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PATHO > nurse 252 thorax and lungs > Flashcards

nurse 252 thorax and lungs Flashcards

1
Q

what is the thoracic cage defined ad?

A

the sternum, 12 pairs of ribs, and 12 thoracic vertebrae

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2
Q

where is the suprasternal notch located?

A

just above the sternum, between the clavicles

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3
Q

where is the sternum located?

A

breast bone-three parts:

manubrium, the body, and the xiphoid process

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4
Q

what is the sternal angle useful for

A

a useful place to start counting ribs, each intercostal space is numbered by the rib above it

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5
Q

where is the vertebra proiminens posterior landmark?

A

start at the base of your neck, flex your head and fell for the most prominent bony protrusion, this is spinous process C7

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6
Q

where is the spinous processes posterior landmark?

A

count down the vertebrae, which stack together to form the spinal column. note that the spinous processes align with their same numbered ribs only down to t4

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7
Q

where is the inferior border of the scapula posterior landmark?

A

the lower tip is usually at the level of the seventh or eight rib

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8
Q

where is the twelfth rib as a posterior landmark

A

palpate midway between the spine and the pts side to identify the free tip of the twelfth rib

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9
Q

where is the midsternal line?

A

the center of the chest, cutting the body in half

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10
Q

where is the midsternal line?

A

just to the side of the midsternal line ( bisects (cuts in two equal parts) the center of each clavicle

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11
Q

posteriorly, where is the midspinal line?

A

extends through the inferior angle of the scapula when the arms are at the side of the body

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12
Q

where is the mediastinum?

A

the middle section of the thoracic cavity and it contains the esophagus, trachea, heart and great vessles (area between lungs)

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13
Q

what do the right and left pleural cavities contain?

A

the lungs

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14
Q

are the lungs symmetrical?

A

no

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15
Q

what is the difference between the left and right lungs?

A
  • the right lung is shorter than the left because of the underlying kidney
  • the left lung is narrower (skinner) than the right lung because the heart bulges to the left
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16
Q

how many lobes does the right lung have?

A

three lobes

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17
Q

how many lobes does the left lung have?

A

two lobes

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18
Q

what is the pleurae?

A

a thin, slippery envelope between the lungs and the chest wall, the lungs slide smoothly up and down during respiration, lubricated with only a few millimeters of fluid

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19
Q

where is the trachea?

A

it lies anteriorly to the esophagus. it begins at the cricoid cartilage and bifurcates just below the sternal angle into the right and left main bronchi

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20
Q

whats the difference between the left and right bronchus?

A

the right main bronchis is shorter and wider and more veritcal than the left main bronchus

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21
Q

what do the trachea and the bronchi do?

A

transport gases between the enivorment adn the lungs. they make up the dead space that is filled with air but no gas exchange occurs

22
Q

what are the three major functions of the respiratory system?

A

1) supplying 02 to the body for energy production
2) removing C02 as a waste produce of energy reactions
3) maintaining homeostatis (acid base balance)

23
Q

what subjective data should be gathered about the respiratory system?

A

cough- do u cough up sputum? any vblood (hemoptysis), does cough seem to come with activity, positioning, or talking?

  • you should have shortness of breath? how many pillows does it take to fall asleep? (related to heart issues) history of infecc? does you feel pain when breathing?
  • ask about history of smoking or thier work enviroment
24
Q

what are the types of sputum?

A

Green phelgm: indicative or viral or bacterial infecc
white or clear: colds, bronchitis, viral infecc
rust color: tubuerculosis, pneumoccoal pneumonia
pink, frosty: pulmonary edema

25
Q

what is orthopnea?

A

difficulty breathing in the supine position, state # of pillowd needed to achieve comfort (eg, two pillow orthopnea”

26
Q

what is paroxysmal noctunal dyspnea?

A

is when pt is woken from sleep with shortness of breath and needed to be upright to acheive comfort

27
Q

how to attain objective data for resp system?

A

perform inspection, palpation, percussion, ausculation on the posterior and lateral thorax. then move to face the pt and repeat thse four manoevers on the anterior chest

28
Q

how to inpect the posterior chest?

A
  • note the shape and configuration of the chest wall
  • note skeletal deformities such as scoliosis and kyphosis
  • “barrel chest” occurs in and COPD chronic emphysema as a result of hyperinflation of the lungs
  • tripod positioning - pts with COPD who sit leaning forwards with arms braced against there knees
29
Q

how to palpate the posterior chest?

