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Jarvis Physical Assessment > Jarvis Chapter 18 Lungs & Thorax > Flashcards

Jarvis Chapter 18 Lungs & Thorax Flashcards

1
Q

Smooth muscle, warms and humidifies, connects larynx to the brochi.

A

Trachea

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2
Q

goblet cells secrete mucus which traps particles, cilia propels particles out to be swallowed or expelled.

A

Bronchi/Terminole Bronchioles

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3
Q

What parts of the lower airway transport air but do not exchange gas.

A

Trachea and Bronchi/Terminole Bronchioles

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4
Q

May indicate pulmonary edema or pneumonia; fine rattling sounds like a carbonated beverage on inhalation and sometimes on exhalation; liquid is in the alveoli & bronchioles; gets louder with coughing; does not clear with coughing

A

crackles

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5
Q

Functional respiratory unit

A

Acinus

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6
Q

Rattles, coarse, rattling sounds on EXHALATION, indicates mucus in bronchii, may clear with coughing;

A

ronchii

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7
Q

Barrel chest, flattening of sternal angle

A

Signs of COPD

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8
Q

What position is helpful to a client in respiratory distress?

A

semi-fowlers position helps them breathe; Lean - lean back, feet out, amrs dangling slows the O2 consumption; tripod position allows upper body to work at moving the air

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9
Q

This portion of the airway is not sterile.

A

Upper Airway

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10
Q

Name the three lung sounds

A

vesicular, bronchial, bronchovesicular

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11
Q

This portion of the upper airway warms, humidifies, and filters air.

A

Nose

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12
Q

Major breath sound over most of the lung; soft, low pitch; inspiration is longer than expiration;

A

Vesicular lung sounds

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13
Q

Maintains inner air pressure, controls infection (traps particles)

A

Pharynx

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14
Q

Intermediate intensity and pitch; inspiration and expiration are equal in length; best herad at 1st and 2nd ICS (anterior) or between the scapula (posterior) when heard at other locations; consolidation is likely;

A

bronchovesicular lung sounds

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15
Q

Incomplete rings, vocal cords (sound and voice), initiates cough reflex.

A

Larynx

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16
Q

Heard over trachea; expiratory sound predominates; is higher pitched and louder; if heard in other locations it indicates consolidation – a space that usually contains air now has fluid

A

bronchial lung sounds

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17
Q

Opening between the vocal cords.

A

Glottis

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18
Q

What are the respiratory centers in the brain?

A

The brain stem: pons and medulla

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19
Q

High CO2

A

hypercapnia

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20
Q

The only complete rigid ring of cartilage.

A

Cricoid Cartilage

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21
Q

Low O2

A

hypoxemia

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22
Q

Slow, shallow breathing causes carbon dioxide to build up in the blood.

A

Hypoventilation

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23
Q

Which muscles are used in inspiration

A

The diaphragm is assisted by the intercostal muscles to lift the sternum and elevate the ribs

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24
Q

Rapid, deep breathing causes CO2 to be blown off.

A

Hyperventilation

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25
Q

Are inhalation and exhalation active or passive?

A

inhalation - active; exhalation - passive

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26
Q

High surface area for gas exchange.

A

Acinus

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27
Q

This lung is responsible for 55% of activity and contains three lobes.

A

Right

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28
Q

postnatal exposure to ETS results in what?

A

increased incidence of otitis media, resp tract infections, & childhood asthma; possibly related are SIDS, negative behavioral and cognitive issues and increased rates of teen smoking

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29
Q

This lung is responsible for 45% of activity and contains two lobes.

A

Left

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30
Q

This portion of the pleura lines the outside of the lungs.

A

Visceral

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31
Q

What changes occur in the thorax and lungs for the aging adult?

A

costal cartilages calcify; elasticity of lungs decreases; vital capacity decreases; increased residual volume; increased risk for dyspnea;

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32
Q

This portion of the pleura lines the chest wall.

