Exam 2 - Chpt 16 Flashcards
primary organs of the respiratory system
lungs
thorax
fundamental responsibility of the lungs and thorax
gas exchange
thorax, thoracic cavity is aka
the chest
3 sections of the thoracic cavity
mediastinum
R, L pleural cavity
what does the mediastinum contain?
heart
trachea
esophagus
major blood vessels
what does each pleural cavity contain?
a lung
major function of the respiratory system
supply body with O2
expel CO2
what occurs during external respiration
exchange of O2, CO2 at alveoli level
what occurs during internal respiration
exchange of O2, CO2 at cellular level
what is included in the upper respiratory tract
nose mouth sinuses pharynx larynx proximal portion of trachea
what is included in the lower respiratory tract
distal portion of trachea bronchi lungs pleural membranes muscles of respiration mediastinum
this helps sweep debris towards the mouth
cilia
how many lobes does the L lung have?
2 (upper, lower)
longer, narrower
how many lobes does the R lung have
3 (upper, middle, lower)
larger, wider, shorter than L lung
thin, double-layered, serous membrane that lines each pleural cavity
pleura
normal breathing
eupnea
SOB, difficulty breathing
dyspnea
which ethnic groups are at higher risk for asthma
Hispanic, Puerto Rican American Indians Alaska Natives non-Hispanic Blacks Filipinos non-Hispanic Whites
ethnic groups with the lowest prevalence of asthma
Asian Americans
Asian Pacific Islanders
ethnic groups with high rates of COPD
non-Hispanic Whites
ratio of length of inspiration and expiration
1:2
anteroposterior chest ration
2:1
funnel chest (pectus excavatum)
depression of sternum and adjacent costal cartilage
scoliosis
lateral curvature, rotation of thoracic and lumbar spine
deviation >45 may distort the lungs
pigeon chest (pectus carinatum)
congenital deformity characterized by forward displacement of sternum
palpable vibration on the chest wall when a pt speaks
fremitus
repeats “99”
4 normal breath sounds heard during auscultation
tracheal
bronchial
bronchovesicular
vesicular
tracheal breath sounds
harsh, high-pitched
heard over treachea
bronchial breath sounds
loud, high-pitched
heard next to trachea
superior to clavicles
1st intercostal space
bronchovesicular breath sounds
medium loudness and pitch
2, 3 intercostal spaces between scapulae
vesicular breath sounds
soft, low pitched
remainder of lungs
adventitious sounds
abnormal breath sounds
fine rales/crackles
high pitched
short
crackling
collapsed or fluid filled alveoli open
coarse rales/crackles
loud
moist
low pitched
bubbling
collapsed or fluid filled alveoli open
wheezes (sibilant)
high pitched
continuous
blocked airway; asthma, infection, foreign body
rhonchi (sonorous)
low pitched
continuous
snoring
rattling
fluid blocked airway
stridor
loud
high-pitched
crowing heard without stethoscope
obstructed upper airway
friction rub
low pitched
grading
rubbing
pleural inflammation
bronchophony
auscultation of voice sounds
says “99”, normal lung sounds will be muffled
egophony
auscultation of voice sounds
says “E”; normal like sounds will sound like “eeeee”
whispered pectoriloquy
auscultation of voice sounds
whispers “1, 2, 3”; normal sounds will be faint
atelectasis
collapse of or impaired inflation of 1 or more parts of the lung (alveoli)
lobar PNA
fluid, bacteria, and celluar debri fill alveoli
pleural effusion
fluid accumulation in pleural space
pneumonothorax
air moves into the pleural space and causes partial or complete collapse of the lung
can be spontaneous, traumatic, or tension
where do you auscultation the upper apex of the lungs
clavicular level
function of visceral pleura
covers lungs
function of parietal pleura
lines ribcage
covers upper surface of diaphragm
function of pleural cavity
space between 2 pleura
contains small amount of fluid
coal miners are susceptible to ___, a form of black lung disease
pneumoconiosis
hazards for respiratory
caustic fumes fungi asbestos coal tar nickel silver textile fibers chromate vinyl chlorides
2nd most dx cancer
lunger
smoking is the cause for 90%
most common chronic childhood disease
asthma
highest burden seen in those living at or below federal poverty level
subjective data r/t respiratory
cough SOB chest pain with breathing hx of respiratory infection smoking status environmental factors
smoking counseling - what are the 5 A’s
ask advise assess assist arrange
polycythemia
excess RBC production
polycythemia is seen in these pts
COPD
CHF
barrel chest ratio
1:1
d/t hyperinflation of lungs
cause of kyphosis
loss of lung resiliency and skeletal muscle
obesity can impede (make absent) ___
fremitus
which part of your hand to use use to test for fremitus
all or ulnar edge of 1 hand
as you move, it should be equal
unequal fremitus is a result of
consolidation
decrease fremitus may indicate
bronchial obstruction air trapping (emphysema) pleural effusion pneumonothorax obstruction of tracheobronchial tree
where to place your hands to assess chest expansion
posterior, thumbs at T9-T10; pinch skin between thumbs
thumbs should move 5-10 cm apart
cause of unequal chest expansion
severe atelectasis
PNA
chest trauma
pneumothorax
what do you tell the pt to do if you hear adventitious breath sounds?
cough, reassess
tachypnea RR
hyperventilation
> 24
cheyne-stokes
unusual, deep breathing pattern that last 30-45 seconds with periods of apnea
may last 20 seconds with cycling
bradypnea RR
hypoventilation
< 10
Biot’s/Ataxic respirations
shallow, deep with periods of apnea
irregular
–respiratory depression, brain damage
breath sounds heard with atelectasis
decreased, absent over the affected area
how is chronic bronchitis Dx
productive cough for at least 3 months/year x2 consecutive years
when are voice sounds (fremitus) louder over an affected area?
lobar PNA
asking a pt how many pillows they sleep on can determine what?
orthopnea
imaging studies for respiratory
CXR
CT
Echo
what to ask female pts when due for imaging study?
date of LMP
pregnancy
