lungs and thorax Flashcards
scapula usually ends at
the 7th rib
axillary line
closer to armpit
then midclavicular line
midline = midsternal line (MSL)
ribs after 7
8.9.10 attch to cartilage above
11 and 12 are free floating
right main bronchus vs left main bronchus
right main is basically straight so if you apirate something - can go right into the lung
left - more at an ablge - less likely to get stuck and asirate
right lung lobes
3
hear which lobes
upper - anterior
lower - posterior
deep breathe in
lungs contract
structures included in the respiratory
respiratory bronchioles
alveolar ducts
alveolar sacs
alveoli
primary role of lungs
distribute air and blood flow for gas exchange
internal vs external respiration
internal = cellular respiration - utalization of oxygen by cells
external = exchange of oxygen and carbon dioxide between organisms and the external environment
breathing is what 3 basic things
automatic
rhythmic
a centrally regulated mechanical process
primary muscles involed in breathing
diaphragm
intercostals
accessory muscles involved in breathing
abdominals
scalenes
sternocleidomastod
some back muscle s
exchange of gases - explain
exchange of gases in the alveoli depend entirely on the diffusion of gases across membranes and is controlled by the partial pressures of the respective gases on either side of the alveolar membrane
steps of respiration 1-5
- exhange of air between atmosphere and lungs
- o2 and co2 alveoli exchange by diffusion
- 02 and CO2 transport via pulmonary and systemic circulations
- o2 and CO2 excahnge in tissue capillaries
- cellular utilization
speed of gas diffusion
across the membranes is controlled by several factors - MOST IMP one is the partial pressure in each compartment
high partial to low partial
lung examination includes
inspection
palpation
percussion
auscultation
regular rate
12 / min
tachypnea vs bradypnea
rapid vs slow breathing
hyperventilation
rapid deep breathing
cheyne- stokes breathin
periods of deep apnea alterante with deep breathing
fremitus is
palpable vibrations
percussion break down
resonane - if palpating lungs - when between the ribs
if hyper - collapsed lungs
dullness - may have some type of pneumonia - b/c consolidated
if below dipragm - will be dull sound
knuckles on skin itself
- in betwenn ribs
patient takes breathe in where do lungs go
lungs drop down
will become resonance again
pattern for percussion and auscultation
latter
and compare one side to other
Abnormal lung findings and what it signifies
crackles - CHF
wheezes - asthma
decreased breath sounds - pneumonia, pneumothorax
rhnochi - secretion in the airway, bronchitis
egophony - the letter E is heard as A
bronchophony - sounds are transmitted louder and clearer
pectoriloquy - whispered sounds are heard louder and clearer
describe asthma
obstructive pulmonary disease
constriction of the bronchi
inflammation / mucus secretions in the bronchi
asthma can present with
dyspnea - shortness of breath
tightness in the chest
cough
asthma physical exam findings / during attack may be
tachypnea - rapid breathing labored breathing expiratory wheezing occasionally productive cough pulmonary function test FEV1/ FVC
pneumonia
acute inflammtion of the lungs
decreased breathe sounds
INCREASED FREMITUS, esophony (e to a), and pectoriloquy
dullness to percussion
pneumothorax
collapse of lung
decreased or absent breathe sounds
HYPERrresonance on percussion
decreased fremitus with
emphysema
emphysema
OVER inflation of the lungs
destruction of the alveolar wall of the distal air spaces
decreased breath sound
decreased fremitus
obstructive disease
CHF characteristics
pulmonary edema in the left sided heart failure crackles at bas of the lungs dysnpnea - shortness of breathe orthopnea - difficulty when laying fown paroxymal nocturnal dyspnea
physical exam of CHF
heart rate - prob low due to medication on beta blocker
systolic heart murmer - aortic stenosis
displacement of point of maximal impulse - due to enlarged heart
crackles on lung exam
peripheral edema
ascites
displacement of PMI?
point of maximal impulse e
peripheral edema occurs with
right sided heart failure - usually due to left sided heart failure
left sided heart failure usually shows signs in
the lungs
see symptoms peripheral – usaully right sided