A

Parietal

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33
Q

Why are elderly at an increased risk of atelactasis and infection, esp post surgical?

A

reduced ability to cough, loss of protective airway reflexes and increased secretions;

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34
Q

Contains a thin layer of fluid, allows lungs to expand without friction, pressure is -4cm H2O.

A

Pleural Space

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35
Q

Where ribs join cartilages; not palpable

A

costochondral junctions

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36
Q

The diaphragm, external intercostals and accessory neck muscles are all considered what kind of muscles.

A

Inspiratory

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37
Q

The abdominals and internal intercostals are considered what kind of muscles.

A

Expiratory

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38
Q

In what groups is TB more common?

A

A disproportionate amount in blacks; and highest in immigrants from Mexico, Phillipines, Vietnam, India, China

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39
Q

Innervated by C3-C5 and phrenic nerve. It increases superior/inferior diameter of chest and elevates lower ribs.

A

Diaphragm

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40
Q

coarse, crackling sensation palpable over the skin surface; subcutaneous emphysema due to open thoracic injury or surgery

A

crepitus

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41
Q

Innervated by T1-T11. Increase anteroposterior diameter by elevating ribs.

A

External Intercostals

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42
Q

predominates in normal healthy tissue

A

resonance

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43
Q

After heavy exercise or occurring with respiratory distress, commands the use of the scalene, sternocleidomastoid and trapezii to heave up the sternum and rib cage for forced inspiration.

A

Accessory neck muscles

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44
Q

too much air is present, i.e. emphysema or pneumothorax

A

hyperresonance

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45
Q

Normally this type of breathing is passive and muscles not needed.

A

Expiration

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46
Q

pneumonia, pleural effusion, atelactasis, tumor

A

dull note

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47
Q

These muscles force abdominal contents up to elevated the diaphragm. Used in forced expiration.

A

Abdominal

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48
Q

What are the four major functions of the respiratory system?

A

1-supplying O2 to the body for energy production 2-remove CO2, the waste product from energy reactions 3-maintain homeostasis (acid-base balance) of arterial blood 4-maintain heat exchange

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49
Q

These costal muscles draw ribs and sternum downward to decrease anteroposture diameter.

A

Internal

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50
Q

How long is the trachea (in cm)?

A

10-11 cm

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51
Q

This color of sputum usually indicates colds, bronchitis, viral infection.

A

White or clear

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52
Q

The postoperative older adult is at greater risk for these 4 pulmonary complications:

A

atelectasis, decreased ability to cough, loss of protective airway reflexes, and increased secretions.

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53
Q

This color of sputum usually indicates a bacterial infection.

A

Yellow or green

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54
Q

Anatomical landmark that marks the site of tracheal bifurcation.

A

Angle of Louis

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55
Q

This color of sputum usually indicates TB or pneumococcal pneumonia.

A

Rust

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56
Q

Term for blood in sputum

A

hemoptysis

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57
Q

This color sputum usually indicates pulmonary edema.

A

Pink and frothy

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58
Q

The normal stimulus to breathe is (hypercapnia or hypoxemia)?

A

hypercapnia

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59
Q

Rapid, shallow breathing >24/min.

A

Tachypnea

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60
Q

The posterior chest contains almost all (upper or lower) lobe.

A

lower

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61
Q

Increased rate and depth of of breathing. Usually causes dizziness. CO2 loss.

A

Hyperventilation

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62
Q

To meet increased O2 demands, pregnant women respond normally by increased RR or increased tidal volume (deeper breathing)?

A

tidal volume

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63
Q

Slow breathing <10/min and regular rate.

A

Bradypnea

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64
Q

The anterior chest contains mostly (upper, middle, or lower) lobe.

A

upper and middle

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65
Q

Difficult, labored breathing. SOB.

A

Dyspnea

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66
Q

Awakens with SOB and must be in upright position to achieve comfort.

