Respiratory Flashcards
What are common causes of fluid in the pleural space?
Cancer, congestive heart failure, infection
If there is fluid in the pleural space, what is the procedure done to drain it?
Thoracentasis
What are important topics you want to cover in a health history for a focused respiratory assessment?
Pulmonary disease
Chronic respiratory infections
Medications
Psychosocial (occupation, exposure to pollutants, smoking history)
Breathing (dyspnea)
Cough (productive vs non productive)
Chest Pain
Health promotion (vaccinations etc)
What kind of sputum is suggestive of heart failure?
“pink, frothy sputum” or “hemoptysis”
How do you assess smoking history?
packs/day x years
= pack years
What position is a patient in during assessment of the lungs?
Sitting
What are signs that a patient is in respiratory distress?
Use of accessory muscles
Tripod position
High RR
What are normal findings when inspecting the thoracic cage?
■ Skin color is uniform and intact; hair
distribution is consistent with gender and
ethnicity.
■ Adult respiratory rate (eupnea) is 12–20
breaths per minute; even and smooth
respirations
■ Transverse diameter is approximately twice
the anteroposterior (AP) diameter; AP-to-
transverse ratio is approximately 1:2, and the
costal angle is less than 90 degrees
Why is hair growth relevant to respiratory function?
Hair grows where there is oxygen
Pectus excavatum, also known as ______ ______ is a congenital deformity; sternum is abnormally depressed or sunken into the chest
Funnel chest
In this condition, anterior posterior-to-transverse ratio is 1:1, and the costal angle is greater than 90 degrees; increase in the costal angle may be a sign of chronic obstructive pulmonary disease
barrel chest
Pectus carinatum aka ______ ________ is a deformity of the chest; the sternum protrudes out from the chest
pigeon chest
prolonged inspiratory phase may indicate
_____ airway obstruction
upper
prolonged expiratory phase
may indicate ____ airway obstruction
lower
eupnea
normal breathing
what are the common causes of tachypnea?
fever, anxiety, exercise, shock
what are common causes of bradypnea?
sleep, drugs, metabolic disorder, head injury, stroke
Respiratory pattern where you have gradual increases and decreases in respirations with periods of apnea
Cheyne-Stokes
What are common causes of Cheyne-Stokes?
Increasing intracranial pressure, brain stem injury, end of life
What is the breathing pattern of people with diabetic acidosis? (“Kussmauls”)
hyperventilation (tachypnea + hyperpnea)
Your patient has had chronic
obstructive pulmonary disease for
the past 20 years. What would you
expect her anterior-posterior chest
ratio to be?
A. 1:1
B. 1:2
C. 2:2
D. 2:1
Correct answer: A
Patients with chronic obstructive
pulmonary disease have a barrel
chest: anterior posterior-to-lateral
ratio is 1:1 and the costal angle >90
degrees.
A light crackling or popping
feeling under the skin caused by leakage
of air into the subcutaneous tissue);
sounds like Rice Krispies cereal popping
under the skin
Crepitus
The following describes the technique for palpating _____ _______:
■ Purpose: To palpate voice sound vibrations through the bronchi
■ Instruct the patient to repeat words such as “ninety-nine, coin, toy, or
boy” in a low- pitched voice.
■ Anterior: Starting just below the clavicle, use palmar base (ball of your fingers) or the ulnar side of your hand and palpate down the anterior lobes as the patient keeps repeating the same word.
■ Feel for the voice vibrations.
■ Repeat on posterior lobes and lateral lobes.
tactile fremitus
_______ fremitus may indicate increased density of the lung tissue; may be related to fluid or pathology in the lung that is changing the density or compressing the lung tissue, such as pneumonia.
Increased
______ fremitus may indicate the vibrations are obstructed with fluid (pleural effusion), decreased air movement (emphysema), obesity, or increased musculature.
Decreased
What is the purpose of auscultating the lungs?
To assess airflow throughout all lobes of the lungs
What side of the stethoscope do you use to auscultate lung sounds?
Diaphragm
What’s the best position to auscultate the posterior lung fields?
Tell the patient to lean forward and give themselves a hug
Adventitious
Abnormal
What are the expected bronchial sounds? (blue area)
Expiration sounds lounger and louder
What are the expected sounds of the bronchovesicular area? (yellow)
Inspiration and Expiration equal in length and volume
What are the expected sounds in the vesicular area? (pink area)
Inspiration longer and louder than expiration
What conditions are crackles or rales associated with?
Associated with small airway disease, bronchitis, pneumonia, pulmonary edema, heart failure, atelectasis
How would you describe crackles or rales?
Discontinuous sounds (dots)
Intermittien, brief, nonmusical
What conditions are associated with wheezes?
Asthma or COPD
What do wheezes sounds like?
Inspiration is clear, expiration has a continuous, musical, high-pitched whistle
What is the physiology of wheezes?
Narrowed passageways in the tracheobronchial tree by secretions, inflammation, obstruction, or foreign body
How would you describe rhonchi?
Continuous breath sounds heard during inspiration and expiration (snoring, gurgling, rumbling)
sometimes described as LOW pitched wheezes
How would you document normal findings when auscultating lungs?
Clear lung sounds throughout
What are rhonchi associated with?
Asthma, COPD, foreign body
What is strider most commonly associated with?
Croup
Sometimes foreign body obstruction
Where causes stridor? (Physiology)
Upper airway narrowing
What does stridor sound like?
You may not need a stethoscope
Loudest over trachea during inspiration
Pleural friction rub is sound produced by rub of _____
inflamed pleural surfaces
Refers to the first occurrence of menstruation or the onset of a girl’s first menstrual period
Menarche
What are conditions of the breast that require further investigation?
– New breast lump/Swelling
– Existing lump with changes
– Axillary lump
– Skin irritation or dimpling
– Nipple discharge
– Nipple retraction
– Breast or nipple Pain
This appearance of the breast is often a symptom or indication of an underlying health issue, particularly breast cancer. It is caused by the infiltration or blockage of the lymphatic vessels in the breast, leading to fluid accumulation and swelling. This results in dimpling or puckering of the skin, resembling the texture of an orange peel.
Peau d’orange
What are common breast and axillary symptoms related to breast cancer?
– Breast pain
– Rash
– Lumps; swelling
– Nipple discharge
Gynecomastia
a condition characterized by the enlargement or swelling of breast tissue in males
when do you start doing routine mammograms?
age 40
