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Medicine > Lung and Thoracic Exam I > Flashcards

Lung and Thoracic Exam I Flashcards

1
Q

fissure

A

line that divides the lobes

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2
Q

sternal angle

A

separates manubrium and body of sternum

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3
Q

interspace of each rib

A

located below that rib

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4
Q

costal angle

A

angle below xyphoid process

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5
Q

which ribs articulate directly with the sternum?

A

true ribs 1-7

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6
Q

which ribs articulate indirectly with the sternum?

A

8-10 (thinner and longer than others-come all the way around the body-easily fractured)

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7
Q

which ribs are called “floating ribs”?

A

11-12

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8
Q

costochondritis

A

pain and inflammation of the cartilage around the ribs

-clinically, palpate, range of motion, deep breathing will cause more pain

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9
Q

where is the lower lung border anteriorly?

A

crosses 6th rib midclavicular line and 8th rib midaxillary line

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10
Q

where is the lower lung border posteriorly?

A

T10 spinous process

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11
Q

when would the diaphragm lose its elasticity?

A

emphysema-loses its ability to move back and forth

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12
Q

base of the lung is where?

A

at the base (bottom)

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13
Q

apex of the lung is where?

A

uppermost portion of the lung

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14
Q

what are the major (oblique) fissures?

A

Right and Left lung are divided in half by them

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15
Q

where is the minor (horizontal) fissure located?

A

in the right lung

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16
Q

which lung is inferior?

A

left lobe, because it holds the heart

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17
Q

lingula

A

area where Left middle lobe should be, but is occupied by the heart

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18
Q

which lobe is matched with the heart space medially?

A

right middle lobe

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19
Q

where does the trachea bifurcate anteriorly?

A

at the sternal angle

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20
Q

where does the trachea bifurcate posteriorly?

A

T4 spinous process

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21
Q

what is the name of the tracheal bifurcation?

A

carina

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22
Q

why is the tracheal bifurcation important?

A

ET tube (endotracheal tube)-needs to sit above bifurcation

23
Q

how many 2nd bronchi does the R bronchi have?

A

3 secondary

24
Q

how many 2nd bronchi does the L bronchi have?

A

2 secondary

25
Q

visceral pleura

A

serous membrane which covers outer surface of each lung including inside the fissures

26
Q

parietal pleura

A

serous membrane which lines the thoracic cavity (inner ribcage and upper surface of the diaphragm)

27
Q

pleural space

A

lubricated space between pleura (pleural fluid)

allows lungs to move freely

28
Q

lung parankima

A

actually lung tissue

has not nerve endings

29
Q

what are the muscles of respiration?

A
  1. diaphragm
  2. muscles in ribcage and neck
  3. parasternals
  4. scalenes
30
Q

when diaphragm contracts, what happens?

A

descends in the chest, which opens thoracic cavity and air rushes into the lungs

31
Q

what is happening at the alveoli?

A

CO2 is going out of the blood

O2 is going into the blood

32
Q

what is the concentration of oxygen in the air?

A

18-20%

33
Q

what muscles would be used if the pt needs to work harder to breathe?

A

sternomastoids
scalenes
abdominal muscles
intercostals

34
Q

when does clubbing happen?

A 
chronic and fairly severe hypoxemia
true clubbing warrants more investigation
-cystic fibrosis
-COPD
-emphysema
35
Q

what are some causes of impaired movement

A

hemothorax
flail chest
fractures rib
pneumonectomy

36
Q

pectus excavatum

A

chest that looks like it’s scooped out

  • many times needs to be repaired
  • partially sternum/articulations of ribs with sternum
37
Q

pectus carinatum

A

chest that looks like to pokes out like a bird’s beak

-does allow more room

38
Q

barrel chest

A

fairly symmetric expansion of chest area
transverse view will look like a barrel (o-shaped)
chronic
-COPD
-emphysema
-air trapping from malfunctioning alveoliq

39
Q

kyphosis

A

major curvature of the spine
causes abnormal use of the lungs
can often cause pneumonia because of atelectasis

40
Q

atelectasis

A

any time the lung can’t open like it’s supposed to.

41
Q

scoliosis

A

abnormal s-type curvature in the spine

42
Q

tactile fermitus

A

not sure yet

43
Q

how far does percussion penetrate into the chest?

A

5-7 cm, but will not help to detect deep lesions

-not effective with obese patients

44
Q

what does percussion accomplish?

A

establish whether underlying tissue is air filled, fluid filled, or solid

45
Q

flatness

A

soft, high pitched, short sound

thigh

46
Q

dullness

A

medium, medium pitched, medium length sound

liver

47
Q

resonance

A

loud, low pitched, long length sound

healthy lung

48
Q

hyperresonance

A

very loud, low pitched, longer length sound

abnormal in most cases

49
Q

tympany

A

loud, high pitched sound

gastric bubbles

50
Q

what is the pattern of auscultation

A

step-ladder approach to be able to compare bilateral sounds

51
Q

what are the different types of breath sounds?

A

vesicular (most of lung sounds you are listening to)
bronchovesicular (lateral of central airways, in between normal lung tissue and bronchi)
bronchial (anteriorly, over the bronchi)

52
Q

what is the most frequent cause of chest pain in children?

A

anxiety

costochronditis

53
Q

what is stridor?

A

audible wheezing which indicates obstruction of the larynx and/or trachea

54
Q

what do sinus tracts indicate?

A

infection of the underlying pleura and lung (TB or actinomycosis

Medicine (146 decks)

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