A

Paroxysmal nocturnal dyspnea

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67
Q

Difficulty breathing when supine.

A

Orthopnea

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68
Q

Contain the respiratory bronchioles,alveolar ducts and alveoli.

A

Acinus

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69
Q

SOB relieved when lying down, worsens with sitting or standing increases.

A

Platypnea

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70
Q

Functional respiratory unit

A

Acinus

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71
Q

SOB sensed while lying on one side but not the other.

A

Trepopnea

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72
Q

High surface area for gas exchange.

A

Acinus

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73
Q

High pitched, musical, squeaking adventitious lung sound. Occurs with airway obstruction and on expiration.

A

Wheezing

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74
Q

The _____ chest contains mostly upper and middle lobe with very little lower lobe.

A

Anterior

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75
Q

High pitched wheezing result from turbulent air flow in upper airway. Primarily inspiratory.

A

Stridor

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76
Q

The trachea lies _____ to the esophagus and is 10 to 11 cm long in an adult.

A

Anterior

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77
Q

Normal Breathing

A

Eupnea

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78
Q

In the anterior chest, the ______, or highest point of the lung tissue is 3-4 cm above the inner third of the clavicles.

A

Apex

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79
Q

Coarse and low pitched sound heard on inspiration and expiration and accompanied by pain with breathing.

A

Pleural friction rub

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80
Q

The _____, or lower border, rests on the diaphragm at about the 6th rib in the midclavicular line.

A

Base

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81
Q

Cough with characteristic timing of being productive for at least 3 months of the year for 2 years.

A

Chronic bronchitis

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82
Q

Slow breathing <10/min and regular rate.

A

Bradypnea

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83
Q

A bony structure with a conical shape, which is narrower at the top.

A

Thoracic cage

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84
Q

goblet cells secrete mucus which traps particles, cilia propels particles out to be swallowed or expelled.

A

Bronchi/Terminole Bronchioles

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85
Q

This is defined by the sternum, 12 pairs of ribs and 12 thoracic vertebrae.

A

Thoracic cage

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86
Q

Cough with characteristic timing of being productive for at least 3 months of the year for 2 years.

A

Chronic bronchitis

87
Q

The floor of the thoracic cage is the.

A

Diaphragm

88
Q

Ribs 8, 9, and 10 attach to the ______ above.

A

Costal cartilage

89
Q

A musculotendinous septum that separates the thoracic cavity from the abdomen.

A

Diaphragm

90
Q

The only complete rigid ring of cartilage.

A

Cricoid Cartilage

91
Q

The first 7 ribs attach directly to the ______ via their costal cartilages.

A

Sternum

92
Q

Area that is filled with air but is not available for gaseous exchange.

A

Dead space

93
Q

Ribs 8, 9, and 10 attach to the ______ above.

A

Costal cartilage

94
Q

_________ expands the lungs and the posterior lower border drops to the level of _____.

A

Deep Inspiration, T12

95
Q

Ribs 11 & 12 are called _______.

A

Floating

96
Q

What is the breathing mechanism?

A

Diaphragm, external and internal intercostals

97
Q

Angle of Louis, this is the articulation of the manubrium and the body of the sternum, and is continuous with the second rib.

A

Manubriosternal Angle

98
Q

A musculotendinous septum that separates the thoracic cavity from the abdomen.

A

Diaphragm

99
Q

What is the breathing mechanism?

A

Diaphragm, external and internal intercostals

100
Q

Innervated by C3-C5 and phrenic nerve. It increases superior/inferior diameter of chest and elevates lower ribs.

A

Diaphragm

101
Q

The ______ is the middle section of the thoracic cavity containing the esophagus, trachea, heart, and great vessels.

A

Mediastinum

102
Q

The floor of the thoracic cage is the.

A

Diaphragm

103
Q

The right and left ______, on either side of the mediastinum contain the lungs.

A

Pleural cavities

104
Q

Difficult, labored breathing. SOB.

