Intro Flashcards by Pearl Anne Pedrajas Ibañez

FOUR COMPONENTS OF A RESPIRATORY ASSESSMENT

INSPECTION

PALPATION

PERCUSSION

AUSCULTATION

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This forms the chest portion of the body. it consist 12 pairs of ribs with their costal cartilages and sternum

Thoracic Cage

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Elongated bony structure that anchors the anterior thoracic cage

Sternum

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what are the 3 parts of the sternum

Manubrium
Body
Xyphoid Process
it can also be spelled as Xiphoid

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What is the U shaped border called at the top of the manubrium

Jugular notch

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The elongated central portion of the sternum is called?

Body

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the inferior tip of the sternum is called?

Xyphoid process

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True ribs

T1-T7

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False ribs

T8-T12

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Floating ribs

T11-T12

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It is located between the ribcage (sternum) and the shoulder blade (scapula) It is a bone that connects the arm to the body

Clavicle

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Anterior Chest Landmarks

Midsternal line
Midclavicular line
Anterior axilary line

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Posterior Chest Landmarks

Left-scapular line
Vertebral line
Right-scapular line

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It is the eponymous name given to the sternal angle which is palpable from the manubriosternal junction

Angle of louis

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It is the joint of the sternal body and the manubrium

Manubriosternal Junction

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A type of joint characterized as a fibrous connection between two bone

Synarthrosis

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How many lobes are there in our Right Lung

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How many lobes are there in our left lung

two

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Inspection 1

Shape
Scars
Prominent veins
Resp rate and rhythm
Chest wall movement
Intercostal recession
Added sounds
Cyanosis
Sputum

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Inspection 2
why we inspect for Shape, scars, prominent veins, RR and chest wall movement

Shape of chest wall and spine
Scars – surgery
Prominent veins – SVC obstruction
RR = normal values
Chest wall movement – symmetrical, hyperinflated, paradoxical etc

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The chest and abdomen move in the same direction during breathing

Symmetrical

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Occur when air gets trapped in the lungs and causes then to overinflate

Hyperinflated lungs

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It can be caused by blockages in the air passages or by air sacs that are less elastic, which interferes with the explosion of air from the lungs

Hyperinflated Lungs

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An obvious sign that the portion of the chest wall is not assisting with the breathing function

Paradoxical Movement

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What do you Palpate

Tenderness Position of apex beat Chest wall expansion

The actual beat which you can feel is the very tip of the left ventricle pushing against the chest wall as the left ventricle contracts and the heart is pushed against it

Apex beat

Where is apex beat can heard

Left ventricle

when do you feel the apex beat

in time with the carotid pulse

What are you assessing in chest wall expansion

(symmetric or asymmetric) = presence of chest wall pathology, lung volume loss or obstruction

What is the normal range of chest expansion

2-5cm

Percussion

compare both sides start over the clavicles move down anterior chest, ensure to percuss over lateral chest

Long, loud, low pitched, hollow

Resonant

Normal Lung sounds

Resonant

Medium in intensity and pitch, moderate length

dullness

areas of increased density/decreased air (consolidation, collapse, fibrosis, abscess, neoplasm)

Dullness

Thudlike

Stony dull

unique for pleural effusion

Stony dull

Very loud, low pitched

Hyper resonant

areas of decreased density-increased air (pneumothorax)

Hyper resonant

often described as rustling.

Normal or “vesicular"

effusion, tumor, pneumothorax, pneumonia or collapse. global = COPD or asthma (life threatening)

Reduced

breathing has a hollow blowing quality = consolidation, abscess, fibrosis, upper edge effusion. Exp sounds longer than inspiratory

Bronchial

No sound can be auscultated

absent

whistling from narrowing of the airways. Polyphonic = asthma and COPD. Monophonic = foreign body, carcinoma. Inspiratory and expiratory

Wheeze

asthma and COPD.

