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HA Exam 4 - Wk 13-16 > Pulmonary - Bates Ch. 8 > Flashcards

Pulmonary - Bates Ch. 8 Flashcards

1
Q

Landmarks for procedures:
2nd intercostal space for needle insertion for ___ ___
4th intercostal space for ___ ___ insertion
T7-8 interspace for ___

A

tension pneumothorax
chest tube
thoracentesis

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2
Q

The 11th and 12th ribs are known as what?

A

“floating ribs” bc they have no anterior attachments

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3
Q

The inferior tip of the scapula lies at the level of the ___ rib/interspace.

A

7th

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4
Q

When the neck is flexed forward, the most protruding process is usually the vertebra of ___

A

C7 (or T1)

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5
Q

Each lung is divided roughly in 1/2 by an ___ (major) fissure.
The Rt lung is further divided by the ___ (minor) fissure, and contains upper, middle, and lower lobes.
The Lt lung contains only 2 lobes, the ___ and ___.

A

oblique
horizontal
upper, lower

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6
Q 
Locations for chest findings:
Supraclavicular = 
Infraclavicular = 
Interscapular =
Infrascapular =  
Bases of the lungs = 
Upper, middle, and lower lung fields
A 
above the clavicles
below the clavicles
btwn the scapulae
below the scapulae
the lowermost portions
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7
Q

The trachea bifurcates into its mainstem bronchi at the levels of the ___ ___ anteriorly and the ___ spinous process posteriorly.

A

sternal angle, T4

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8
Q

2 pleural surfaces, or serous membranes, cover the lung:
The ___ pleura covers the outer surface.
The ___ pleura lines the inner rib cage and the upper surface of the diaphragm.

A

visceral

parietal

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9
Q

This is a type of fluid that lubricates the pleural surfaces of the lungs, allowing them to move more easily w/in the rib cage during inspiration and expiration.

A

Pleural

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10
Q

Pleural effusions may be seen in what conditions?

A

atelectasis, HF, nephrotic synd, pneumonia, TB, pulm embolus, pancreatitis, and malignancy

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11
Q

Breathing is ___, controlled by respiratory centers in the ___ that produce the neuronal drive for the muscles of respiration.

A

automatic, brainstem

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12
Q

Principal muscle of inspiration = ___

A

diaphragm

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13
Q

During inspiration, the diaphragm ___. As the thorax expands, intrathoracic pressure ___, drawing air thru the tracheobronchial tree into the ___, filling the expanding lungs.

A

contracts, decreases, alveoli

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14
Q

During expiration, the chest wall and lungs ___, and the diaphragm ___ and ___ passively. As air flows ___, the chest and abd return to their resting positions.

A

recoil, relaxes, rises, outward

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15
Q

Extra work is required to breathe during what?

A

exercise and certain diseases

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16
Q

What are some sources of chest pain and related causes?

A

myocardium, pericardium, aorta, trachea and large bronchi, parietal pleura, chest wall including the musculo system and skin, esophagus, extrathoracic structures including neck, GB, and stomach

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17
Q

A clenched fist over the sternum =
A finger pointing to a tender area on the chest wall =
A hand moving from neck to epigastrium =

A

angina pectoris

musculo pain
heartburn

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18
Q

What is the most frequent cause of CP in children?

A

anxiety (costochondritis is also common)

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19
Q

Lung tissue has ___ pain fibers.

A

no

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20
Q

What is the term for painless but uncomfortable awareness of breathing that is inappropriate to the level of exertion?

A

Dyspnea (aka SOB)

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21
Q

What is the term for sensations or tingling or “pins and needles” around the lips or in the extremities?

A

paresthesias

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22
Q

What type of lung sound is musical and occurs in partial airway obstruction from secretions and tissue inflam?
What conditions is it associated with?

A

wheezing

asthma or foreign body

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23
Q

While cough typically signals a problem in the resp tract, it may also be ___ in origin. Cough can be a symptom of what heart condition?

A

cardiovascular

Lt sided HF

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24
Q

A cough lasting < 3 wks =
A cough lasting 3-8 wks =
A cough lasting > 8 wks =

A

acute
subacute
chronic

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25
Q

Acute cough can be caused by what conditions?
Subacute?
Chronic?

