRATION CONTROLLED?
- through the RESP. CENTERS within the BRAIN STEM
- also asesses the CO2 levels within the blood
which area is the best for assessing the RIGHT MIDDLE LOBE?
the MID AXILLARY LINE
describe LUNG ANATOMY
- UNGS:
- RIGHT LUNG - has 3 lobes
- LEFT LUNG - has 2 lobes
- has various fissures for division
- contains over 300 million within an adult
describe the ANTERIOR ASPECT VIEW OF LUNGS
- indication of RIGHT & LEFT LOBE CAVITIES
- difficulty to see RIGHT INFERIOR LOBE & LEFT INFERIOR LOBE
describe the POSTERIOR ASPECT VIEW OF THE LUNGS
- 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
describe the LATERAL ASPECT VIEW OF THE LEFT LUNG
- clear view of BOTH LOBES of the LEFT LUNG
describe the LATERAL ASPECT VIEW OF THE RIGHT LUNG
- CLEAR VIEW OF ALL THREE LOBES
- best aspect view to see the RIGHT MIDDLE LOBE
are the LUNGS SYMMETRICAL?
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
pleurae
thin slippery envelope that between the lungs & chest wall
visceral pleura
lining outside of the lungs
parietal pleura
lines the inside of the chest wall & diaphragm
what is the PLEURAL SPACE filled with?
lubricating fluid - want to reduce friction
where is the TRACHEA LOCATED?
- around 10-11 cm long
- is ANTERIOR TO the ESOPHAGUS
- bifuracates at T4/T5
important questions to ask regarding HISTORY OF PRESENT ILLNESS?
- can really vary pertaining between COUGH, SOB, CHEST PAIN
- onset/duration?
- dyspnea?
- location?
- any a/b factors?
- different positioning that helps?
- medications?
what are some RESPIRATORY DISEASES to consider during FAMILY Hx?
- ALLERGIES
- ASTHMA
- ATOPIC DERMATITIS (goes in hand in hand with eczema - genetic)
- CYSTIC FIBROSIS
- CLOTTING DISORDERS (risk of pulmonary embolism
- TB
- EMPHYSEMA/BRONCHITIS/ETC»>
what are some considerations to observe for OLDER ADULTS for respiratory issues?
- 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??
describe CHEST INSPECTION
- inspecting landmarks (shape, color, symmetry)
- inspecting RESPIRATIONS (rate, rhythm)
- any audible sounds?
(nasal flaring, accessory muscle use, retraction etc…) - PULSE OX
what is a NORMAL A/P DIAMETER vs. an ABNORMAL ONE?
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.
describe CHEST PALPATION
- 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
how do we test THORACIC EXPANSION?
- 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
