Lecture 4.1 thorax and lung pt 1 (3%) Flashcards
Anatomy, Health History, Health Counseling, Physical Exam
1) What line is straight down the middle of the back?
2) What line is lateral to that?
1) Vertebral line
2) Scapular line
1) What line is at the midline of the chest?
2) What two lines are parallel and on opposite sides of this line?
1) Anterior median (midsternal) line
2) Midclavicular lines
1) What line runs through the middle of the armpit?
2) What line runs parallel and anterior to this?
3) What line runs parallel and posterior to this?
1) Midaxillary line
2) Anterior axillary line
3) Posterior axillary line
How far do the lungs rise up?
3-4cm above inner 1/3 of the clavicles
Lung sounds will be harsher where?
Over trachea and bronchi
The space in between the lungs and where the lungs sit is called what?
Pleura
1) Breathing is least visible when?
2) Where is there movement during breathing?
1) The pt is supine
2) Some thoracic movement, but mostly in the abdomen.
When sitting, what is more easily observed in motion?
The rib cage
___________________ are recruited when breathing becomes more labored, either due to exercise or pathology.
Accessory muscles
What are the two groups of accessory muscles?
Sternocleidomastoid and scalenes
1) What does “pulling hard” mean?
2) What 5 places do you need to look for this?
1) Breathing difficulty, causing retractions (sucking tissue into thoracic cavity)
2) Subcostal, intercostal, substernal, suprasternal, supraclavicular
What are the 7 respiratory red flags?
1) Chest pain
2) Shortness of breath
3) Wheezing
4) Cough
5) Blood-streaked sputum
6) Painful inspiration
7) Daytime sleepiness
What are the 5 Ps of respiratory related chest pain?
1) Pneumonia (Pneu. . .)
2) Pneumothorax (Pneu. . .)
3) Pulmonary embolus (P E)
4) Pleural effusion (P E)
5) Bronchitis (The ugly P. . .)
What are the 3 key questions you should ask about respiratory related chest pain? What would the answers indicate?
1) Does it hurt when I press on it?
2) Is it worse when you breathe in?
-PE
3) Is there one-sided swelling/redness/pain in your calves?
-DBT
Define SOB / dyspnea / wheezing. Is this subjective or objective?
The feeling of being out of breath; a subjective sensation
What are the 6 diagnoses you should consider when a pt complains of SOB/ dyspnea/ wheezing?
1) COPD: smoking
2) Asthma: childhood
3) PNA (pneumonia): Infxn
4) Anxiety: associated symptoms
5) Cancer: progressive symptoms
6) Heart failure: rapid weight gain and lower extremity edema
-anxiety is a diagnosis of exclusion
What two key questions should you ask when a pt complains of SOB/ dyspnea/ wheezing?
1) Under what circumstances or particular activities does this occur?
2) How much of the activity can you perform?
What are the 3 types of cough? Define the parameters for each
1) Acute: < 3 weeks
2) Subacute: 3-8 WEEKS
3) Chronic: > 8 WEEKS
1) What is the most common cause of cough?
2) What are some other causes?
1) Acute respiratory infxn (virus)
2) Smoking, asthma, COPD, pneumonia, acid reflux, FB, postnasal drip, bronchiectasis, medicines (ACE inhibitor)
1) What is the key question to ask about a cough?
2) What conditions cause foul smelling sputum?
3) What condition causes thick sputum?
4) What causes profuse sputum?
1) Is it productive?
2) Lung abscess
3) CF
4) Bronchiectasis
True or false: sputum is not specific for bacterial infection
True
What 4 diagnoses should you consider regarding hemoptysis?
1) Cancer
2) TB
3) PE
4) Out of the box dx: upper GI bleed or epistaxis
What is the key question to ask when a pt displays/ reports hemoptysis?
Define the source and amount and note the color; is it truly bright red blood from the lungs?
What 3 Dxs should you consider when a pt has painful inspiration?
1) PE
2) Pleurisy
3) MSK
