Lungs Flashcards
(hint: this one is not a deformity)
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Normal adult
The thorax in the normal adult is wider than it is deep. Its lateral diameter is larger than its anteroposterior diameter.
![](https://s3.amazonaws.com/brainscape-prod/system/cm/122/370/887/q_image_thumb.png?1659496709)
Funnel chest (pectus excavatum)
Note depression in the lower portion of the sternum. Compression of the heart and great vessels may cause murmurs.
![](https://s3.amazonaws.com/brainscape-prod/system/cm/122/370/938/q_image_thumb.png?1659496710)
Barrel Chest
There is an increased anteroposterior diameter. This shape is normal during infancy, and often accompanies aging and chronic obstructive pulmonary disease.
![](https://s3.amazonaws.com/brainscape-prod/system/cm/122/370/984/q_image_thumb.png?1659496710)
Pigeon Chest (Pectus Carinatum)
The sternum is displaced anteriorly, increasing the anteroposterior diameter. The costal cartilages adjacent to the protruding sternum are depressed.
Breath Sounds:
Transmitted voice sounds: (bronchophy, egophony, whispered pectoriloquy)
Tactile Fremitus:
![](https://s3.amazonaws.com/brainscape-prod/system/cm/122/371/071/q_image_thumb.png?1659496711)
Breath sounds: Predominantly vesicular
Transmitted voice sounds: Spoken words muffled and indistinct, Spoken “ee” heard as “ee”, Whispered words faint and indistinct, if heard at all
Tactile fremitus: Normal
Breath Sounds:
Transmitted voice sounds: (bronchophy, egophony, whispered pectoriloquy)
Tactile Fremitus:
![](https://s3.amazonaws.com/brainscape-prod/system/cm/122/371/245/q_image_thumb.png?1659496711)
Breath sounds: Bronchial or bronchovesicular over the involved area
Transmitted voice sounds: Spoken words louder, clearer (bronchophony), Spoken “ee” heard as “ay” (egophony), Whispered words louder, clearer (whispered pectoriloquy)
Tactile fremitus: Increased
Chest Disorders: Consolidation
Defn:
Percussion:
Breath sounds:
Adventitious sounds:
Tactile fremitus and transmitted voice sounds:
Alveoli fill w/ fluid or blood (pneumonia, pulmonary edema, hemorrhage)
Percussion: dull
Breath sounds: bronchial over involved area
Adventitious sounds: late crackles
Tactile fremitus and transmitted voice sounds: increased TF and yes to broncho, ego, whispered pectoriloquy
Chest Disorders: Atelectasis
Defn:
Percussion:
Breath sounds:
Adventitious sounds:
Tactile fremitus and transmitted voice sounds:
Plug in bronchus obstructs air flow, affected lung tissue collapses into airless state
Percussion: dull
Breath sounds: may be absent if bronchial plug persists
Adventitious sounds: none
Tactile fremitus and transmitted voice sounds: may be absent or increased
Chest Disorders: Pleural Effusion
Defn:
Percussion:
Tracheal deviation:
Breath sounds:
Adventitious sounds:
Tactile fremitus and transmitted voice sounds:
Fluid accumulates in pleural space, blocks transmission of sound
Percussion: dull to flat over fluid
Trachea shifted toward OPPOSITE side of effusion
Breath sounds: decreased to absent
Adventitious sounds: possible pleural rub
Tactile fremitus and transmitted voice sounds: decreased to absent, may be increased on top of large effusion
Chest Disorders: Pneumothorax
Definition:
Percussion:
Tracheal deviation:
Breath sounds:
Adventitious sounds:
Tactile fremitus and transmitted voice sounds:
air leaks into pleural space, usually unilaterally. Air blocks the transmission of sound.
Percussion: hyperresonant over pleural air
Trachea: shifted toward opposite side if much air
Breath sounds: decreased to absent
Adventitious sounds: possible pleural rub
Tactile fremitus and transmitted voice sounds: decreased/absent over air
Chest Disorders: COPD
Definition:
Percussion:
Breath sounds:
Adventitious sounds:
Tactile fremitus and transmitted voice sounds:
slowly progressive disorder, distal air spaces enlarge and lungs become hyperinflated. associated w/ chronic bronchitis, emphysema, smoking.
Percussion: hyperresonant
Breath sounds: decreased to absent
Adventitious sounds: generally none, sometimes crackles, wheezes, rhonchi of associated chronic bronchitis
Tactile fremitus and transmitted voice sounds: all decreased
Chest Disorders: Asthma
Definition:
Percussion:
Breath sounds:
Adventitious sounds:
Tactile fremitus and transmitted voice sounds:
widespead, reversable narrowing of the tracheobronchial tree diminshes air flow. During attacks, air flow decreases, lungs hyperinflate
Percussion: resonant to hyperresonant
Breath sounds: obscured by wheezes
Adventitious sounds: Wheezes, possible crackles
Tactile fremitus and transmitted voice sounds: all decreased
Where do you hear vesicular sounds?
Where do you hear bronchovesicular sounds?
Where do you hear bronchial sounds?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/122/813/610/a_image_thumb.png?1659442152)
In order of loudest to softest and high-pitched to low-pitched, put the following in order:
Bronchial
Vesicular
Bronchovesicular
Tracheal
- vesicular
- Sounds: soft & low pitched
- Bronchovesicular
- Sounds: louder than vesicular, softer than bronchial or tracial; middle pitch
- Bronchial
- Sounds: loud and high pitched
- Tracheal
- Sounds: VERY loud, high pitched
Describe if expiration > inspiration, inspiration > expiration, or if the breath sounds are = for:
tracheal
bronchial
bronchovesicular
vesicular
Which breath sound has a pause between the two?
Bronchovesicular & Tracheal: exp = insp
Bronchial: exp > insp - this one has pause
Vesicular: insp > exp
What do you suspect if you hear BV or bronchial sounds outside of where they should be?
Fluid-filled lungs or solid lung tissue.
What should you expect in a ptn w/ decreased air flow (msk weakness, obstructive lung disease) or poor transmission (COPD, pleural effusion, pneumothorax)?
decreased breath sounds
What occurs during inspiration?
●diaphragm moves down
●intercostal msks lift sternum & ribs
●accessory neck msks used if forced/heavy