Respiratory Assessment Pt. II

Question 1

Pleurae:

Answer 1

• membranous, serous sac
  
  • Visceral: covers lung tissue
  • Parietal: covers chest wall
  • Visceral and parietal pleura are in close approximation
    
    • Thin serous film separates the membranes

**thinhgs can accumulate in space (ex fluid)

Question 2

Parenchyma

Answer 2

porous, spongy lung tissue

Question 3

Naming Convention for Lung Fields

Answer 3

• Side=
  
  • Right, left
• Lobe=
  
  • Left upper, right upper, Left lingua, right middle, Left lower, right lower
• Location / View=
  
  • Anterior, posterior, lateral, superior, inferior
  • Segment

Question 4

Auscultation of Lung Fields

Answer 4

• Use diaphragm of stethoscope
• Follow systematic approach
  
  • Superior to inferior
  • Alternating left/right or right/left
  • May begin on either anterior or posterior surface
    
    • Complete full anterior/posterior analysis before switching to other surface
    • Lateral segments often easiest to access via posterior approach if patient sitting
• Skin to stethoscope contact
  
  • Draping essential
• Patient technique
  
  • Breathe at normal rate
  • Breaths should be of slightly larger than normal volume
  • Breaths should be taken through the mouth
  • Change after coughing?

Question 5

Normal breath sounds- Tracheal

Answer 5

Location- over trachea

Description/quality- harsh, loud

Question 6

Normal breath sounds- Bronchial

Answer 6

Location- 1st ICS immed lateral to manubrium

Description/Quality- less harsh, loud. Hollow, high pitch. Expiraion temporally longer than inspiration.

Question 7

Normal breath sounds- Bronchiovesicular

Answer 7

Location- 2nd and 3rd ICS immed lateral to sternum/ Post chest between middle 3rd of scapulae in region of T3-T6

Description/Quality- softer than bronchial, tubular, expiration temporally equal to inspiration

Question 8

Normal breath sounds- Vesicular

Answer 8

Location- over lung tissue

Description/Quality- soft, muffled low pitch, inspiratory temporally longer than expiration

Question 9

Abnormal breath sounds- absent breath sounds

Answer 9

no audible sounds= complete airway obstruction, complete alveolar collapse, absent underlying lung

Question 10

Abnormal breath sounds-Diminished breath sounds

Answer 10

Sounds heard softer than typically expected in area auscultated (typically referenced as an inspiratory finding)= poor inspiratory effort, partial airway obstruction, incomplete alveoar aeration with inspiration, dec chest wall mobility

Question 11

Major adventitious breath sounds- Crackles/rales

Answer 11

Intermittent popping, may be coarse or fine (typically ins or exp finding)= atelectasis, fluid or secretions in alveoli

Question 12

Major adventitious breath sounds- Wheeze/ rhonchi

Answer 12

Continuoius, may be of high or low pitch (typically ins or exp finding)= fluid or secretions in airway, brochospasm or otherwise narrowed airway

Question 13

Other breath sounds- Stridor

Answer 13

Harsh, corase wheeze when may occur during ins or exp= Upper airway onstruction

Question 14

Other breath sounds- pleural friction rub

Answer 14

low pitch creaking most often heard during inspiration= inflammation of pleura

Question 15

Other breath sounds= Death rattle

Answer 15

Gurguling of saliva and bronchial secretions= impending death!

Question 16

Anterior Surface Lung Auscultation

Question 17

Posterior Surface Lung Auscultation

Answer 17

Question 18

Lateral Surface Lung Auscultation

Question 19

Confirmatory Assessments

Answer 19