Respiratory Flashcards
Respiration
process of exchanging gases (O2 and CO2) across respiratory surfaces through diffusion. Two types:
- Internal Respiration: exchange of gases between systemic circulation and cells in tissues of body
- External Respiration: exchange of gases between venous system and alveoli in lungs
Ventilation
the movement of air into and out of the lungs
Tracheal breath sounds
relatively high-pitched, harsh; heard over the trachea and neck. “darth vader”
Bronchial breath sounds
relatively high pitch; heard over the manubrium, if heard at all. Abnormal anywhere else. Can indicate consolidation or compression of the lung
Bronchovesicular breath sounds
heard over main bronchus area, 1st and 2nd ICS and between the scapulae; medium pitch; expiration equals inspiration
Vesicular breath sounds
soft, short expirations; low-pitch, low-intensity; heard over healthy lung tissue
Discontinuous breath sounds (fine crackles and course crackles / rales)
A crackle is an abnormal respiratory sound hears more often during inspiration, characterized by discrete discontinuous sounds. Caused by the disruptive passage of air through the small airways (over production of mucus/secretions)
Fine-high pitched, relativilty short duration
Course-Low-piched, longer in duration
Rhonchi
Deeper, more rumbling, and more pronounced during expiration. Prolonged and continuous
Wheezes
Continuous, high-pitched, musical sound (almost a whistle) heard during either inspiration or expiration. (asthma/copd) Caused by relatively high-velocity airflow through a narrowed or obstructed airway.
Egophony
“voice of the goat”, bleating quality, E -> A change (emphysema)
Whispered pectoriloquey
“voice of the chest”, whispered words have increased intensity and pitch (pneumonia, fibrosis)
Tactile fremitus
Palpable vibrations transmitted through chest wall when patient speaks, sound waves transmit better through solid/fluid medium than gaseous medium.
Increased tactile fremitus
Lung tissue density increases due to:
1. Consolidation (air space filled with fluid) - pneumonia,
pulmonary edema
2. Fibrosis (thickening of lung tissue) - pulmonary fibrosis
Decreased tactile fremitus
Lung tissue replaced by fluid/air due to:
Airway obstruction - pleural effusion (fluid outside of lung),
pneumothorax (air outside of lung), emphysema/COPD,
foreign body obstruction
Bronchophony
“bronchial sounds”, spoken words are louder than normal
Diaphragmatic excursion
expansion of lungs, normally 3-5 cm
What causes decreased diaphragmatic excursion when the lung is unable to expand?
- Pleural effusion
- Pneumonia
- Atelectasis
- Hemothorax
- Neuromuscular disease
What causes decreased diaphragmatic excursion when the lung is able to expand?
- Emphysema
2. Asthma
A/P diameter
anterior/posterior diameter, should be less than the lateral diameter, may be increased in emphysema (increased space for overinflated lungs -> barrel chest)
What other organ systems should you examine when evaluating a respiratory complaint?
Musculoskeletal: Ribs, thorax symmetry, AP diameter, chest expansion, accessory muscle use
Cardiovascular: Ratio of respirations to heartbeat
HEENT: Nasal flaring, tracheal deviation
Skin and nails: cyanoisis, pursing lips, clubbing nails, diaphoresis
Abdominal: Liver enlargement
Barrel chest
increase in the anterior posterior diameter of the chest (resembling a barrel) often associated with emphysema
Flail chest
loss of stability of the chest wall when a segment of rib cage breaks and becomes detached from the rest of the chest wall and moves independently
Scoliosis
abnormal lateral curvature of the spine
Kyphosis
excessive outward curvature of the spine, causing hunching of the back