A

Dyspnea

105
Q

In the anterior chest, the ______, or highest point of the lung tissue is 3-4 cm above the inner third of the clavicles.

A

Apex

106
Q

The valve attached to the entrance of the larynx.

A

Epiglottis

107
Q

The _____, or lower border, rests on the diaphragm at about the 6th rib in the midclavicular line.

A

Base

108
Q

Normal Breathing

A

Eupnea

109
Q

______, lung tissue extends from the apex of the axilla down to the 7th or 8th rib.

A

Laterally

110
Q

Normally this type of breathing is passive and muscles not needed.

A

Expiration

111
Q

______, the location of ____ marks the apex of lung tissue and ____ usually corresponds to the base.

A

Posteriorly, C7, T10

112
Q

The abdominals and internal intercostals are considered what kind of muscles.

A

Expiratory

113
Q

_________ expands the lungs and the posterior lower border drops to the level of _____.

A

Deep Inspiration, T12

114
Q

Innervated by T1-T11. Increase anteroposterior diameter by elevating ribs.

A

External Intercostals

115
Q

The _____ lung is shorter because of the _____.

A

Right, liver

116
Q

The lobes of the lungs are separated by ______.

A

Fissures

117
Q

The ____ lung is narrower because of the _____.

A

Left, heart

118
Q

Ribs 11 & 12 are called _______.

A

Floating

119
Q

The _____ lung has three lobes.

A

Right

120
Q

Opening between the vocal cords.

A

Glottis

121
Q

The _____ lung has two lobes.

A

Left

122
Q

Coughing up blood.

A

Hemoptysis

123
Q

The lobes of the lungs are separated by ______.

A

Fissures

124
Q

Increased rate and depth of of breathing. Usually causes dizziness. CO2 loss.

A

Hyperventilation

125
Q

If you swallow an object it will go into the _____ lung because the bronchi is wider.

A

Right

126
Q

Rapid, deep breathing causes CO2 to be blown off.

A

Hyperventilation

127
Q

The trachea lies _____ to the esophagus and is 10 to 11 cm long in an adult.

A

Anterior

128
Q

Slow, shallow breathing causes carbon dioxide to build up in the blood.

A

Hypoventilation

129
Q

The _____ main bronchus is shorter, wider, and more vertical.

A

Right

130
Q

The diaphragm, external intercostals and accessory neck muscles are all considered what kind of muscles.

A

Inspiratory

131
Q

The _____ and ______ transport gasses between the environment and the lung parenchyma.

A

Trachea, bronchi

132
Q

These costal muscles draw ribs and sternum downward to decrease anteroposture diameter.

A

Internal

133
Q

The _____ and _____ constitute the dead space, or space that is filled with air but is not available for gaseous exchange.

A

Trachea, bronchi

134
Q

Incomplete rings, vocal cords (sound and voice), initiates cough reflex.

A

Larynx

135
Q

Area that is filled with air but is not available for gaseous exchange.

A

Dead space

136
Q

______, lung tissue extends from the apex of the axilla down to the 7th or 8th rib.

A

Laterally

137
Q

The _____ lung has no middle lobe.

A

Left

138
Q

The ____ lung is narrower because of the _____.

A

Left, heart

139
Q

The _____ chest contains mostly upper and middle lobe with very little lower lobe.

A

Anterior

140
Q

The _____ lung has no middle lobe.

A

Left

141
Q

The ____ chest contains almost all lower lobe.

A

Posterior

142
Q

The _____ lung has two lobes.

A

Left

143
Q

What are the important landmarks for the thorax and lungs?

A

substernal notch, sternal angle, 2nd rib, 2nd intercostal space, intercostal spaces, costal angle (<90), 7th cervical vertebral prominence; angle of Louis

144
Q

This lung is responsible for 45% of activity and contains two lobes.

A

Left

145
Q

What is the angle of Louis

A

The angle at the manubrial-stternal border

146
Q

This portion of the airway is sterile.

