Respiratory Flashcards
sternal angle (angle of louis)
level of 2nd cartilage and heart’s upper border,
anterior reference lines
midsternal line (RSB, LSB), midclavicular line (RMCL, LMCL), anterior axillary (AAL)
lateral reference lines
anterior axillary line, midaxillary line, posterior axillary line
lobes of each lung
right has 3, left has 2
right bronchus is _ so more _ happens on the right side
wider, shorter, more vertical. aspiration
lower lobes expand to what vertebrae posteriorly
T10 on expiration and T11 on inspiration
barrel chest
AP diameter 1:1, can be due to emphysema (damage to air sacks)
normal nail angle
160
bronchial sounds
normal, high pitched and loud, harsh 1(insp):2(exp)
Bronchovesicular sounds
normal, medium pitched, 1(insp):1(exp)
vesicular sounds
normal, low pitched and soft, blowing sound 2.5(insp):1(exp)
crackle sounds
discontinuous, high pitched, crackling or popping, during inspiration
pleural friction rub sounds
discontinuous, coarse low grating sounds, inflamed pleura
wheezing sounds
continuous, high pitched, during expiration
rhonchi sounds
continuous, low pitched snoring, throughout breathing
stridor sounds
continuous, high pitched crowing sound, during inspiration, louder in neck
egophony
listen to chest while person says “e”, abnormal if sounds like “a”
bronchophony
patient says “99”, the sounds should be muffled while listening
lobar pneumonia
dull percussion, increased tactile fremitus, bronchophony and egophony are present
pleural effusion
flat or dull percussion, decreased or absent tactile fremitus, breath sounds decreased, trachea shifts
pneumothorax
hyperresonant, decreased tactile fremitus, decreased breath sounds, unequal chest expansion
COPD
increased A/P diameter, hyperresonant, decreased tactile fremitus, prolonged expiration w/ wheeze
atelectasis (lung collapse)
Decreased expansion, dull percussion, decreased tactile fremitus, breath sounds decreased, crackles
crepitation
air in subcutaneous tissue, tested by palpating anterior chest wall
what to inspect during assessment
facial expression, color, respiratory rhythm, use of accessory muscles, A/P diameter, cap refill, clubbing