A

Acute: Viral URI, acute bronchitis, pneumonia, LT ventricular HF, asthma, foreign body
Subacute: Postinfection cough, bacterial sinusitis, asthma
Chronic: Postnasal drip, asthma, GERD, chronic bronchitis, bronchiectasis

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26
Q

Translucent, white, or grey sputum =

Yellow or green sputum =

A

Mucoid

Purulent

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27
Q

What is the term for coughing up of blood from the lungs?

What condition is it typically seen in?

A

Hemoptysis

Cystic Fibrosis

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28
Q

When blood is vomited, it probably originated in the ___ tract. Blood originating in the stomach is usually ___ than blood from the resp tract.

A

GI, darker

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29
Q

Smoking increases risk of developing what conditions?

A

CAD, stroke, PVD, COPD, Lung CA

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30
Q

Smoking contributes to ___ types of CA and increases risk of what conditions?

A

15, infertility, preterm birth, low birth wt, SIDS

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31
Q

Nonsmokers exposed to smoke also have increased risk of what conditions?

A

Lung CA, ear and resp inf, and asthma

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32
Q

___ is the leading preventable cause of death.

A

Smoking

33
Q

What is included in the 5 A’s model to assess readiness for quitting smoking?

A 
Ask about tobacco use
Advise to quit
Assess willingness to make a quit attempt
Assist in quit attempt
Arrange F/U
34
Q

Stimulation of the nicotinic cholinergic receptors in the brain increase release of what neurotransmitter? What does the neurotransmitter do for the body?

A

dopamine, enhances pleasure and modulates mood

35
Q

Important to educate pt’s who may be trying to quit smoking on signs of withdrawal such as ?

A

irritability, depressed mood, poor concentration, anxiety

36
Q

Annual influenza vaccination is recommended for what ages?

A

6 months and older

37
Q

Influenza vaccine is especially important for who?

A

Pt’s w/chronic pulm conditions, immunocompromised, pregnant women, residents of nursing homes, American Indians and Alaska natives, health care personnel, and caregivers of children 5 yrs of age and younger and of adults 50 yrs and older w/medical conditions placing them at higher risk

38
Q

What causative agent causes pneumonia and meningitis and can lead to sepsis and death?

A

Streptococcus pneumonia

39
Q

For adults, use the ___-valent inactivated pneumococcal vaccine. For children, use the ___-valent conjugate inactivated vaccine.

A

23, 7

40
Q

Pneumococcal vaccine is especially recommended for who ?

A

adults > 65 yrs, children and adults w/chronic illnesses specifically assoc w/increased risk of pneumococcal inf (sickle cell anemia, cardio/pulm dis, diabetes, cirrhosis, leaks of cerebrospinal fluid), smokers age 19-64, anyone w/a cochlear implant, immunocompromised

41
Q

Examine the posterior thorax and lungs while the pt is ___, and the anterior thorax and lungs while the pt is ___.

A

sitting, supine

42
Q

Resp rate should be btwn ___-___.

A

14-20

43
Q

Assess the pt’s color for ___, which indicates what?

A

cyanosis, hypoxia

44
Q

Clubbing of the nails occurs in what conditions?

A

bronchiectasis, CHD, pulm fibrosis, cystic fibrosis, lung abscess, and malignancy

45
Q

Audible ___ is a high-pitched wheeze that indicates upper airway obstruction in the larynx or trachea.

A

stridor

46
Q

Lateral displacement of the trachea occurs in what conditions?

A

pneumothorax, pleural effusion, atelectasis

47
Q

The anteroposterior (AP) diameter increased w/___, which is normal. It also increases w/what condition?

A

aging, COPD

48
Q

There is typically intercostal tenderness over inflamed ___.

A

pleura

49
Q

Unilateral decrease or delay in chest expansion occurs in what conditions?

A

chronic fibrosis, pleural effusion, lobar pneum, and unilateral bronchial obstruction

50
Q

What is it called when you ask the pt to inhale deeply while you watch the distance btwn your thumbs as they move apart during inspiration?

A

lung excursion

51
Q

What is the term that refers to the palpable vibrations transmitter thru the bronchopulmonary tree to the chest wall as the pt is speaking? It is felt best by having the pt say “99” or “1-1-1”.