A

Lower Airway

147
Q

How many lobes on each lung? Which can be heard from the back?

A

Left side: 2 lobes, Right side, 3 lobes; Cannot hear the right middle lobe from the back; nearly all of the back consists of lower lobes; upper lobe is only to T3 or T4.

148
Q

Trachea, Bronchi/Terminole Brochioles and Acinus make up the

A

Lower Airway

149
Q

Where are the lungs located?

A

The apex is above 3-4 cm above the inner clavicle; the lower border is about the 7th rib resting on the diaphragm; On posterior side C7 is apex and T10 is base;

150
Q

Angle of Louis, this is the articulation of the manubrium and the body of the sternum, and is continuous with the second rib.

A

Manubriosternal Angle

151
Q

What is dyspnea?

A

shortness of breath

152
Q

The ______ is the middle section of the thoracic cavity containing the esophagus, trachea, heart, and great vessels.

A

Mediastinum

153
Q

What is the rating scale for dyspnea?

A

0 - never; 1 - ealking 20’ or climbing stairs; 2 - w/moderate exertion such as dressing, bedside commode or distance < 20’; 3-w/minimal exertion such as eating, talking or performing ADL’s or w/agitation; 4-at rest, day or night

154
Q

This portion of the upper airway warms, humidifies, and filters air.

A

Nose

155
Q

What are important sujective data for the thorax and lungs health history?

A

Cough - productive?, sputum?, SOB, breathing difficulties, chest pain w/ breathing, history of respiratory diseases, smoking, 2nd hand smoke, allergies, past chest trauma, environmetnal exposure; recent TBC skin test, chest x-ray, flu or pnuemococcal vac

156
Q

Difficulty breathing when supine.

A

Orthopnea

157
Q

What does chest pain with breathing usually indicate?

A

pleuritis

158
Q

This portion of the pleura lines the chest wall.

A

Parietal

159
Q

What is the first step in the interview?

A

Obtain all the data you can from observing the patient; for example, agitated patients or low conscious patients may have a breathing issue; mouth vs nose breathing; patent or flaring nares? pursing of lips; color; facial expression; neck trachial

160
Q

Awakens with SOB and must be in upright position to achieve comfort.

A

Paroxysmal nocturnal dyspnea

161
Q

Why do people purse their lips?

A

prolongs expiration and increases positive pressure

162
Q

Maintains inner air pressure, controls infection (traps particles)

A

Pharynx

163
Q

What is RSV?

A

Respiratory synctial virus; a common virus among children and adults; may cause more serious problems in older adults and adults with heart/lung disease, preemies and babies with other medical conditions

164
Q

This color sputum usually indicates pulmonary edema.

A

Pink and frothy

165
Q

What are causes of clubbing?

A

chronic hypoxia; lung cancer

166
Q

SOB relieved when lying down, worsens with sitting or standing increases.

A

Platypnea

167
Q

What is a normal Respiration rate?

A

12-20 RPM

168
Q

The right and left ______, on either side of the mediastinum contain the lungs.

A

Pleural cavities

169
Q

What do you report about respirations?

A

raterhythmdepth*effort

170
Q

Coarse and low pitched sound heard on inspiration and expiration and accompanied by pain with breathing.

A

Pleural friction rub

171
Q

regular irregularity often w/periods of apnea; seen in patients who are dying; heart failure

A

Cheyne Stokes breathing

172
Q

Contains a thin layer of fluid, allows lungs to expand without friction, pressure is -4cm H2O.

A

Pleural Space

173
Q

iregular with apnea; brain damage; respiratory depression; may be normal in babies

A

Biot’s breathing

174
Q

The ____ chest contains almost all lower lobe.

A

Posterior

175
Q

What are childrens respiratory rates by age?

