Lungs and Thorax Flashcards
exam technique order
Inspection, palpation, percussion, auscultation
How do you measure Diaphragmatic excursion
checking chest expansion by placing thumbs close to pts spine @ level of the 10th ribs and spread fingers across lateral thorax, ask pt to inhale and exhale deeply
supraclavicular
above clavicle
infraclavicular
below clavicle
interscapular
inbetween the scapule
infrascapular
below the scapule
parietal pleura
lines inside the chest wall
Visceral pleura
covers surface of lungs
when feeling for tactile fremitus, how many points are you inspecting
4
How many areas on the posterior lungs do you percuss?
7
percussion sound on thigh
flat, short duration
percussion sound on liver
dull, medium duration
percussion sound on healthy lungs
resonant, long duration
percussion sound on COPDers
hyperresonant, longer duration
percussion sound of gastric bubble
tympanitic, longer duration
4 kinds of breath sounds
tracheal, vesicular, bronchial, bronchovesicular
tracheal I:E ratio, quality and location
I=E, Inspiratory sounds last same as expiratory sounds, harsh, high pitched, hollow, loud, heard over trachea
Vesicular I:E ratio. quality and location
I>E, Inspiratiory sounds lasts longer that expiratory sounds, soft, low pitched, heard over most lung fields
Bronchial I:E ratio, quality and location
I
Bronchovesicular I:E ratio, quality and location
I=E, Inspiratory sounds last same as expiratory sounds, louder and harsher than vesicular, heard over 2nd ICS anterior and T4 posterior
Continuous adventitious breath sounds
wheezes and Rhonchi
Discontinous adventitious breath sounds
crackles
normal forced expiration
3-4 seconds
Egophony
“ee” turns into “aa” which means there is consolidation
Bronchophony
patients say “99” which will come through louder d/t airless tissue
Whispered pectoriloqury
patients whisper “1,2,3” which will sound louder
Dyspnea occurs when?
when youre hypoxic
10 P’s of dyspnea rapid onset
Pna Pneumothorax Pulmonary constriction (asthma) Pulmonary embolism Peanut or other foreign body Pericardial tamponade Pump failure Peak seekers (high altitude) Psychogenic Poisons (ASA)
Where is the apex of each lung?
2-3cm above the 3rd clavicle
anterior axillary line is located where?
Far left or right of chest
which muscles are the accessory muscles?
supraclavicular and scalenes