Respiratory Flashcards
What is the Mediastinum
contains esophagus, trachea, heart, and great vessels
xipoid process, manubrium, lingula
epiglotitis is what ? Know RSV
why does the right side have an extra lobe compared to the left ?
Because the heart is in the way
Top of lung is called? bottom of lung
apex and base ( top is actually the bottom and bottom is the top )
rihgt middle lobe you would listen to on which side of the body
The front
what is rhe pleura?
a slipperly sac that has a thin amount of fluid- think seran wrap sprayed with cooking spray - anything that can cause and infection in the lung can cause infection in the pleura -
primary muscles we need to breathe
Primary muscles are the diaphragm and external intercostal muscles
recruitment of the accessory muscles (Accessory muscles” refers to muscles that assist, but do not play a primary role, in breathing)
the sternocleidomastoid, internal intercostals and trapezius muscles that are used only during exertion (exercise or COPD
Expiration is mostly
passive in nature and occurs with relaxation of intercostal muscles & diaphragm.
what are the bad signs
retractions, use of accessory muscles, grunting ( an emergency)
Why do we have to be careful giving o2 to COPD patients
because the respiratory drive will change from a CO2 drive to an O2 drive and this means that giving too much o2 at once can be dangerous
difference between tachypnea and hyerpventilation
hyperventilating is rapid , deep breathing , whereas tachypnea would be just taking more breaths per minute with normal depth of respirations
can you have normal respiration but abnormal type of ventilation ( what does the depth look like )
yes you can
what is hypoventilation
(slow, shallow breathing) causes carbon dioxide to build up in blood,
what is hypoxemia ? vs hypoxia. Can you have one without the other?
mid axillary
under the arm pit
track scalpula , not on top of it but beside it
questions to ask
trouble breahthing, do you have a cough, do you have chest pain
different kinds of pain it could be
pulmonary pain, pleural pain, muscular pain, cardiac pain, gastric pain describe in detail
pleural pain ?
happens with inspiration or cough
muscular pain
can you reproduce the pain ? can the patient touch the pain ? if the pain is the same always can be pneumonia,
signs of a heart attack
Nausea vomitting, pale , pain radiating down the left side , women will experience more jaw pain and neck pain
percussing over air, it should sound
resonant or hollow
never listen to breath sounds through clothing
anterior to posterior ratio
1:2 , COPD patients will have a 1:1 ratio due to barrel chest
Tactile fremitius
a tactile vibration
Conditions that increase density of lung tissue make a better conducting medium for sound vibrations and increase tactile fremitus
Fremitus varies among persons, but symmetry is most important; vibrations should feel same in corresponding area on each side
thoracic excursison
percussion should be done
in the intercostal spaces
what is a wheeze ?
Musical or squeaking
* High-pitched, continuous sounds
* Auscultated during inspiration and expiration
* Occurs in small air passages(unrelieved by coughing)
- Often heard in diffuse airway obstruction like in acute asthma or chronic emphysema
what is a rhonchi ?
Sonorous or course or mourning sounds
* Low-pitched snoring or moaning, continuous sounds
- Occurs in large air passages(bronchi and trachea)
* Coughing may clear the sound
- heard in bronchitis and pneumonia
what is a stridor
narrowing of the upper airway , whooping cough it is common, choking , airway obtruction and croup.
Heard on inspiration
High pitched , whistling sound
Harsh quality
- continuous sounds
what is crackling
- Bubbling, crackling, popping
- Low- to high-pitched, discontinuous sounds
- Auscultated during inspiration
- Occurs in small air passages, alveoli, bronchioles, bronchi, and trachea (unrelieved by coughing
- heard in pneumonia, , CCF , Bronchitis, asthma, emphysema, COPD, pulmonary edema
what is friction rub ?
Continuous low pitched dry, Rubbing or grating sound and discontinuous
* Loudest over lower lateral anterior surface
* Auscultated during inspiration and expiration
- Heard in pleuritis
Occurs as a result of rubbing of two inflamed plural surfaces.
what are the situations where pulse ox would not be accurate
cyanosis, nail polish, when there is carbon monoxide poisoning, people who go through trauma and lose blood
people with carbon monoxide poisoning will look like what ?
Like they have a sun burn
hemoglobin should be
around 13- 15
what are kussmauls breaths ?
often happens in diabetics, fruit acetone breath
what are cheyne stokes breaths ?
waxing & waning at regular intervals)
biots breathing is what ?
few normal respirations followed by apnea)
l purcussed lung sounds in emphysema and pneunothorax
percussion sounds will be exagerated ( normal air sounds will be hollow, low in pitch and long in duration
purcussed lung sounds with plural effusion and pulmonary consolidation
Hyperresonantsounds may also be heard when percussinglungshyperinflated with air, such as may occur in patients with
COPD, or patients having an acute asthmatic attack. An area ofhyperresonanceon one side of the chest may indicate a pneumothorax.
