Lung And Respiration Assesement Flashcards
Define Ventilation
The mechanical movement of air
Where are the two types of gas exchange and where do they occur?
- Pulmonary/external - alveoli
- Cellular/internal - cells
What is the sternal angle (angle of Louis)?
The angle where the manubrium meets the sternum at the 2nd rib
What is the costal margin?
The border of the lower ribs and the abdomen
How do you count intercostal spaces?
The rib above it (top palpable intercostal space = first intercostal space)
Which lung has a middle lobe?
Right lung
Where is the pleural space?
Between the parietal and visceral pleura
What aligns with the split of the trachea?
The sternal angle and T4 vertebrae
Which bronchus is more prone to foreign body aspiration?
Right
How much air comes in on an inspiration?
500-800mL
Which is longer and by how long: inspiration or expiration?
Expiration, 2x
What muscles are used in expected inspiration?
Intercostal muscles and diaphragm
What muscles are used in expected expiration?
None (passive recoil of inspiration muscles)
What are the accessory muscles/muscle groups in active breathing?
- Abdominals
- Sternocleidomastoid
- Scalene
- Pectoralis minor
What are the three anterior columns for landmarking the chest?
- Anterior axillary line
- Midclavicular line
- Midsternal line
What are the two posterior columns used for landmarking the upper back?
- Scapular line
- Vertebral line
Where are the lung fields?
2-4 cm above the clavicles to the 6th rib (clavicular)/8th rib (axilary)
Where can the right middle lobe be auscultated?
Between the 4th and 6th right ribs anteriorly
Where should the lower lobes be auscultated?
Between T3 and T10 posteriorly
How should the base of the lungs move in inspiration?
Descend by ~2 rib spaces
What is barrel chesting?
A change of thorax shape linked to COPD; the chest is equally as wide transverse as longitudinal
What is crepitus?
The feel of air trapped within the pleural cavity; “bubble wrap” feel
What is the preferred search pattern of the lungs?
Ladder pattern
Can you auscultate over clothing?
No
What is spirometry?
A measure of the patients lung volume/expiration volume
What is dyspnea?
Difficulty breathing
What is orthopnea?
Difficulty breathing while lying flat
What is paroxysmal nocturnal dyspnea?
In which patients wake, breathless, during the night
What is sputum?
Fluid that may be coughed up; mucus, phlegm
What does clear/white/grey mucoid sputum indicate?
Bronchitis
What does purulent yellow/green sputum indicate?
Bacterial infection
What does overly thick sputum indicate?
Dehydration or cystic fibrosis
What does rusty/bloody sputum indicate?
Tuberculosis, Pneumococcal penumonia or lung cancer
What does thin, frothy sputum indicidate?
Heart failure
What is hemoptysis?
Sputum bloodied through contact with upper respiratory lesions
What is the tripod position?
A position where a patient in respiratory distress leans forwards, stabilizing themselves on their knees or objects in front of them
What is stridor?
High pitched crowing sound from laryngal/tracheal spasm
What is scoliosis?
Unusual horizontal spinal curvature
What is kyphosis?
Hypercurvature of the upper spine
What is subcutaneous emphysema?
Air collecting and displacing below the skin
What are retractions?
Indentations between bones caused by pressure while struggling to breathe
What is tactile fremitus?
Assesement in which the vibration from speaking is evaluated
What might ronchal fremistus (coarse vibration) indicate?
Pneumonia or other airway exudates
What is pleural friction fremitus?
Grating sensations caused by pleural friction
What might hyperressonance of the lungs indicate?
Hyperinflation of the lungs
What is diaphragmatic excursion?
An evaluation in which the displacement if the diaphragm is measured using percussion
What is the expected displacement of the diaphragm?
3-5 cm (7-8cm in well conditioned adults)
What are the three key breathsounds?
- Vesicular - soft, low pitched near sites of gas exchange
- Bronchivesicular - mid volume and pitched
- Bronchial - loud, high-pitched near the trachea/larynx
What is egophony?
A muffled distortion of sound that makes “ee” sound like “a”
What are the 6 adventitious breath aounds?
- Fine rales/crackles
- Coarse rales/crackles
- Wheeze
- Ronchi
- Pleural friction rub
- Stridor
What is the APGAR scoring system?
An evaluation of newborns and vital signs (HR, Resp. effort, muscle tone, reflexes, colour)
What is acrocyanosis?
Blueish of extremities such as hands and feet
