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Pain Control II > lungs and thorax > Flashcards

lungs and thorax Flashcards

1
Q

scapula usually ends at

A

the 7th rib

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2
Q

axillary line

A

closer to armpit
then midclavicular line

midline = midsternal line (MSL)

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3
Q

ribs after 7

A

8.9.10 attch to cartilage above

11 and 12 are free floating

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4
Q

right main bronchus vs left main bronchus

A

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

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5
Q

right lung lobes

A

3

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6
Q

hear which lobes

A

upper - anterior

lower - posterior

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7
Q

deep breathe in

A

lungs contract

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8
Q

structures included in the respiratory

A

respiratory bronchioles
alveolar ducts
alveolar sacs
alveoli

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9
Q

primary role of lungs

A

distribute air and blood flow for gas exchange

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10
Q

internal vs external respiration

A

internal = cellular respiration - utalization of oxygen by cells

external = exchange of oxygen and carbon dioxide between organisms and the external environment

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11
Q

breathing is what 3 basic things

A

automatic
rhythmic
a centrally regulated mechanical process

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12
Q

primary muscles involed in breathing

A

diaphragm

intercostals

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13
Q

accessory muscles involved in breathing

A

abdominals
scalenes
sternocleidomastod
some back muscle s

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14
Q

exchange of gases - explain

A

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

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15
Q

steps of respiration 1-5

A
  1. exhange of air between atmosphere and lungs
  2. o2 and co2 alveoli exchange by diffusion
  3. 02 and CO2 transport via pulmonary and systemic circulations
  4. o2 and CO2 excahnge in tissue capillaries
  5. cellular utilization
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16
Q

speed of gas diffusion

A

across the membranes is controlled by several factors - MOST IMP one is the partial pressure in each compartment

high partial to low partial

17
Q

lung examination includes

A

inspection
palpation
percussion
auscultation

18
Q

regular rate

A

12 / min

19
Q

tachypnea vs bradypnea

A

rapid vs slow breathing

20
Q

hyperventilation

A

rapid deep breathing

21
Q

cheyne- stokes breathin

A

periods of deep apnea alterante with deep breathing

22
Q

fremitus is

A

palpable vibrations

23
Q

percussion break down

A

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

24
Q

patient takes breathe in where do lungs go

A

lungs drop down

will become resonance again

25
Q

pattern for percussion and auscultation

A

latter

and compare one side to other

26
Q

Abnormal lung findings and what it signifies

A

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

27
Q

describe asthma

A

obstructive pulmonary disease

constriction of the bronchi

inflammation / mucus secretions in the bronchi

28
Q

asthma can present with

A

dyspnea - shortness of breath

tightness in the chest
cough

29
Q

asthma physical exam findings / during attack may be

A 
tachypnea - rapid breathing
labored breathing
expiratory wheezing 
occasionally productive cough 
pulmonary function test FEV1/ FVC
30
Q

pneumonia

A

acute inflammtion of the lungs

decreased breathe sounds

INCREASED FREMITUS, esophony (e to a), and pectoriloquy

dullness to percussion

31
Q

pneumothorax

A

collapse of lung
decreased or absent breathe sounds

HYPERrresonance on percussion

32
Q

decreased fremitus with

A

emphysema

33
Q

emphysema

A

OVER inflation of the lungs
destruction of the alveolar wall of the distal air spaces

decreased breath sound
decreased fremitus

obstructive disease

34
Q

CHF characteristics

A 
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
35
Q

physical exam of CHF

A

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

36
Q

displacement of PMI?

A

point of maximal impulse e

37
Q

peripheral edema occurs with

A

right sided heart failure - usually due to left sided heart failure

38
Q

left sided heart failure usually shows signs in

A

the lungs

see symptoms peripheral – usaully right sided

Pain Control II (15 decks)

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