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Cardiopulmonary > Respiratory Assessment #2 > Flashcards

Respiratory Assessment #2 Flashcards

1
Q

Nasotracheobronchial tree (gas transport)

A 
Nose
Pharynx
Larynx
Trachea
Mainstem Bronchi
Lobular Bronchi
Segmental Bronchi
Sub-Segmental Bronchi
Lobular Bronchioles
Respiratory Bronchioles
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2
Q

Alveoli (gas exchange)

A

Small bulbous structures at terminal aspect of respiratory bronchioles

Alveolar walls approximate each other

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3
Q

What do Lambert Canals allow for?

A

Collateral ventilation.

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4
Q

What are the pleurae?

A

Membranous, serous sacs.

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5
Q

How close are the visceral and parietal pleura?

A

Very close. A thin serous film separates the membranes.

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6
Q

What is parenchyma?

A

porous, spongy lung tissue.

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7
Q

What are the three components to naming the lungs?

A

Side, Lobe, Location/View

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8
Q

What are the lobes of the lung?

A 
Left upper
Right upper
Left lingua
Right middle
Left lower
Right lower
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9
Q

What are the location/views of the lung fields?

A

Anterior, Posterior, Lateral, Superior, Inferior segments

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10
Q

What approach should be used during auscultation?

A

Systematic approach.

Make sure to alternate between left and right.

Complete full ant/pos analysis before switching to other surface.

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11
Q

What position are the lateral segments most easily accessed in?

A

Sitting

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12
Q

When instructing a patient prior to auscultation, what should you do?

A

Instruct them to breathe normally.

Slightly larger volume.

Breathe through the mouth.

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13
Q

Stethoscope placement for the tracheal and normal sound?

A

Over trachea

Harsh and loud

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14
Q

Stethoscope placement for bronchial?

Normal sound?

A

1st intercostal space immediately lateral to manubrium.

Less harsh, loud
Hollow, high pitch
Expiration longer than inspiration.

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15
Q

Bronchiovesicular stethoscope placement?

Normal Sound?

A

2nd/3rd Intercostal space lateral to sternum.
or
Post. chest between middle 3rd of scapulae in region of T3-T6.

Softer than bronchial
Tubular
Expiration temporally equal to inspiration

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16
Q

Vesicular stethoscope placement?

Normal Sound?

A

Over lung tissue

Soft
Muffled, low pitch
Inspiratory longer than expiration.

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17
Q

Cause of absent breath sounds..

What do they sound like?

A

Complete airway obstruction.

Complete alveolar collapse.

Absent underlying lung.

They dont sound like anything you dumbass.

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18
Q

What do diminished breath sounds (sound) like?

A

softer than typically expected in area.

Typically referenced as an inspiratory findings.

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19
Q

What can cause a diminished breath sound?

A

Poor inspiratory effor.
Partial airway obstruction.
Incomplete alveolar aeration with inspiration.
Decreased chest wall mobility.

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20
Q

Is it abnormal to hear a normal breath sound in an atypical location?

A

Yes

21
Q

What are Cackles/Rales?

A

Intermittent popping, may be coarse or fine.

Can be an inspiratory or expiratory finding.

22
Q

What can cause cackles or rales?

A

Atelectasis

Fluid or secretions in alveoli.

23
Q

What are wheezes/rhonchi?

A

Continous, may be of high or low pitch.

Typically referred to as an inspiratory or expiratory findings.

24
Q

What can cause wheezes/rhonchi?

A

Fluid or secretions in airway.

Bronchospasm or otherwise narrowed airway.

25
Q

What is Stridor?

A

harsh, coarse wheeze that may occur both during inspiration and expiration

26
Q

What can cause Stridor?

A

Upper airway obstruction.

27
Q

What is a pleural friction rub?

A

Low pitch creaking most often heard during inspiration.

28
Q

What can cause a pleural friction rub?

A

Inflammation of the pleura.

29
Q

What is a death rattle.

A

Gurgling of saliva and bronchial secretions.

30
Q

What can cause a death rattle?

A

Impending death

31
Q

ANTERIOR

Where to auscultate the R/L upper lobe anterior apical segment?

A

Superior to clavicle at mid-clavicular line

Expected Finding: Vesicular

32
Q

ANTERIOR

R/L upper lobe anterior segment

A 
1st ICS immediately lateral to manubrium
(vesicular)
and
2nd ICS at mid-clavicular line
(bronchial)
33
Q

ANTERIOR

Right middle lobe medial segment

A

4th ICS at mid-clavicular line

vesicular

34
Q

ANTERIOR

Left lingula superior segement

A

3rd ICS at anterolateral border of chest wall

vesicular

35
Q

ANTERIOR

Left lingula inferior segment

A

4th ICS at mid-clavicular line

vesicular

36
Q

ANTERIOR

R/L lower lobe anterior segment

A

5th or 6th ICS adjacent to costo-sternal junction

vesicular

37
Q

POSTERIOR

R/L upper lobe posterior apical segment

A

1st ICS immediately lateral to spinous process

vesicular

38
Q

POSTERIOR

R/L upper lobe posterior segment

A

2nd ICS medial to medial border of scapula

vesicular

39
Q

POSTERIOR

R/L lower lobe posterior superior segment

A

5th ICS medial to medial border of scapula

bronchiovesicular

40
Q

POSTERIOR

R/L lower lobe posterior inferior segment

A

8th ICS medial to inferior angle of scapula

vesicular

41
Q

LATERAL

Right middle lobe lateral segment

A

4th ICS at mid-axillary line.

vesicular

42
Q

LATERAL

Left lingula lateral segment

A

4th ICS at mid-axillary line.

vesicular

43
Q

LATERAL

R/L lower lobe lateral segment

A

7th ICS at mid-axillary line

vesicular

44
Q

Confirmatory Assessments

A

Bronchophony, Egophony, Whispered Pectoriloquy, Tactile Fremitus

45
Q

Confimatory Assessments:

Bronchophony

A

Patient vocalizes 99 in normal volume and pitch

Normal: muffled 99

Abnormal: clear, crisp 99

Cause of abnormal findings:
Secretions in lung segement

46
Q

Confirmatory Assessments:

Egophony

A

Patient vocalizes “E” in normal volume and pitch.

Normal: “E” sound

Abnormal: “A” sound

Cause of findings: Secretions in lung segments.

47
Q

Confirmatory Assessments:

Whispered Pectroiloquy

A

Patient whistpers “E” or “1,2,3”.

Normal: Absent sound

Abnromal: Audible E or 1,2,3

Cause of Abnormal Findings:
Secretions in lung segment
Airless lung segment

48
Q

Confirmatory Assessments:

A

Examiner places hands over chest wall while patient vocalizes “99”.

Normal: Customary Vibration

Abnormal/Cause: Increased vibration with secretions in lung segments. Decreased vibration with hyperinflation.

Cardiopulmonary (9 decks)

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