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NCM132/RLE102 > Prefinal - Thorax > Flashcards

Prefinal - Thorax Flashcards

1
Q

maneuver is a test used in an exam of neurological function for balance

A

Romberg’s Test

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2
Q

Excessive swaying when eyes are open or closed =

A

cerebellar deficit/cerebellar ataxia

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3
Q

Excessive swaying only when eyes are closed = (this is a positive Romberg’s sign)

A

procioceptive deficit/sensory ataxia

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4
Q

Nasal abnormality during breathing that is significant with labored or dyspnea and is indicative of hypoxia.

A

Nasal flaring

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5
Q

is a state in which oxygen is not available in sufficient amounts at the tissue level to maintain adequate homeostasis

A

Hypoxia

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6
Q

Nasal abnormality during breathing that is significant in asthma, CHF, and COPD.

A

Pursed lip breathing

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7
Q

is indicative of emphysema (gradual thinning and destruction of the alveoli or air sacs) due to hyperventilation of the lungs.

A

Barrel-chest

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8
Q

The gradual thinning and destruction of the alveoli or air sacs

A

Emphysema

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9
Q

The client should not be using accessory (trapezius/shoulder) muscles to assist breathing.

A
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10
Q

This position is taken by clients with difficulty breathing. It includes the inability to lie flat, leaning forward with arms and elbows supported over the bed table.

A

Tripod position

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11
Q

Possible Etiology for the Tripod Position



A

COPD, Asthma in exacerbation, and pulmonary edema indicate moderate to severe respiratory distress

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12
Q

Exaggeration of thoracic curve caused by muscular weakness or structural changes in vertebral bodies/ intervertebral discs. It is often due to weakness in the spinal bones that causes them to compress or crack

A

Kyphosis

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13
Q

Exaggeration of lumbar curve caused by diseases of the vertebral column like spondylolisthesis. There are several causes and risk factors, including congenital conditions, uneven posture, and injuries.

A

Lordosis

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14
Q

is a condition that occurs when one vertebral body slips with respect to the adjacent vertebral body causing radicular or mechanical symptoms or pain.

A

Spondylolisthesis

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15
Q

Kyphosis = stomach in, Lordosis = stomach out

A
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16
Q

Palpate posterior thorax for tenderness. Palpate also crepitus and fremitus (vibrations of air in the bronchial tubes transmitted to the chest wall). Ask the client to say 99.

A
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17
Q

This lung sound is usually significant in bronchial obstruction (foreign body, tumor, thick secretions, spasm), air trapping in emphysema (thinning and destruction of alveoli), pleural effusion (water in the lungs), and pneumothorax (air leakage).

A

Unequal fremitus

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18
Q

Normally, a 2-5” chest expansion can be observed.



A
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19
Q

Symmetric chest expansion
Place warmed hands on posterolateral chest wall with thumbs at level of T9 or T10 Slide hands medially to pinch up a small fold of skin between thumbs
Ask the person to take a deep breath As the person inhales, the thumbs should move apart symmetrically Unequal chest expansion occurs with atelectasis, pneumonia, thoracic trauma
Pain accompanies deep breathing when pleurae are inflamed

A
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20
Q

Unequal chest expansion is significant in clients with the following disorders:

A
  1. Severe atelectasis, collapse or incomplete expansion
  2. Pneumonia, lung infection
  3. Chest trauma
  4. Pneumothorax
  5. COPD
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21
Q

drum-like sounds heard over air-filled structures during the abdominal examination

A

Tympany -

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22
Q

(pneumothorax), said to sound similar to percussion of puffed-up cheeks, extremely abnormal sound

A

Hyperresonance -

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23
Q

the sound produced by percussing a normal chest.

A

Resonance

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24
Q

similar to percussion of a mass such as a liver

A

Dullness

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25
Q

heard on hard surfaces like bone

A

Flatness

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26
Q

Harsh, high-pitched
I=E
Above the supraclavicular notch, over the trachea

A

Tracheal

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27
Q

Loud, high-pitched
I<E
Just above the clavicles on each side of the sternum, over the manubrium

A

Bronchial

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28
Q

Medium in loudness and pitch
I=E
Next to the sternum, between the scapulae

A

Bronchovesicular

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29
Q

Soft, low-pitched
I>E
Remainder of lungs

A

Vesicular

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30
Q

is a deformity of the chest wall where there is an unusual bulging of the anterior thoracic wall.

A

Pectus carinatum

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31
Q

is a deformity of the anterior thoracic wall that produces a caved-in or sunken appearance of the chest.

A

Pectus excavatum

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32
Q

Retraction of the thoracic cage is significant in increased inspiratory effort. Bulging is indicative of trapped air like asthma.

A
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33
Q

Inspect pulsations with the client in a supine position with the head elevated between 30 and 45 degrees. The nurse should stand on the client’s right side.

A
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34
Q

The apical impulse is palpated in the mitral area about 1 – 2 cm. It feels like a gentle tap.

A
35
Q

The apical pulse may be impossible to palpate in clients with emphysema. If the heart is larger than 1 – 2 cm, displaced, more forceful, or of longer duration, this is indicative of cardiomegaly.

A
36
Q

Resonance is the percussion tone elicited over normal lung tissue.

A
37
Q

Heart Murmur Grade: faint murmur, barely audible.

A

Grade I:

38
Q

Heart Murmur Grade: soft murmur.

A

Grade II:

39
Q

Heart Murmur Grade: easily audible but without a palpable thrill.