A

tactile fremitus

52
Q

Fremitus is typically more prominent in the ___ area than in the ___ lung fields, and is more prominent on the ___ side than on the ___. It disappears below the ___.

A

interscapular, lower
right, left
diaphragm

53
Q

When percussing lung sounds, avoid surface contact w/any other part of the hand bc it ___ out vibrations.

A

dampens

54
Q

Healthy lungs should sound ___.

A

resonant

55
Q

Dullness replaces resonance when what occurs? Examples include?

A

When fluid or solid tissue replaces air

lobar pneum, pleural effusion, hemothorax, empyema (pus), fibrous tissue, tumor

56
Q

Hyperresonance may be heard in hyperinflated lungs like what conditions?
Unilateral hyperresonance suggests what?

A

COPD, asthma

large pneumothorax

57
Q

Estimate the extent of diaphragmatic excursion by determining the distance btwn the level of dullness on full ___ and the level of dullness on full ___, normally about ___-___ cm.

A

expiration, inspiration, 3-5.5cm

58
Q

This type of breath sound is soft and low pitched, heard thru inspiration, continue w/out pause thru expiration, and then fade away about 1/3 of the way thru expiration.

A

Vesicular

59
Q

This type of breath sound is where inspiratory and expiratory sounds are about equal in length, and sometimes separated by a silent interval. Detecting differences in pitch is often easier during expiration.

A

Bronchovesicular

60
Q

This type of breath sound is louder, harsher, and higher in pitch, w/a short silence btwn inspiratory and expiratory sounds. Expiratory sounds last longer than inspiratory sounds.

A

Bronchial

61
Q

Breath sounds may be decreased w/what conditions?

A

when air flow is decreased as in obstructive lung dis

62
Q

Clearing of crackles, wheezes, or rhonchi after coughing or position change suggest what conditions?

A

bronchitis or atelectasis

63
Q

This type of adventitious breath sound is discontinuous, intermittent, nonmusical, and brief.

A

Crackles (rales)

64
Q

This type of adventitious breath sound is continuous, musical, and prolonged.

A

Wheezes and rhonchi

65
Q

Adventitious breath sounds:
Sounds like dots in time =
Sounds like dashes in time =

A

Crackles (rales)

Wheezes and rhonchi

66
Q

___ crackles are soft, high-pitched and very brief. ___ crackles are somehwat louder, lower in pitch, and brief.

A

Fine

Coarse

67
Q

___ are relatively high-pitched w/hissing or shrill quality. ___ are relatively low-pitched w/snoring quality.

A

Wheezes

Rhonchi

68
Q

Findings that are predictive for what condition include wheezing, hx of smoking, age, and decreased breath sounds. Dx requires ___.

A

COPD

spirometry

69
Q

Sound the voice makes when listening over large airways. Words are louder and clearer when there is consolidation.

A

bronchophony

70
Q

If “ee” sounds like “aa”, this is known as ? This typically presents in what condition?

A

egophony

lobar pneumonia

71
Q

Presence of bronchial breath sounds and egophany more than triples the likelihood for what condition?

A

pneumonia

72
Q

Pt’s w/what condition present w/leaning forward, lips pursed during exhalation and arms supported on their knees or table?

A

COPD

73
Q

Abnormal retraction occurs in what conditions?

A

severe asthma, COPD, upper airway obstr.

74
Q

Tender pectoral muscles or costal cartilages typically suggest that CP is what?

A

musculoskeletal in origin

75
Q

A lung affected by COPD often displaces the upper border of the liver ___ and ___ the level of diaphragmatic dullness posteriorly.

A

downward, lowers

76
Q

___ tests are practical, simple ways to assess cardiopulmonary function.

A

Walk

77
Q

What type of test is used when you ask the pt to take a deep breath in and then breathe out as quickly and completely as possible w/mouth open?

A

Forced expiratory time

78
Q

Pt’s older than 60 yrs w/a forced expiratory time of 6-9 seconds are twice as likely to have what condition?

A

COPD

79
Q

What are you testing for if you place one hand on the sternum and the other on the thoracic spine and squeeze the chest?

A

Fx rib

HA Exam 4 - Wk 13-16 (5 decks)

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