A
  • confirm symmetrical chest expansion by placing your hands on the back with your thumns at T9 or T10
  • slide your hands medially and pincj a small fold of skin between your thumbs
  • as pt takes deep breaths, ur thumbs should move apart symmertrically
30
Q

what should u suspect about an unequal posterior chest?

A

-if unequal, suspects atelectasis, pneumonia or thoaracic trauma

31
Q

what percussion notes could be expected for posterior chest?

A

1) resonance (normal)
2) hyperresonacne (hollow sound)
3) Dull notes (abnormal finding)

32
Q

what does resonance sound like?

A

low pitched, clear, hollow sound that predominated healthy lung tissue in adults

33
Q

what does hyperresonace sound like?

A

lower pitched, booming sound found when too much air is present in lungs, as in emphysems or pneumothorax

34
Q

what does dull note sound like?

A

abnormal- soft, muffled, thud signals abnormal density in the lungs as with pneumonia, pleural effusion, atelectiasis ot tumor

35
Q

how to ausculate the posterior chest?

A

evaluate the presense and quality of normal breath sound

  • while stanfing behind pt, listen to the following lung areas: posterior from the apices at C7 to the bases at T10 and laterally from the axilla down to the seventh or eight rib
  • ask pt to take beep breaths, in through nose and out through mouth, just letting air out of mouth
36
Q

what are some abnormal findings wih auscultations of lungs?

A
  • decreased breath sounds
  • hear dullness when auscultating
  • obstruction of the bronchial tree by secretions, mucous plug or foreign body
  • emphysema (as result of loss of elasticity in lung fibers
  • obstruction of the transmission of sounds ( pneuthorax or pleurl effusion)
37
Q

what does an absence of breath sounds indicate?

A

a silent chest means no air is moving in or out which is an ominous sign for impending respiratory failure

38
Q

is it a good sign when a wheezing pts who as asthma stops wheezing?

A

no- wheezing means air is still going in and out, when it suddently stops- its because now thier bronchials are so constricted, they cant get air in and out
wheezing does not mean severe asthma attack

39
Q

02 stats less than ____ on room air must be attended to immediately

A

93%

40
Q

what should a nurse do before putting a pt on 02?

A

put pt in high fowlers (takes weight of fat off of chest) tell them to take some deep breaths, if that doesnt improve, put them on 02

41
Q

what should you ensure about a pt before putting them on 02?

A

make sure they arent a CO2 retainer (COPD). normla levels for such pts range from 88% to 92%

42
Q

what are adventitous sounds?

A

abnormal sounds - ones that are not normally heard by the lungs
-always notes presense of these sounds

43
Q

what are adventitous sounds made by?

A

caused by the collision of moving air with secretions in the tracheobroncial passageways or by the popping open of previous defalted airways

44
Q

what is a crackle noise from the lungs? caused by what?

A

a low pitched, bullbing and gurgling, caused by pulmonary edema (fluid in lungs), pneumonia, pulmonary fibrosis

45
Q

what does a wheeze sounds like? caused by what?

A

low pitched, heard throughout respiration but more prominent on expiration, caused by bronchitis, bronchus obstruction from airway tumor, asthma

46
Q

what is a stridor sounds like? cause?

A

loud and high pitched , inspiratory, cause by croup and epiglottis in children, foreign body inhalation and obstructed airway (all may be life threatening)

47
Q

what is tachypnea?

A

rapid, shallow breathing

  • more than 24 breaths per min
  • normla response to fever or excersise
  • resp tate also increases with pneumonia, alkalosis, and pleurisy
48
Q

what is bradypnea?

A

slow breathing
resp reates less than 10 per min
caused by drug induced depression of the resp center

49
Q

what is hyperventilation?

A

Increase in both rate and depth; causes by extreme exertion, fear, anxiety salicyalte overdose, and lesions of the midbrain. hyperventilation causes the level of carbon dioxide in the blood to decrease (alkalosis)

50
Q

what is hypoventilation?

A

an irregular shallow pattern caused by an overdose of narcotics or anesthesia

51
Q

what is cheyne strokes and what is cause

A

a cycle in which respirations gradually wax and wane in a regular pattern, increasing in rate and depth and then decreasing

  • most common cause is severe heart failure, drug overdose or increased intracranial pressure
  • pts who are breathin like this are often at the end of thier life
52
Q

what is kussumal breathing?

A

occurs with diabetic ketoacidosis- deeo, laboured breathing

-we have to fix the underlying cause to fix the breathing

PATHO (15 decks)

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