lungs

Question 1

injuries to cervical pleura and apex of lung

Answer 1

Cervical pleura and apex of lung extend above the the 1st pair of ribs, and is libel to injury in the base of the neck, especially in children who have short necks. (injury often leads to pneumothorax)

Question 2

atelectasis

Answer 2

Collapse of a previously inflated lung (secondary) or failure of a lung to inflate at birth (primary).

• air enters between visceral pleura and the parietal pleura and surface tension is lost causing the collapse of the lung.
• lungs do not generally communicate so loss of one lung does not result in collapse of both

Question 3

Pneumothorax

Answer 3

entry of air into the pleural cavity

-may come from injury such as bullet wound or fractured ribs or bronchopulmonary fistula

Question 4

hydrothorax

Answer 4

fluid in the pleural cavity–may be caused by a pleural effusion. If it fills with blood it is a hemothorax. Both air and blood is a hemopneumothorax. Air-fluid level will have a sharp line horizontal to the ground.

Question 5

Thoracentesis

Answer 5

insertion of a hypodermic needle through an intercostal space into the pleural cavity to obtain a sample of fluid or remove blood or pus

Question 6

insertion of a chest tube

Answer 6

removal of large amounts of blood, air, or pus from the lungs by a chest tube. Incision generally made in 5th or 6th intercostal space in midaxillary line (~nipple level). May be directed superiorly or inferiorly for air or liquid removal.
-failure to remove fluid from lung may cause lung to develop a resistant fibrous covering that inhibits expansion unless it is peeled off (lung decoration

Question 7

pleurectomy

Answer 7

removal of pleural cavity during surgery. may be obliterated by pleural cavity disease such as pleuritis.

Question 8

pleurodesis

Answer 8

adherence of layers of pleura is induced by covering the apposing layers of pleura with and irritating powder or sclerosing agent.
-pleurectomy and pleurodesis preformed in junction to prevent spontaneous secondary atelectasis

Question 9

thoracoscopy

Answer 9

diagnostic and sometimes therapeutic procedure where pleural cavity is examined with a thoracoscope. small incisions made in pleural cavity in intercostal space.

Question 10

pleuritis (pleurisy)

Answer 10

inflamaiton of the pleura that produces audible rubbing sound during auscultation of the lungs. inflamed surfaces may also cause parietal and visceral layers to adhere causing pleural adhesion. pleuritis marked by acute stabbing pain when rate and depth of respiration is increased.

Question 11

appearance of lungs inhaling carbon particles and irritants

Answer 11

generally lungs are light pink, but those who smoke and live in dirty environments commonly have dark and mottled lungs.
smoker’s cough results from the inhalation of these irritants, though lungs can accumulate a considerable amount of carbon without being affected and lymph from the lung carries phagocytes that remove carbon from lung and deposit in “inactive” connective tissue or lymph nodes

Question 12

auscultation of the lungs

Answer 12

listening to sounds of lungs with a stethoscope. assesses airflow through tracheobronchial tree into lobes of the lung.
-ausc. base of the lung is application of a stethoscope to posterior thoracic wall at level of 10th thoracic vert.

Question 13

percussion of thorax

Answer 13

tapping on fingers pressing firmly on the thorax and listening to flat and resonant sounds

Question 14

aspiration of foreign bodies

Answer 14

right main bronchus is wider and shorter than the left main bronchus, so aspirated bodies are more likely to go down right branches. can be a concern for dentists.

Question 15

bronchoscopy

Answer 15

passing of a bronchoscope down trachea to main bronchus. observe the carina, a keel like ridge (cartilaginous projection of last tracheal ring) between the orifices of right and left main bronchi.
if tracheobronchial lymph nodes are enlarged because of cancer cells, the carina may be distorted, widened and immobile.

Question 16

cough reflex

Answer 16

mucous membrane covering carina is one of most sensitive areas of tracheobronchial tree, and it senses mucus or foreign bodies it will cause a cough reflex.

Question 17

segmental atelectasis

Answer 17

blockage of a segmental bronchus prevents air fro reaching that bronchopulmonary segment, and segment will collapse (air gradually absorbed into the blood). adjacent segments will expand to compensate for reduced volume

Question 18

pulmonary embolism

Answer 18

occurs when blood clot dislodges and travels in the blood to the lungs. It may block a pulmonary artery or one of its branches and results in a lung or sector that is ventilated with air but not perfused with blood.

Question 19

acute pulmonary distress

Answer 19

major decrease in oxygenation of blood, often due to a large pulmonary embolism. right side of heart may be dilated by difficulty in pushing volume.

Question 20

pulmonary infarct

Answer 20

area of dead (necrotic) tissue in the lung often due to medium pulmonary embolisms

Question 21

hemoptysis

Answer 21

spitting of blood from lungs or bronchial tree is due to bronchial or pulmonary hemorrhage. generally from bronchial arteries, and causes are generally bronchitis (inflammation of bronchi), lung cancer, pneumonia, bronchiectasis, pulmonary embolism and tuberculosis

Question 22

lung cancer and mediastinal nerves

Answer 22

due to intimate relationship of recurrent laryngeal nerve and apex of the lung, the nerve may be involved in apical lung cancers–usually involves hoarseness.

Question 23

pleural pain

Answer 23

visceral is insensitive because it receives no nerves of general sensation, parietal is extremely sensitive and may produce local or referred pain.

• irritation in costal and peripheral parts results in local and referred pain to the dermatones of thoracic and abdominal walls
• irritation of the mediastinal and diaphragmatic areas results in referred pain to root of nek and over the shoulder (C3-C5)

Question 24

PA radiograph

Answer 24

posterior anterior used to examine thoracic respiratory and cardiovascular structures as well as the thoracic wall. image viewed as if facing the patient.

Question 25

PA radiograph positioning

Answer 25

patient faces the x-ray detector or film cassette with anterior thorax against the detector. patient rotates the shoulders anteriorly to move the scapula away from the superior parts of the lungs. takes a deep breath and holds to increase radiolucency of the lungs and to move inferior margins into costodiaphragmatic recess.
some middle and inferior thoracic vertebrae obscured by organs in diaphram, as well as inferior ribs

Question 26

lateral projections

Answer 26

side of thorax against film cassette/x-ray detector and upper limbs elevated above the head. middle and inferior thoracic vertebrae are visible as well as parts of the sternom