Respiratory

Question 1

respiratory anatomy

Answer 1

Sternal notch/Manubrium—angle of Louis; Sternum/Xiphoid process; Thoracic cage—ribs, costal margin, clavical; Spinal process, Scapula; Imaginary Lines: Midsternal, Midclavicular, Midaxillary

Question 2

structures of the respiratory system

Answer 2

Nasal cavity; Pharynx; Larynx; Trachea; Main stem bronchus; Bronchioles; Alveolar ducts, Alveolar sacs; Pleura (parietal/visceral)

Question 3

Medulla Oblongata and Pons –

Answer 3

respiratory and center of the brain

Question 4

Medulla Oblongata –

Answer 4

Motor function of breathing, controls diaphragm movement

Question 5

Pons -

Answer 5

responsible for rhythm of breathing

Question 6

neurological system

Answer 6

medulla oblongata and pons; if damage to area then changes to patterns; Consider- Traumatic brain injuries and Increased intracranial pressure

Question 7

circulatory system

Answer 7

bronchial circulation and pulmonary circulation

Question 8

Bronchial circulation –

Answer 8

attends to metabolic demands of the lung

Question 9

Pulmonary Circulation –

Answer 9

fosters the exchange of gases between alveoli and the blood in the pulmonary capillaries

Question 10

The Musculoskeletal System

Answer 10

Diaphragm and Accessory Muscles Accessory muscles enhance ventilation by
increasing chest expansion and lung size during inspiration; Internal and External intercostal muscles; Abdominal muscles (rapid breathing, deep breathing, exercise, coughing, sneezing)

Question 11

diagram

Answer 11

allows to breathe in and exhale

Question 12

family history of…

Answer 12

lung disease, cystic fibrous

Question 13

focused health history

Answer 13

Respiratory disease; Allergies; Cough; Tobacco exposure; Immunizations; Family; Environment—occupation, housing, travel; Review of Systems

Question 14

cough

Answer 14

color of secretion, how forcefully and how frequently

Question 15

breathing patterns

Answer 15

(rate, depth, rhythm); Eupnea, tachypnea, bradypnea; Cheyne-stokes; Biots; Kussmauls; Hyperventilation

Question 16

inspection

Answer 16

breathing patterns; accessory muscles; thoracic contour; clubbing

Question 17

biots

Answer 17

brain stem injuries, rapid then pause

Question 18

kussmauls

Answer 18

deep, when blood sugar is high

Question 19

hyperventilation

Answer 19

panic attack

Question 20

thoracic contour

Answer 20

1-2

Question 21

tachypnea

Answer 21

over 20

Question 22

bradypnea

Answer 22

less than 12

Question 23

Thoracic contour

Answer 23

Barrel chest; Pectus excavatum; Pectus carinatum; Spinal deformities

Question 24

palpation

Answer 24

Diaphragm at level of T-10; Thoracic excursions (Posterior or Lateral); Tactile fremitus; Crepitus; Tracheal position

Question 25

Tactile fremitus—

Answer 25

posterior 4-5 placements

Question 26

crepitus

Answer 26

around opening of chest tube/ contrail line (pacemaker)

Question 27

percussion

Answer 27

Normal percussion note over adult lung fields is resonance—loud, low, long hollow note; Hyperresonance; Diaphragmatic excursion (3-6cm) ; if dull then fluid

Question 28

palpation

Answer 28

Diaphragm at level of T-10; Thoracic excursions (Posterior or Lateral); Tactile fremitus; Crepitus; Tracheal position

Question 29

tactile fremitus -

Answer 29

posterior 4-5 placements

Question 30

Hyperresonance—

Answer 30

overinflated air filled, louder, lower, longer note (children) (palpation)

Question 31

vesicular sounds

Answer 31

soft, airy breezy in periphery; inspiration is longer than experiation

Question 32

bronchovesicular sounds

Answer 32

blowing quality over right & left 2nd ICS @ main stem bronchi ; equal inspirations and experations

Question 33

Bronchial sounds

Answer 33

harsh, coarse sound over trachea; harsh heard best over the trachea; expiration is longer

Question 34

Crackles/rales—*

Answer 34

discrete, non-continuous, short (fine, medium, coarse)

Question 35

Rhonchi—*

Answer 35

continuous, musical quality, usually clears with cough; Sonorous (low pitch)

Question 36

Wheezes*

Answer 36

Sibilant (high pitch)

Question 37

Stridor—*

Answer 37

harsh, continuous, honking ; closing of the larynx

Question 38

Friction Rub—*

Answer 38

high-pitch grating, squeak

Question 39

Bronchophony—*

Answer 39

increase loudness/clarity of vocal sounds

Question 40

Egophony—*

Answer 40

normally muffled “eee”, abnormal hear “eee” ∆ to “ay”

Question 41

Whispered pectoriliquy—*

Answer 41

normal barely audible nondistinct word ∆ to clear, distinct word

Question 42

Asthma—*

Answer 42

reactive airway disease

Question 43

Bronchitis—*

Answer 43

excessive mucus production

Question 44

Emphysema—*

Answer 44

enlarged alveoli

Question 45

Pleural Effusion—*

Answer 45

fluid in pleural space

Question 46

Pneumonia—*

Answer 46

infection

Question 47

Pneumothorax—*

Answer 47

collapse of lung

Question 48

ronchi*

Answer 48

low pitch, garling, may clear w/ cough; air flow as it passes through secretions (ie pneumonia)

Question 49

bronchial*

Answer 49

loud and high, coarse or tubular, inspiration < expiration, located in larynx and trachea

Question 50

bronchovesicular *

Answer 50

intermediate, inspiration = expiration, anteriorly located between first and second interspaces between scapula

Question 51

vesicular*

Answer 51

soft and low, inspiration > expiration, over most of the lung fields