A

12 15-20

176
Q

______, the location of ____ marks the apex of lung tissue and ____ usually corresponds to the base.

A

Posteriorly, C7, T10

177
Q

What is PECTUS EXCAVATUM

A

Sunken chest; congenital defect

178
Q

The _____ lung is shorter because of the _____.

A

Right, liver

179
Q

What is rectus carniatum

A

prominent sternum; congenital

180
Q

If you swallow an object it will go into the _____ lung because the bronchi is wider.

A

Right

181
Q

You can see the ribs working hard to move the air; example croup

A

Retractions

182
Q

The _____ lung has three lobes.

A

Right

183
Q

Upper airway obstruction

A

stridor

184
Q

The _____ main bronchus is shorter, wider, and more vertical.

A

Right

185
Q

Lower airway obstruction; musical, may hear without a stethoscope; high pitch notes; asthma; emphysema

A

wheeze

186
Q

This lung is responsible for 55% of activity and contains three lobes.

A

Right

187
Q

Caused by air in tissues; feels like bubble wrap or rice krispies under the skin;

A

crepitus

188
Q

This color of sputum usually indicates TB or pneumococcal pneumonia.

A

Rust

189
Q

The first 7 ribs attach directly to the ______ via their costal cartilages.

A

Sternum

190
Q

High pitched wheezing result from turbulent air flow in upper airway. Primarily inspiratory.

A

Stridor

191
Q

Rapid, shallow breathing >24/min.

A

Tachypnea

192
Q

A bony structure with a conical shape, which is narrower at the top.

A

Thoracic cage

193
Q

This is defined by the sternum, 12 pairs of ribs and 12 thoracic vertebrae.

A

Thoracic cage

194
Q

What parts of the lower airway transport air but do not exchange gas.

A

Trachea and Bronchi/Terminole Bronchioles

195
Q

The _____ and _____ constitute the dead space, or space that is filled with air but is not available for gaseous exchange.

A

Trachea, bronchi

196
Q

The _____ and ______ transport gasses between the environment and the lung parenchyma.

A

Trachea, bronchi

197
Q

Smooth muscle, warms and humidifies, connects larynx to the brochi.

A

Trachea

198
Q

SOB sensed while lying on one side but not the other.

A

Trepopnea

199
Q

This portion of the airway is not sterile.

A

Upper Airway

200
Q

This portion of the pleura lines the outside of the lungs.

A

Visceral

201
Q

High pitched, musical, squeaking adventitious lung sound. Occurs with airway obstruction and on expiration.

A

Wheezing

202
Q

This color of sputum usually indicates colds, bronchitis, viral infection.

A

White or clear

203
Q

This color of sputum usually indicates a bacterial infection.

A

Yellow or green

204
Q

is measured by the ration of lecitin and sphingolin

A

fetal pulmonary development

205
Q

is facilitated by diaphragm and intercostals muscles

A

inspiration

206
Q

there is an increase in tactile fremetus in individual with pneumonia

A

pneumonia

207
Q

seen in COPD

A

purse lip breathing

208
Q

is defined by sternum, ribs, diaphragm

A

the thoracic wall

209
Q

An acute pulmonary insult (trauma, gastric acid aspiration, shock, sepsis) damages alveolar capillary membrane, leading to increased capillary permeability of pulmonary capillaries and alveolar epithleium, and to pulmonary edema.

A

ARDS

210
Q

Acute onset of apprehension and dyspnea.

A

Restlessness, Disorientation,Rapid shallow breathing, productive cough,

211
Q

An allergic hypersensitivity to certain inhaled allergens, irritants, microbes, stress, or exercise that produces bronchospasm, inflammation, edema in walls of bronchioles, and secretion of highly viscous mucus.

A

Athsma

212
Q

Airway resistance.

A

Wheezing, dyspnea, and chest tightness.

213
Q

Collapsed shrunken section of alveoli or an entire lung&raquo_space;> airway obstruction, compression on the lung, lack of surfactant.

A

Atelectasis

Jarvis Physical Assessment (9 decks)

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