Polyphonic

foreign body, carcinoma. Inspiratory and expiratory

Monophonic

air entering collapsed airway. Coarse =fluid or infection. Fine = fluid, infection, fibrosis

Crackles

fluid or infection. (lung sound)

Coarse

fluid, infection, fibrosis (lung sound)

Fine

heard at end of inspiration from inflamed pleural surfaces = pneumonia

Rub

inspiratory, musical, very loud, monophonic wheeze (crowing sound). Caused by laryngeal spasm and mucosal swelling which contracts the vocal cords and narrows the airways – usually occurs with upper airway infection / obstruction.

Stridor

Damage to the lungs result in difficulty blowing air out, causing shortness of breath. smoking by far is the most common cause

Chronic obstructive pulmonary disease (COPD)

A form of COPD usually caused by smoking. the fragile walls between the lings' air sac (alveoli) are damaged, trapping air in the lungs and making breathing difficult

Emphysema

Repeated, frequent episodes of productive cough, usually caused by smoking. Breathing also becomes difficult in this form of COPD.

Chronic bronchitis

Infection in one or both lungs. bacteria especially Streptococcus pneumoniae, are the most common cause but it man also be cause by a virus

Pneumonia

The lungs' airway (bronchi) became inflamed and can spasm, causing shortness of breath and wheezing. allergies, viral infections or air pollution often trigger this

Asthma

An infection of the lungs' large airways (bronchi), usually caused by a virus. cough is the man symptom

Acute bronchitis

A form of intestinal lung disease. The interstitium become scarred, making the lungs stiff causing shortness of breath

Pulmonary fibrosis

Fluid builds up in the normally tiny space between the lung and the inside of the chest wall.

Pleural effusion

Inflammation of the lining of the lung, which often causes pain when breathing in. Autoimmune conditions, infections, or a pulmonary embolism

Pleurisy

The airways (bronchi) become inflamed and expand abnormally, usually after repeated infections. Coughing with large amounts of mucus, is the main symptom

Bronchiectasis

A genetic condition in which mucus does not clear easily from the airways. the excess mucus causes repeated episodes of bronchitis and pneumonia throughout life

Cystic fibrosis

A collection of conditions in which the interstitium becomes diseased. Fibrosis (scarring) of the interstition eventually results, if the process cant be stop

Interstitial Lung disease

Cancer may affect almost any part of the lung. caused by smoking

Lung cancer

A slowly progressive pneumonia caused by the bacteria Mycobacterium tuberculosis. chronic cough, fever, weight kiss, and night sweats are common symptoms

Tuberculosis

What bacteria causes tubercolosis

Mycobacterium tuberculosis

What kind of bacteria causes Pneumonia

Streptococcus Pneumoniae

A blood clot (usually from a vein in the leg) may break off and travel to the heart which pumps the clot (embolus) into the lungs. sudden shortness of breath is the most common symptoms

Pulmonary embolism

Air in the chest; it occurs when air enters the area around the lung (the pleural space) abnormally. Can be caused by an injury or may happen spontaneously.

Pneumothorax

An X-ray is the most common first test for lung problems

Chest X-ray

Uses X-rays and a computer to make detailed pictures of lungs and nearby structures

Computed tomography (CT scan)

A series of test to evaluate how well the lungs work. Lung capacity, the ability to exhale forcefully, and the ability to transfer air between the lungs and blood are usually tested

Pulmonary function test (PFTs)

Parts of PFTs measures how fast and how much air you can breathe out

Spirometry

Culturing mucus coughed up from the lungs can sometimes identify the organism responsible for a pneumonia or bronchitis

Sputum culture

Viewing sputum under a microscope for abnormal cells can help diagnose lung cancer and other conditions

Sputum cytology

A small piece of tissue is taken from the lungs either through bronchoscopy or surgery

Lung biopsy

an endoscope is passed through the nose or mouth into the airways. a doctor can take biopsies or samples for culture

Flexible bronchoscopy

A rigid metal tube is introduced through the mouth into the lungs' airways. often more effective than flexible bronchoscopy, but requires general anesthesia

Rigid bronchoscopy

Uses scanner radio waves in a magnetic field to create high-resolution images of structures inside the chest

Magnetic resonance imaging (MRI scans)