Lungs

Question 1

What are these landmark lines?

Answer 1

1. Posterior Axillary Line (PAL)
2. Mid Axillary Line (MAL)
3. Anterior Axillary Line (AAL)

Question 2

What are these landmarks?

Answer 2

1. Left-scapular line
2. Vertebral Line
3. Right-scapular line

Question 3

The top part of the lungs:

The bottom of the lungs from T10-T12:

Answer 3

Apex of lungs

Base of lungs

Question 4

How many lobes do the lungs have?

Answer 4

Right lung= 3 lobes

Left Lung= 2 lobes

Question 5

What part of the lung do you listen to when ausculating anterior?

Ausculating posterior?

Answer 5

Anterior= Upper lobes (listening to bronchial)

Posterior= Lower lobes (For fluid/infection)

Question 6

What triggers involuntary breathing?

Answer 6

• Increase in CO2 in blood (hypercapnia)
• pH of blood

Question 7

What is orthopnea:

What is Dyspnea:

Answer 7

Ortopnea: Difficulty breathing when lying down

Dyspnea: Shortness of breath

Question 8

What is blood sputum referred to as?

Answer 8

Hemoptysis

Question 9

A respiratory rate >24:

A RR >24 and deep:

Answer 9

>24: Tachypnea

>24 and deep: Hyperventilation

Question 10

A RR <10:

A RR <10 and shallow:

Answer 10

A RR <10: Bradypnea

RR <10 and shallow: Hypoventilation

Question 11

What are common risk factors for lung disease?

Answer 11

1. Smoking
2. Environmental
3. Family History
4. Being Immunocompromised (> infections)

Question 12

What subjective data is important to collect about the lungs?

Answer 12

1. Persistant cough
2. Bloody sputum
3. Voice change
4. Orthopnea
5. Activity intolerance

Question 13

A patient exhibits

1. pursed lip breathing,
2. clubbing,
3. sitting in a tripod position

What might these symptoms indicate?

Answer 13

COPD

1. Slow expiration prevents airway collapsing
2. Position allows all muscles to aid in expiration

Question 14

When inspecting the patient, what do you look for?

Answer 14

1. RR: 10-20
2. Quality of breath
3. Trachea (midline?)
4. Use of accessory muscles

Question 15

What is this condition?

Answer 15

Intercostal retractions when breathing (abnormal)

Question 16

When inspecting the thorax, what is expected symmetry?

Answer 16

Anterior-posterior diameter: 1

Transverse diameter: 2

Question 17

Barrel chest (AP=Transverse) indicates:

Answer 17

Long term hypoxia with emphyzema

Question 18

When palpating the thorax, what are you assessing for?

Answer 18

1. Tenderness
2. Lesions
3. Temperature
4. Moisture

Question 19

When percussing the thorax (intercostal spaces), what are expected findings?

Answer 19

Expected: Resonance

Question 20

What do these abnormal percussion noises of the thorax indicate:

1. Hyper resonance (hollow)
2. Dullness (dense)
3. Flat (very dense)

Answer 20

1. Hyper resonance= emphysema
2. Dullness= Pneumonia
3. Flat= Tumor

Question 21

How many regions do you inspect when auscultating the lungs?

Answer 21

Anterior= 6-8 (Above clavicles, 2nd ICS-4th ICS)

Posterior= 8-10 (above first rib, 4th ICS, 6th, 8th, 9th)

Right side= 1 (5th ICS)

Question 22

Normal tracheal and bronchial sounds:

Answer 22

Harsh, hollow, high pitched, and loud

Question 23

Normal bronchiovesicular sounds:

Answer 23

Soft blowing, medium pitch, moderate loudness

Question 24

Normal vesicular sounds:

Answer 24

Rustling, low pitch, soft loudness

Question 25

What are these adventitious lung sounds:

• Discontinuous, high pitched, short popping
• Loud, low pitched bubbling

Answer 25

• Crackles (fine)
• Crackles (course)

Question 26

What are these adventitious lung sounds:

• High pitched, muscal squeking on expiration
• High pitches, crowing on inspiration caused by airway obstruction

Answer 26

• Wheezing
• Stridor

Question 27

Patient reports:

• Producing cough >3 months
• Peripheral edema
• Cyanotic skin

Answer 27

Chronic Bronchitis

Question 28

Patient reports:

• Older and thin
• Severe dyspnea
• Hyperresonance of lung fields

Answer 28

Emphysema