Lecture 4: chest

Question 1

thorax

Answer 1

between neck and diaphragm

Question 2

bronchi

Answer 2

air passaged with irregularly placed plates of hyaline cartilage, interlacing networks of smooth muscle and a mucous membrane of columnar ciliated epithelium

Question 3

bronchioles

Answer 3

tine (less than 1 mm in diameter), branching airways tat lead from the bronchi to the alveoli. they have elastic fibers and smooth muscle.

Question 4

oxygen exchange begins at the…

Answer 4

respiratory brionchioles and continues at the alveolar ducts and alveolar sacs.

Question 5

pain in the lungs

Answer 5

the lung tissue itself doesn’t have pain fibers, pain usually arises from inflammation o the adjacent parietal pleura.

Question 6

5 A’s of tobacco cessation

Answer 6

Ask, Advise, Asses (pts readiness), Assist, arrange for follow-up

Question 7

Who should get the strep pneumonia vaccine?

Answer 7

adults older then 65. Pt 2-64 with chronic illnesses. Immunocompromised, Alaskan natives

Question 8

the pulmonary exam (4)

Answer 8

inspect, palpate, percuss, auscultate

Question 9

pectus excavatum vs. pectus carinatum

Answer 9

sticking in vs sticking out

Question 10

cheyne-stokes breathing

Answer 10

periods of deep breathing alternating with apnea

Question 11

Boit’ breathing

Answer 11

unpredictable irregularity with breaths that may be shallow or deep and stop for short periods. causes include respiratory depression and brain damage

Question 12

kussmaul breathing

Answer 12

fast, normal or slow deep breathing. Due to metabolic acidosis

Question 13

barrel chest

Answer 13

increased AP diameter

Question 14

increased fremitus in …

Answer 14

fluid/pus/blood is in the lung. ex. pneumonia

Question 15

decreased fremitus

Answer 15

voice vibrations transmitted to the chest wall are blocked by a cushion of fluid outside the lung ex. pneumothorax

Question 16

how many places on chest/back for fremitus?

Answer 16

3, 4

Question 17

how many locations for chest/back for percussion?

Answer 17

6, 7

Question 18

diaphragmatic excursion

Answer 18

difference in position of lower lung fields between inspiration and expiration

Question 19

vesicular breath sounds

Answer 19

inspiratory longer than expiratory. Pitch is soft, over most of both lungs

Question 20

bronchovesicular sounds

Answer 20

inspiratory and expiratory are the same length. Intermediate pitch.

Question 21

Bronchial breath sounds

Answer 21

expiratory sounds last longer than inspiratory, loud pitch

Question 22

tracheal breath sounds

Answer 22

equal sounds, very loud pitch

Question 23

crackles/rales

Answer 23

intermittent, nonmusical and brief sounds created when air is forced through respiratory passages that are narrowed by fluids, mucus or pus. Heard on inspiration.

Question 24

wheezes

Answer 24

a continuous, coarse, whistling sound (heard on expiration). Thought to occur due to narrowing in the respiratory tree and increased airflow velocities across the narrowed spaces.

Question 25

stridor

Answer 25

type of high pitched wheeze that is primarily inspiration, loud over the neck than chest and indicated partial obstruction of the larynx or trachea

Question 26

rhonchi

Answer 26

similar to wheeze though lower pitch with snoring like quality. Suggests secretions in the large airways.

Question 27

bronchophony

Answer 27

normally sounds becomes less distinct and much softer when pt speaks. If there is consolidation then the sound is very loud and

Question 28

whispered pectoriloquy

Answer 28

normal: sound hardly heard

if present you will be able to distinguish clearly

Question 29

egophony

Answer 29

pt says “e” and results in “a” sound. caused by an increased resonance of voice sounds heard when auscultating the lungs due to compressed lung tissue