A

Grade III:

40
Q

Heart Murmur Grade: easily audible murmur with a palpable thrill.

A

Grade IV:

41
Q

Heart Murmur Grade: loud murmur, audible with stethoscope lightly touching the chest.

A

Grade V:

42
Q

Heart Murmur Grade: loudest murmur, audible with stethoscope not touching the chest.

A

Grade VI:

43
Q

Hyperresonance is significant in trapped air such as in emphysema, and pneumothorax. Dullness is indicative of pleural effusion/tumor.

A
44
Q

Heart sound ___ is caused by turbulence caused by the closure of mitral and tricuspid valves at the start of systole.

A

S1

45
Q

Heart sound ___ is caused by the closure of the aortic and pulmonic valves, marking the end of
systole.

A

S2

46
Q

S1 corresponds with each carotid pulsation and is loudest at the apex of the heart. S2 follows after S1 and is loudest at the base of the heart.

A
47
Q

Abnormal sounds consist of clicking, rushing, or gurgling noises that are either heard before, between, or after the normal heart sounds

A

Heart Murmurs

48
Q

is a high-pitched, “diamond shaped” crescendo-decrescendo, midsystolic ejection murmur heard best at the right upper sternal border radiating to the neck and carotid arteries

A

Aortic Stenosis

49
Q

is caused by the retrograde flow of blood from the left ventricle (LV) into the left atrium (LA) through the mitral valve (MV), causing a systolic murmur heard best at the apex of the heart with radiation to the left axilla

A

Mitral regurgitation (MR)

50
Q

also known as aortic insufficiency, is a decrescendo blowing diastolic murmur heard best at the left lower sternal border, heard when blood flows retrograde into the left ventricle

A

Aortic regurgitation

51
Q

is of low pitch, rumbling in character, and best heard at the apex with the patient in the left lateral position. It commences after the opening snap of the mitral valve, and the duration of the murmur correlates with the severity of the stenosis

A

Mitral Stenosis

52
Q

is a continuous, “machinery” murmur below the clavicle, radiating to the back, although it can also manifest as a systolic or holosystolic murmur

A

Patent Ductus Arteriosus

53
Q

■ Heart Sounds: “lub” occurs at the beginning of systole (mitral and tricuspid close)

A

S1

54
Q

■ Heart Sounds: “dub” marks the start of diastole,
(aortic and pulmonic close)

A

S2

55
Q

■Heart Sounds: early signs of CHF (ventricular gallop)

A

S3

56
Q

■Heart Sounds: pulmonic stenosis, aortic stenosis, hypertension, MI & cardiomyopathy (atrial gallop)

A

S4

57
Q

One breast may normally be larger than the other.

A
58
Q

Pigskin-like or peau d’orange appearance is significant when there is edema due to blocked lymphatic drainage.

A
59
Q

Perform a self-breast exam every month, ___ days after menstruation.

A

3-5

60
Q

Nipples can either be normal, flat, or inverted.

A
61
Q

Small montgomery tubercles are present on the areolas.

A
62
Q

Peau d’orange skin is significant with breast cancer.

A
63
Q

Red scaly, crusty area is significant of ___ (malfunction of osteoblasts and osteoclasts).

A

Paget’s disease

64
Q

When checking for dimpling or retraction, raise arms, place hands on hips, and place hands together.

A
65
Q

Dimpling or retraction of the breast can be indicative of cancer.

A
66
Q

A milky discharge is normal only during pregnancy.

A
67
Q

Some women may normally have a clear discharge.

A
68
Q

BSE directions can be wedge, circular, or up and down.

A
69
Q

BSE directions can be wedge, circular, or up and down.



A
70
Q

All women age 20 years and older perform BSE on a monthly basis. Beginning in their 20’s, women should be told about the benefits and limitations of breasts self examination. The importance is prompt reporting of any new breast symptoms to a health professional should be emphasized.

A
71
Q

All women ages 29 to 39 should have clinical examinations every 3 years preferably be part of a periodic health examination.

A
72
Q

All women ages 40 years and older have regular (every 1 to 2 years) mammograms.
Asymptomatic women ages 40 and older should continue to receive clinical breast examination preferably be part of a periodic health examination annually.

A
73
Q

Discharges may be seen in endocrine disorders. Discharge from one breast is
significant in ___

A

benign intraductal papilloma

74
Q

is a small, noncancerous (benign) tumor that grows in a milk duct of the breast.

A

Intraductal papilloma

75
Q

The major barrier to BSE is the lack of CONFIDENCE.

A
76
Q

NX BC Gradient: lymph nodes cannot be clinically evaluated.

A
77
Q

N0 BC Gradient: no identifiable cancer in the axillary lymph nodes.

A
78
Q

N1 BC Gradient: cancer is present in the axillary lymph nodes. However, it is not attached to the chest wall or between different axillary lymph nodes.

A
79
Q

N2 BC Gradient: cancer is identified in the axillary lymph nodes. The cancer has linked between different axillary lymph nodes and/or the chest wall.

A
80
Q

N3 BC Gradient: in addition to N2, cancer has spread above and below the collarbone.

A
81
Q

Around 20 - 30 axillary lymph nodes.

A
82
Q

These axilla nodes are located along the lower border of the pectoralis minor muscle.

A

Level I (low axilla):

83
Q

These axilla nodes lie beneath the pectoralis minor muscle.

A

Level II (mid axilla):

84
Q

These axilla nodes are situated above the pectoralis minor muscle, close to the axillary vein.

A

Level III (high axilla):

NCM132/RLE102 (9 decks)

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