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Fall- PE Exam > Lungs & Thorax > Flashcards

Lungs & Thorax Flashcards

1
Q

What is the costal angle?

A

??

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2
Q

What rib is in intercostal space 2

A

Rib 2

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3
Q

How many ribs

A

1-7 true ribs
8-10 false ribs
11 & 12 floating ribs

12 total

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4
Q

What rib space is used for needle aspiration of tension pneumothorax

A

Intercostal space 2

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5
Q

What rib space is used for chest tube placement?

A

Intercostal space 4

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6
Q

Posteriorly where do the ribs articulate?

A

Facets on transverse process and vertebral body

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7
Q

Where do neurovascular structures of ribs run posteriorly?

A

Along lower side of rib

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8
Q

Near what rib does the scapula end posteriorly?

A

7th rib

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9
Q

T1 vertebrae articulates with what rib

A

Rib 1

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10
Q

What is the angle of Louis

A

point where 2nd rib attaches to sternum

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11
Q

What vertebrae is correlated with anterior attachment of rib2

A

T4

-also area where trachea bifurcates into right and left side

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12
Q

What landmark is superior to the angle of Louis

A

Supra-sternal notch

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13
Q

What line runs down sternum

A

Midsternal line

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14
Q

What line is lateral to the midsternal line?

A

Midclavicular line

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15
Q

What line runs through C7

A

Midspinal line

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16
Q

What lines run lateral to the midspinal line?

A

Scapula lines

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17
Q

What does infra-mammary mean?

A

Below the nipples

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18
Q

Anteriorly how far does the apex extend above the clavicle?

A

2-4cm

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19
Q

Where approx. is the horizontal fissure?

A

Level of 4th rib

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20
Q

Right laterally, lung extends from ___ to _____

A

Peak of axilla

to 7th or 8th rib

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21
Q

What lobes make up the left lung?

A

LUL, LLL, lingual

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22
Q

What is the lower border of the lungs posteriorly

A

T10 at rest

T12 on inspiration

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23
Q

What bronchus is wider?

A

Right main stem, is also shorter

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24
Q

Mucoid sputum is_____ in color and probably signifies______

A

Translucent

Viral URI

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25
Q

Purulent sputum is _______ in color and probably signifies_____

A

Yellow or Green

bacterial infection

26
Q

When examining lungs/thorax posteriorly how should the patient sit?

A

Sitting up with arms crossed over each other

27
Q

What are purplish/blue lips significant for

A

Cyanosis- sign of inadequate oxygenation of tissue

28
Q

What main conditions appear with clubbing?

A

Bronchiectasis, malignancy, congenital heart disease, pulmonary fibrosis, CF
but NOT COPD

29
Q

What is a barrel chest?

A

Increased A/P diameter

seen in aging and COPD

30
Q

What is pectus excavatum?

A

Congenital funnel chest

can compress mediastinal structures

31
Q

What is pectus carinatum

A

Congenital pigeon chest

32
Q

What is traumatic flail chest?

A

Seen in traumatic injury
Paradoxical breathing from separation of part of the chest wall moving in opposition
-medical emergency

33
Q

What is kyphosis

A

excess curvature of the back “hunch back”
dorsal curvature of thoracic spine
seen often in elderly women with osteoporosis

34
Q

What is kyphoscoliosis?

A

Spinal convexity into other plane than normal
Forward hunching
Widely separated ribs on one side and other side has tight ribs

35
Q

What accessory muscles participate in breathing

A

abdominal
SCM
trapezius
scalenus

36
Q

What is the term for intercostal muscles working hard often seen in supraclavicular fossa

A

retractions

37
Q

What is hyperpnea of variable rates seen in DKA?

A

Kussmal’s respirations

38
Q

What breathing is associated with brain lesions and is increased with bouts of no breathing?

A

Cheyne-Stokes

39
Q

What is bradypnea

A

<12 breaths/min

40
Q

What is tachypnea

A

> 20/min with normal depth

41
Q

What is a normal respiration rate?

A

14-20

42
Q

What would cause asymmetry of respiratory excursion?

A 
pain (splinting)
paralysis
pneumothorax
Hemothorax
pleural effusion
43
Q

Would could decreased of absent tactile fremitus indicate?

A 
Voice too soft
COPD
thick chest wall
pneumothorax
obstruction of any kind (air, fluid, tumor)
44
Q

What is hyperresonant percussion over interspaces indate?

A

pneumothorax or COPD

45
Q

What does a dull sound during percussion indicate?

A

Probably not in interspaces

tumor or pneumonia

46
Q

What does a flat sound during percussion indicate?

A

Probably not in interspaces

pleural effusion

47
Q

What sound is expected during percussion of lungs?

A

Resonance

48
Q

What does abnormally high levels of diaphragmatic excursion mean?

A 
diaphragm too high
pleural effusion
atelectasis
phrenic nerve injury
paralysis
49
Q

If bronchovesicular or bronchial sounds are heard in locations distant from expected sites, suspect

A

that air filled lung has been replaced by fluid-filled or solid lung tissue

50
Q

Decreased intesnsity of normal lungs sounds seen in

A

obesity
thick chest wall
shallow breaths
pathology

51
Q

What are crackles?

A

brief discontinuous sounds, most often at end of inspiration

52
Q

What are ronchi

A

Snoring or gurgling sound

indicates secretions in large airways

53
Q

What are wheezes?

A

Musical sounds created when air flows rapidly through significantly narrowed bronchi
heard in expiation and sometimes on inspiration

54
Q

What is stridor?

A

wheeze heard primarily during inspiration and mainly over large airways

55
Q

What can stridor be a sign of?

A

Foreign body aspiration
croup
epiglottitis

56
Q

What is a pleural rub?

A

Related to inflammation of pleural spaces

Coarse grating sound timed with lung movement

57
Q

A increased intensity of transmitted voice sounds is indicative of

A

Consolidation

typical of pneumonia

58
Q

A decreased intensity of transmitted voice sounds common in

A

normal

or when fluid or air pushes lung away from chest wall

59
Q

What is bronchophony

A

Listening through chest wall as patient says number

60
Q

What is egophony?

A

an E to A change demonstrating consolidation or mass

Fall- PE Exam (8 decks)

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