HA Chapter 19 Flashcards
Thoracic cage
bony, conical, narrow at top
Sternum, ribs (12), vertebrae, diaphragm, costal cartilages, costochondral junctions
Diaphragm
Musculotendinous septum that separates the thoracic cavity from the abdomen
Cotochondral junctions
Points at which the ribs join their cartilages
Not palpable
Anterior thoracic landmarks
Supra stern also notch, sternum, eternal angle, costal angle
Supersternal notch
U-shaped depression above sternum and between clavicles
Sternum
Breastbone
3 parts: manubrium, the body, xiphoid process
walk fingers down the manubrium a few centimeters until you get to a bony ridge (sternum angle)
Sternal angle
“Angle of Louis”
Continuous with second rib
Marks site of tracheal bifurcation into the right and left main bronchi; corresponds to upper border of atria of the heart, lies above the 4th thoracic vertebra on the back
When does the costal angle increase?
when the rib cage is chronically overinflated (eg: emphysema)
Normal: 90 degree angle or less
Posterior thoracic landmarks
Vertebra prominens, spinous processes, inferior border of the scapula, twelfth rib
Reference Lines
Helps pinpoint finding on chest
Eg: midsternal, midclavicular, vertebral, scapular, anterior auxiliary, posterior auxiliary, midaxillary
Mediastinum
Middle section of thoracic cavity
Esophagus, trachea, heart, great vessels
Pleural cavities
Right and left, on either side of the mediastinum
Contain the lungs
Pleurae
Serous membranes that form an envelope between lungs and chest wall
Visceral: lines the outside of the lungs, dipping down into fissure
Parietal: line inside of chest wall and diaphragm
Costodiaphragmatic Recess
where the pleurae extend about 3 cm below the level of the lungs
Issue: potential compromises lung expansion if it abnormally fills with air or fluid
Main functions of the respiratory system
1- supply oxygen to body for energy production
2- remove carbon dioxide as a waster product of energy reactions
3- maintain homeostasis (acid-base balance) of arterial blood
4- maintain heat exchange
Maintains pH or acid/base balance of blood
Respiratory center in brain
Pons and medulla
Hypercapnia
Increase of carbon dioxide in the blood
hypoxemia
Decrease of oxygen in the blood
Subjective Data: Thorax and Lungs
Cough, SOB, chest pain with breathing, history of respiratory infections, smoking history, environmental exposure, patient-centered care
Summary: thoracic and lung examination
Inspection: thoracic cage, respiration’s, skin color and conditions, person’s position, facial expression, LOC
Palpation: confirm symmetric expansions, tactile fremitus, detect any lumps, masses, tenderness
Percussion: percussion over lung fields
Auscultation: assess normal breath sounds, not any abnormal breath sounds, if abnormal breath sounds present, perform bronchophony, whispered pectoriloquy, egophony, not any adventitious sounds
Subjective Data: Thorax and Lungs
Cough SOB Chest pain with breathing History of respiratory infections Smoking history Environmental exposure Patient-centered care
Subjective data: cough
Do you have a cough? How long have you had it? How often do you cough? Do you cough up phlegm or sputum? How would you describe the cough? Hacking, dry, barking, hoarse, congested, bubbling Anything aggravate the coughing? What about activity? Chest pain with cough? Treatments?
Subjective data: SOB
Any SOB? Affected by position? Any specific time of day? Related to food/ pollen? Treatment?
Subjective data: chest pain with breathing
Any chest pain with breathing?
Describe pain.
Treatments?
