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Health Assessment- Respiratory > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Posteriorly upper lung lobes are separated from lower lobes at ___

A

T3

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2
Q

Where is the angle of louis

A

The sternal angle, the anterior angle formed by the junction of the manubrium and the body of the sternum

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3
Q

Posteriorly lungs at rest end at______

A

T10

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4
Q

Posteriorly when you take a big breath in lungs end at __

A

T12

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5
Q

If you listen only posterior chest you will hear almost no__

A

upper lobes and no right middle lobe

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6
Q

If you listen anteriorly on the Rt side you will hear what lobes

A

Upper and middle right

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7
Q

Horizontal fissure separates

A

Rt upper and Rt middle lobes

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8
Q

Horizontal fissure separated Rt upper and Rt middle lobes at __

A

4th intercostal space

4th rib

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9
Q

Location of oblique fissure on anterior

A

6 rib (separates RML and RLL, LUL and LLL)

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10
Q

A patient using accessory muscles in respiration, you look for retractions at

A

suprasternal notch

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11
Q

You listen at 2 intercostal space and it’s located

A

At the angle of Louis to the right

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12
Q

Lift shirt to inspect ___

A

skin, muscle and chest deformities, accessory muscle use/retractions

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13
Q

Normal AP diameter

A

2;1

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14
Q

Pectus excavatus

A

Funnel chest, wider front than side to side

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15
Q

Pectus carinatum

A

Pigeon chest. The bulging gives the chest a birdlike appearance.

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16
Q

Palpate anterior

A

Tracheal position, chest wall tenderness, tactile fremitus, thoracic expansion/diaphragmatic excursion

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17
Q

When palpate for chest wall tenderness, you check for

A

Fractured rib, inflamed pleura, costochondritis

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18
Q

Tactile fremitus is

A

Transmission of vibration from larynx to chest

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19
Q

Increased tactile fremitus means

A

Consolidation of tissue (pneumonia)

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20
Q

Decreased/absent tactile fremitus

A

Obstructed bronchus, tumor, effusion, too much air (COPD),

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21
Q

If a patient has high pitch voice tactile fremitus may be

A

Decreased, less vibration

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22
Q

When assessing tactile fremitus, you look for

A

symmetrical vibration

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23
Q

Anterior tactile fremitus location

A

2 intercostal space, at nipple line (4-5 intercostal space), and laterally

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24
Q

Posterior tactile fremitus location

A

Avoid scapulae

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25
Q

where and how is respiratory excursion

A

Posterior, hands at the base lungs at T10, have patient breathe in, look for equal movement of hand when patient is breathing out

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26
Q

Percussion sound FLAT

A

over a bone

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27
Q

percussion sound DULL

A

over an organ (dull)

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28
Q

RESONANT percussion sound

A

over a lung ( airy)

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29
Q

HYPER-RESONANT sound

A

over a bronchus, louder than resonant

30
Q

Abdomen (like a drum)

A

Tympanic percussion sound

31
Q

Percuss chest in what pattern

A

ladder pattern

32
Q

If patient exhales, percussion will sound__ posteriorly at T10-T12

A

Dull

33
Q

If patient inhales deeply, persucussion at T10-T12 posteriorly will sound

A

Resonant (T10-T12 - 3-5 cm)

34
Q

breath sounds

A

bronchial, bronchovesicular, vesicular

35
Q

bronchial

A

over trachea and heard bronchus

36
Q

bronchovesicular

A

heard Anterior mid chest, posterior between scapulae, mix of vesicular and bronchial

37
Q

vesicular

A

the soft, low-pitched, normal breath sounds heard over peripheral lung fields

38
Q

vesicular

A

soft and low
*Heard over most of lung

39
Q

Adventitious breath sounds

A
  • Rales/crackles
  • Rhonchi
  • Wheeze
  • Friction rub
  • Stridor
  • Grunting
40
Q

posterior breath sounds

A

no bronchial

41
Q

adventitious breath sounds

A

rales/crackles, rhonchi/wheezes, friction rub, stridor, grunting

42
Q

rales/crackles

A

Intermittent, non-musical, brief (bubbly). pneumonia

43
Q

rhonchi

A

Low-pitch, continuous, snoring (mucus is moving). CHF, bronchitis.

44
Q

wheezes

A

Continuous, high pitches, musical, hissing or shrill in quality

45
Q

friction rub

A

Low-pitched, grating, inflamed pleural surfaces rubbing

46
Q

stridor

A

harsh inspiratory noise from larynx or trachea when obstructed

47
Q

Egophony

A

patient says “ee”, sounds like “ay” over area of pneumonia

48
Q

Bronchophony

A

Patient says “99”. positive if louder in area of consolidation (pneumonia)

49
Q

Whispered pictoriloquy

A

Patient whispers “99”.Sound is increased in area of pneumonia

50
Q

Egophony, bronchophony, whispered pectoriloquy

A

positive in pneumonia

51
Q

what does a normal chest look like

A

AP diameter 2:1
No tenderness, fremitus equal bilaterally
Resonant throughout
BS equal and easily heard throughout

52
Q

what is pleural effusion

A

May have a cough
Fremitus decreased over effusion
Dullness over effusion
Decreased sounds over effusion
May have pleural friction rub

53
Q

pneumonia

A

May look ill, feverish ,erythema, sweating, may cough
Fremitus increased over pneumonia
Percuss dullness over pneumonia
Decreased sounds over pneumonia, crackles over involved area

54
Q

COPD

A

Barrel chest
Decreased fremitus on palpation
Hyper-resonant percussion
Decreased/ distant breath sounds

55
Q

pneumothorax

A

Shortness of air
Fremitus decreased/absent over area
Percussion hyper resonant over area in pleural space.
Decreased or absent breath sound

56
Q

what are the changes with aging

A

Decreased vital capacity
Decreased rate of breathing
Can have increased AP diameter-Kyphosis

57
Q

site 1 auscultation

A

Rt upper and Lt upper lobes at midclavicular line

58
Q

site 2 auscultation

A

Rt and Lt, 2nd intercostal space lateral to sternal border

59
Q

site 3 auscultation

A

4th intercostal space lateral to sternal border, Rt Middle and Left Upper (Rt middle starts at 4th intercostal)

60
Q

site 4 auscultation

A

5th intercostal space, lateral to sternal border, Rt middle, Lt upper

61
Q

site 5 auscultation

A

5th intercostal space, Midaxillary line, Rt middle, Left lower

62
Q

site 6 auscultation

A

6th intercostal space, midaxillary line, Rt lower, Lt lower

63
Q

Suprasternal notch

A

look for retractions

64
Q

anatomical locations

A

Suprasternal notch
*Manubrium
*Angle of Louis
* Flush joint between
manubrium and
sternum
*Sternum
*Xiphoid

65
Q

normal anterior -posterior

A

transverse diameter

66
Q

increased diameter

A

posterior diameter

67
Q

what does age increase

A

posterior diameter

68
Q

what chest is a sx of COPD

A

barrel chest

69
Q

wht cant hear sounds d/t too much air

A

COPD , pneumothorax

70
Q

T10 hands on base of lungs. what does breathing in tell us about pt

A

are hands equal when pt is breathing in if not equal =blockage or pneumothorax

Health Assessment- Respiratory (6 decks)

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