Lesson 7 (Thorax and lung Assessment) Flashcards
Four components of a respiratory assessment
INSPECTION
PALPATION
PERCUSSION
AUSCULTATION
Forms the thorax (chest) portion of the body
thorax cage (rib cage)
The ribs are anchored,,,
Posteriorly to the 12 thoracic vertebrae (T1-T12)
how many pairs of ribs in the human body
12
What protects the heart and lungs?
Thoracic cage
The ribs are classified as…
True ribs (1-7) and false ribs (8-12)
The last two pairs of false ribs are also known as…
Floating ribs (11-12)
It is the elongated bony structure that anchors the anterior thoracic cage
Sternum
The sternum consists of three parts:
manubrium, body, xiphoid process
wide superior portion of the sternum
manubrium
The top of the manubrium has a shallow, U-shaped border called…
Jugular (suprasternal) notch
The elongated, central portion of the sternum is the…
Body
The inferior tip of the sternum is…
Xiphoid process
This small structure is cartilaginous in the early stages of life, but gradually becomes ossified during middle age.
Xiphoid process
It is located between the rib cage (sternum) and the shoulder blade (Scapula)
Clavicle
It is the bone that connects the arm to the body.
Clavicle
Anterior chest landmarks
Midsternal line
Midclavicular line
Anterior axillary line
Posterior chest landmarks
Left-scapular line
Vertebrae line
Right-scapular line
It is the eponymous name given to the sternal angle which is the palpable anatomical feature formed from the manubriosternal junction
Angle of locus
What type of joint is the angle of locus?
Synarthrosis
A type of joint characterized as a fibrous connection between two bones
Synarthrosis
What are the two bones in the synarthrosis joint?
Manubrium and Sternal
What are the lobes in the right lung?
Upper
Middle
Lower
What are the lobes in the left lung?
Upper
Lower
Shape of chest wall and spine
Scars in inspection
Surgery
Prominent veins in inspection
SVC obstruction
RR in inspection
Normal values
Chest wall movement in inspection
symmetrical, hyperinflated, paradoxical etc
The chest and abdomen move in the same direction during breathing.
Symmetry
occurs when air gets trapped in lungs and caused them to overinflate
Hyperinflated lungs
An obvious sign that the portion of the chest wall is not assisting with function
Paradoxical movement
Palpation includes:
Tenderness
Position of apex beat
Chest wall expansion
The actual beat you can feel is the very tip of the…
Left ventricle
As you feel the apex beat, it should be on time with what pulse?
Carotid pulse
Assessing for chest expansion (symmetric or asymmetric) provides clues in regards to the presence of…
Chest wall pathology, lung volume loss or obstruction
The normal range of chest expansion is…
(2-5 cm)
Percussion includes:
1) compare both sides
2) start over the clavicles move down anterior chest, ensure to percuss over lateral chest
Breath sounds in Auscultation
Normal
Absent
Reduced
Bronchial
Resonant
Normal lung sounds
Dullness
areas of increased density/decreased air (consolidation, collapse, fibrosis, abscess, neoplasm)
Stony dull
unique for pleural effusion
Hyper resonant
areas of decreased density-increased air (pneumothorax)
Normal breath sound
Rustling
Reduced breath sound
local = effusion, tumor, pneumothorax, pneumonia or collapse. global = COPD or asthma (life threatening)
Has a hollow blowing quality
“bronchial” breathing
Bronchial breath sound
consolidation, abscess, fibrosis, upper edge effusion. Exp sounds longer than inspiratory
Added sounds
Wheeze
Crackles
Rub
Stridor
whistling from narrowing of the airways
wheeze
air entering collapsed airway.
Crackles
heard at end of inspiration frominflamedpleural surfaces
Rub
inspiratory, musical, very loud, monophonic wheeze (crowing sound).
Stridor
Caused by laryngeal spasm and mucosal swelling which contracts the vocal cords and narrows the airways
Stridor
usually occurs with upper airway infection / obstruction.
stridor
