PUL- highlights- LF Flashcards
angle of louis
manubriosternal angel
mediastinum contains
esophagus, trachea, heart and great vessels. space between the lungs
apex of the lungs=
highest point of the lungs
how far do the lungs go above the clavicle
2-4cm above the inner third of the clavical
how high posteriorly do the lungs go.
posteriorly at around C7
what do we call the lower borders of the lungs
bases
anteriorly where do the lungs end
6th rib mid clavicular line
posteriorly where do the lungs end
T10
vertical axis
such as 2nd intercostal space
so this is the top to bottom axis
circumference of the chest
such as midclavicular midaxillary
pleural cavity
slight potential space filled with surfactant
pleural fluid
lubricates the pleural surfaces and allows for lung expansion
what is pleurisy
inflammation of the pleura- related to infectious process
what can pleurisy develop into
pleural effusion may develop- percussive dullness, decreased fremits, ego phony, and decreased breath sounds.
what will a chest X-ray show for pleuristy
WNL- infiltrate or pleural effusion.
acinus
bronchioles, alveolar ducts and sacs and alveoli responsble for respirations
Costodiaphragmatic recess
potential space in the pleural cavity below the level of the lungs- when filled can compromise lung expansion
postnatal exposure to tobacco increases their rate of
om, URI, asthma in children
after age 50 what happens to the lungs
respiratory muscle strength decline.
elastic properties within lungs become more rigid.
increased risk of postoperative atelectasis.
there are two membranes around the lungs=
visceral pleura
parietal pleura
this membrane covers the outer surface of each lung
visceral pleura
this membrane also covers the inner rib cage and upper surface of the diaphragm
parietal pleura
if it takes a lot of pressure to bag your patient- so it is difficult to open up their airways - what damage could you cause and how do you prevent it
you can cause a pneumo- slowly work at opening your patient up.
ask the patient about their cough- what type of questions
ask whether the cough is dry or produces sputum or phlegm - what color is it?
does it wake them up in the night.
do they take ace inhibitors
have you been diagnosed with GERD
dyspnea- an uncomfortable awareness of breathing - what do you need to do
ask if they have trouble breathing.
determine the severity of the dyspnea
do you feel pain from the lung tissue?
no it has no pain fibers
so when people complain of chest pain (from lungs) what is actually causing their pain
inflammation of the adjacent parietal pleura
other surrounding structures may also irritate the parietal pleura-causing pain
mallory weiss tear
hard to find unless they are actually bleeding- but causes hemotypsis
if the patient is obese- how do we know what is normal or not
look for symmetry
if they are asymmetric- something is wrong
normal AP:1=
should be 2:1
when is the AP:1 not normal
barrel chested
COPD
pectus carinatum=
pigeon chest- chest protrudes
precuts excavatum
funnel chest- independent above the xiphoid process.
egophony=
ee sounds like aa
bronchophony=
increased lung density- clear 99
wheezing=
narrowing, asthma, cold, bronchitis
when listening to breath sounds and you hear adventitious breath sounds. what should you ask your patient todo?
cough - did they clear
if you patient has acute bronchitis what is a cardinal sign
persistent cough!
usually viral
acute bronchitis xray
normal chest xray
chronic bronchitis is from
long term exposure to tobacco smoke
breath sounds for chronic bronchitis
wheezing and inspiratory crackles
breath sounds for acute bronchitis
rhonchi
do patients with COPD have have loss or gain of elastic recoil
loss of elastic recoil
in additional to barrel chest for COPD- what other finding is associated with COPD
cor pulmonale- Right heart failure
what is PNA
inflammation and consolidation of the lung
what lobes does PNA commonly affect
right middle/lower lobes
the consolidation of PNA produces what percussive sound
dullness
PNA can come from two places
HAI
CAP
what is a bleb
a blister
how does a pneumothorax occur
rupture of a sub pleural bleb or penetrating chest trauma allowing air to enter the pleural space
symptoms of a pneumothorax
unilateral pain
dyspnea
cyanosis
deviated trachea away from the affected side
remits and voice sounds are reduced/absent
pulmonary HTN is present with pulmonary embolism- what other clue will help you determine the right side of the heart is in trouble
palpable precordial thrust of the right ventricle
CURB-65
confusion urinary (BUN >19) R- respiratory rate>=30 BP sys<90 dia<60 65>= to 65
metabolic syndrom
syndrom X
Metabolic syndrome includes high blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol levels
The syndrome increases a person’s risk for heart attack and stroke.
Amphoric breath sounds (BOOK)
breath sounds are abnormal sounds heard with consolidation or a tension pneumo- thorax; they are hollow, low-pitched sounds
Cavernous breath sounds (BOOK)
Cavernous breath sounds are an empty tympanic sound heard over a fibrotic lesion/cavity.
Bronchial lung sounds
Heard over the trachea; abnormal if heard over the peripheral lung base.
High in pitch and intensity
Bronchovesicular
Heard over the major bronchi; abnormal if heard over the peripheral lung base.
Moderate in pitch and intensity
Vesicular
Vesicular
Heard over healthy lung tissue.
Low in pitch and intensity
