Respiratory

Question 1

What are adventitious sounds?

Answer 1

Crackles, wheezes and Stridor

Question 2

Listening sequence of anterior chest

Answer 2

1. above clavicle to hear lung apices
2. second intercostal space, near sternum
3. 5th intercostal space, next to sternum
4. 7th intercostal space, wider from sternum

Go left to right for each site

Question 3

Listening sequence for posterior chest

Answer 3

1. Below cervical region of neck
2. Top of scapula, near spine
3. Middle of scapula, near spine
4. Just past the scapula, near spine
5. At the bases of lungs, midclavical region, between 10th and 12th spinous process

Question 4

Normal Respiration qualities

Answer 4

Rate: 15-20 BPM
Even depth
Regular pattern
Chest expansion is equal on both inhalation and exhalation

Question 5

Qualities of a healthy Thorax and good oxygenation

Answer 5

1. skin color is pink
2. skin temp: is warm and dry
3. Capillary refill is <3 seconds
4. AP ratio of the chest is 1:2
5. Costal angle should be 90 degrees
6. No accessory muscles used to

Question 6

Qualities of an abnormal thorax and poor oxygenation

Answer 6

abnormal thorax skin color is apparent with cyanosis, ruddy skin color
skin temperature:
- cool with delayed capillary refill
-nails are clubbing which means long-term hypoxia
-respiration rate rhythm and depth: using accessory muscles respiratory as uneven
-posture is kyphosis and scoliosis

Question 7

What is a barrel chest?

Answer 7

The person that has a barrel chest which is an AP ratio of 1 to 1 and a coastal angle greater than 90 degrees is very likely to have COPD the person looks like a barrel when they’re width and their depth are both equal to one

Question 8

Describe crackles

Answer 8

crackles
-can occur either early or late inspiration and
- sound like a popping or hair be enrolled between fingers near the ear.
Is a discontinuous sound caused by air moving into previously deflated airways.
crackles can because by:
- asbestos in the lung disease caused by breathing asbestos fibers
-bronchitis
-pneumonia
-COPD

Wheezes which are audible during inspiration or expiration and they sound squeaky musical,continuous sounds associated with air rushing through narrowed airways and can be heard with a stethoscope and
caused by inflammation bronchospasm Edema secretions and pulmonary vessel engorgement also known as cardiac asthma

Question 9

Character of wheezes

Answer 9

Wheezes which are

• audible during inspiration or expiration and they
• sound squeaky musical,continuous sounds associated with air rushing through narrowed airways and can be heard with a stethoscope and
• caused by
  
  • inflammation
  • bronchospasm
  • Edema secretions
  • pulmonary vessel engorgement also known as cardiac asthma

Question 10

Character of Stridor

Answer 10

Stridor:  (audible inhalation, exhalation or both) characterized by high-pitched crowing sound caused by:
Abscess or swelling of upper airway
Paralysis or malfunction of vocal chords
Tumor
Marilyn of windpipe
Swelling of the voice box
Engorgement of thyroid

Question 11

Character of decreased breath sounds

Answer 11

Decreased breath sounds: absence of sounds from breathing. Called by:

• Lack of breathing
• Disorders the block transmission of sounds to the surface of the chest (new pneumothorax or collapsed along due to air pressure pushing down on the long so I can’t reinflate)
• Pleural effusion which is a buildup of fluid between the layers of tissue that line the lungs in the chest cavity

Question 12

Qualities of Bronchial breath sounds

Answer 12

Bronchial breath sounds:

• loud,
• high-pitched,
• tubular sounds.
• Heard an expiration longer than inspiration.
• Heard over trachea on front of chest, below neck on posterior chest.

Question 13

Qualities of Bronchovesicular breath sounds

Answer 13

Bronchovesicular sounds:

• medium pitch.
• Equal sound with inhalation and exhalation.
• Best heard between first and second intercostal space next to the sternum and between the scapula on the posterior.

Question 14

Qualities of Vesicular breath sounds

Answer 14

Vesicular sound:

• soft, low pitch, breezy sounds.
• Long inspiration phase and short expiratory phase.
• Found over all one fields (air moving through smaller airways)

Question 15

signs and symptoms of Pneumonia

Answer 15

• pneumonia: typically coughing with a fever, chest pain and shortness of breath

Question 16

Signs and symptoms of Emphysema

Answer 16

Emphysema:

• often seen with accessory muscles being used for breathing, -shortness of breath,
• hypoxia and increased carbon dioxide levels.
• Person positions themselves with arms in front of themselves in order to get more lung volume.

Question 17

Signs and symptoms of Bronchitis

Answer 17

Bronchitis:

• productive cough making large amounts of sputum,
• dyspnea,
• dependent edema,
• distended neck veins,
• increased pulmonary blood pressure
• enlarged right ventricle

Question 18

Signs and symptoms of airway obstruction (Atelectasis)

Answer 18

Airway obstruction (atelectasis): is the airlessness of the lung but may be caused by an obstruction. Could be foreign object or sputum

Question 19

Describe the location and functions of trachea and bronchial tree

Answer 19

Describe the location and functions of the trachea and bronchial tree.
right bronchus is slightly wider, shorter and more vertical within the left bronchus because the right is slightly larger it can be accidentally intubated and when a foreign object is aspirated it usually goes into the right bronchus.

Trachea is the largest airway and this spits into primary bronchial tubes.

Question 20

Describe age related changes that occur within the lungs

Answer 20

Age-related changes associated with the thoracic cavity

Reduced lung expansion
Less of velar inflation
Difficulty expelling mucus
Exhalation becomes less efficient (air gets trapped)
Decreased immune response
All leads to: risk for URI/pneumonia

Question 21

Distinguishing between normal and abnormal breath sounds

Answer 21

Distinguish between normal and abnormal lung sounds.

Lung sounds are identified by their location, intensity, pitch and duration. Normal sounds are known as bronchial or tubular (based on location). Bronchovesicular are heard over the branching bronchi. When bronchial sounds are heard at the lung edges they are considered abnormal as you would expect vesicular sounds to be present