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Y2 OSPE > RESPIRATORY > Flashcards

RESPIRATORY Flashcards

1
Q

What are the identifying features of the thoracic vertebrae?

A

2 pairs of demi facets

  • Superior costal facet articulates with head of rib of the same number
  • Inferior costal facet articulates with head of rib below

Transverse processes have an additional facet = transverse costal facet which articulates with tubercle of rib of same number

Body of tharacic vertebrae typically heart shaped

Vertebral foramen typically circular

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2
Q

Name the 3 parts of the sternum and their corresponding vertebral levels.

A

Manubrium - T2/3- T4/5
Body - T5-8
Xiphoid process - T8/9

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3
Q

Describe the true and false ribs and where they articulate

A

R1-7 = true ribs
- articulate anteriorly with sternum via costal cartilages

R8-12 = false ribs

  • R8 - 10 articulate anteriorly with the costal cartilage of the rib above
  • R11 + 12 = floating - no anterior articulation, posteriorly articulate with bodies of their own vertbrae
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4
Q

vertebral level of subcostal plane

A

Level of L3

plane passing through lowest margin of the ribs

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5
Q

Surface mark the upper lobe of the right lung

A

apex - 2-3cm above medial 3rd of clav

sternoclavicular joint –> right 2nd CC –> 4th right CC –> T3 just lateral to PML –> T1 just lateral to PML

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6
Q

surface mark the middle lobe of the right lung

A

4th right CC –> 6th right CC –> 6th rib at MCL –> 4th rib at MAL (where oblique fissure meets horizontal fissure)

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7
Q

surface mark the lower lobe of the right lung

A

6th right CC –> 6th rib at MCL –> 8th rib MAL –> 10th rib just lateral to PML

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8
Q

surface mark the upper lobe of the left lung

A

apex 2-3cm above clav –> left 2nd CC –> 4th CC –> 6th CC –> T3 –> T1

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9
Q

surface mark the lower lobe of the left lung

A

6th left rib at MCL –> 8th rib at MAL –> 10th rib lateral to PML

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10
Q

demonstrate the oblique fissure in both lungs

A 
palpate T3 (scapular spine) 
and 6th CC anteriorly - then connect the two points
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11
Q

demonstrate the transverse fissure of the right lung

A

palpate 4th CC anteriorly –> trace along 4th rib until it meets oblique fissure at MAL near axilla (no posterior surface markings)

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12
Q

surface mark the right parietal pleura

A

apex = 2-3cm above clav –> 6th CC at sternal border –> 8th rib at MCL –> 10th rib at MAL –> T12 at scapular line

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13
Q

surface mark the left parietal pleura

A

apex = 2-3cm above clav –> defelect left between 4th and 6th CC –> 6th CC at sternal border –> 8th rib at MCL –> 10th rib at MAL –> T12 at scapular line

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14
Q

surface mark the right visceral pleura

A

apex = 2-3cm above clav –> 6th CC at sternal border –> 6th rib at MCL –> 8th rib at MAL –> T10 at scapular line

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15
Q

surface mark the left visceral pleura

A

apex = 2-3cm above clav –> defelect left between 4th and 6th CC –> 6th CC at sternal border –> 6th rib at MCL –> 8th rib at MAL –> T10 at scapular line

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16
Q

palpate the trachea

A

using index fingers palpate above the jugular notch and comment whether it is central or deviated

17
Q

Which way would the trachea deviate in a tension pneumothorax?

A

away from the affected side

18
Q

which way would the trachea deviate in an upper lobe collapse or fibrosis?

A

towards affected side

19
Q

investigate the breathing pattern and breathing rate

A

breathing pattern - regular/irregular

breathing rate 12-20 breaths per min = normal

20
Q

demonstrate percussion of the upper, middle and lower lobes of the right lung on the anterior chest wall

A

apex = use the clavicle
upper lobe = 3rd ICS at MCL
middle lobe = 5th ICS/just below axilla at AML
lower lobe = 7th ICS near MAL

21
Q

demonstrate percussion of the upper, and lower lobes of the right lung on the posterior chest wall

A

upper lobe = T1 and T3

lower lobe = anywhere below scapula above T10

22
Q

what sound is expected during percussion of a pneumothorax?

A

hyperresonant (air-filled)

23
Q

what sound is expected during percussion of a haemothorax?

A

hyporesonant (blood filled)

24
Q

demonstrate auscultation of the upper, middle and lower lobes of the right lung on the anterior chest wall

A

apex = above the clavicle (use the bell)
upper lobe = 3rd ICS at MCL
middle lobe = 5th ICS/just below axilla at AML
lower lobe = 7th ICS near MAL

25
Q

demonstrate auscultation of the upper, and lower lobes of the right lung on the posterior chest wall

A

upper lobe = T3

lower lobe = anywhere below scapula above T10

26
Q

borders of the triangle of safety

A

post - ant border of lat dorsi
ant - lat border of pec major
inf - 5th ICS at MAL
sup - apex of axilla

27
Q

position of patient for chest exam

A

supine at 45 degrees

Y2 OSPE (8 decks)

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