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Health Assessment > Respiratory system > Flashcards

Respiratory system Flashcards

1
Q

Thoracic cage

A

The outer structure of the thorax

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2
Q

Thoracic cage consists of:

A 
The sternum
12 pairs of ribs 
12 thoracic vertebra 
Muscles 
Cartilage
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3
Q

Sternum

A

Lies in the center of the chest and is divided into the manubrium, the body and the xiphoid process

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4
Q

Manubrium

A

Connects laterally w/ the clavicles and the first 2 pairs of rib

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5
Q

Suprasternal notch

A

U-shaped indentation on the superior proud of the manubrium

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6
Q

Manubriosternal angle

A

“Angle of Louis”

Few centimeters below the suprasternal notch

Location of the second pair of ribs

Reference point for counting ribs and intercoastal spaces

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7
Q

1st - 7th pair of ribs articulate with

A

The sternum

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8
Q

8th - 10th pair of ribs connect to

A

Cartilages of the pair lying superior to them rather than to the sternum.

This forms an angle called the costal angle

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9
Q

11th and 12th pair are called

A

“Floating” ribs

Because they do not connect to either the sternum or another pair of ribs.

They are connected to the vertebrae and their posterior tips are free and palpable.

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10
Q

Three vertical imaginary landmarks of the anterior chest

A

Midsternal line
Right midclavicular line
Left midclavicular line

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11
Q

Three vertical imaginary landmarks of the posterior chest

A

Vertebral line
Right scapular line
Left scapular line

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12
Q

Three vertical imaginary landmarks of the lateral chest

A

Anterior axillary line
Midaxillary line
Posterior axillary line

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13
Q

Thoracic cavity

A

Consists of the mediastinum, lungs and is lined by the pleural membranes

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14
Q

The bronchi enter the lungs at the

A

Hilum

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15
Q

TRUE OR FALSE: The right lung has three lobes and the left lung has only two lobes

A

TRUE

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16
Q

Parietal pleura

A

Lines the chest cavity

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17
Q

Visceral pleura

A

Covers the external surfaces of the lungs

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18
Q

TRUE OR FALSE: The lubricating serous fluid between the layers allows movement of the visceral layer over the parietal layer during ventilation without friction

A

TRUE

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19
Q

Ventilation

A

The mechanical act of breathing which is accomplished by expansion of the chest.

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20
Q

Inspiration

A

The inflow of air into the lungs as a result of a slight negative pressure created in the lungs in relation to the atmospheric pressure

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21
Q

Expiration

A

The forcing of air out of the lungs as a result of positive pressure within the lungs

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22
Q

Expiration

A

The forcing of air out of the lungs as a result of positive pressure within the lungs

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23
Q

Respiration is involuntarily controlled by the

A

Medulla and pons, located in the brainstem

Hypothalamus and the SNS also play a role

24
Q

Actual Nursing Diagnoses for the Respiratory System

A 
Anxiety 
Activity intolerance 
Ineffective airway clearance 
Impaired gas exchange 
Disturbed sleep pattern 
Impaired breathing patterns
25
Q

Pleural cavity

A

A potential space between visceral and parietal pleura that is filled only with a few milliliters of lubricating fluid.

26
Q

TRUE OR FALSE: Trachea and bronchi transport gases between the environment and lung parenchyma.

A

TRUE
Constitute dead space, or space that is filled with
air but is not available for gaseous exchange.

27
Q

Acinus

A

a functional respiratory unit that consists
of bronchioles, alveolar ducts, alveolar sacs, and the
alveoli.

27
Q

Four major functions of respiratory system

A
  • Supplying oxygen to the body for energy production
  • Removing carbon dioxide as a waste product of
    energy reactions
  • Maintaining homeostasis (acid-base balance) of
    arterial blood
    (-) By supplying oxygen to blood and eliminating
    excess carbon dioxide, respiration maintains pH
    or acid-base balance of blood.
  • Maintaining heat exchange (less important in
    humans)
28
Q

Hypercapnia

A

excessive carbon dioxide in the bloodstream, typically caused by inadequate respiration

29
Q

Equipment

A

Stethoscope
Small ruler
Marking pen
Alcohol wipe

30
Q

Preparation

A

Client should remove all clothing from the waist up and put on examination gown or drape.

31
Q

Position

A

Client should sit in an upright position with arms relaxed at the sides.

32
Q

Inspection of Posterior Thoracic Cavity

A

Scapulae and the shape as well as the configuration of the chest wall should be assessed, noting symmetry.

  • Shoulders and scapulae should be equally horizontal
  • Anteroposterior to transverse diameter should also be noted (Anterior posterior should be less to transverse)

Assess use of accessory muscles, chest expansions and client’s positioning; if they are relaxed and can breath easily

Assess skin color and condition; note any lesions

33
Q

Palpation of Posterior Thoracic Cavity

A

Confirm symmetric chest expansion by placing hands on posterolateral chest wall with thumbs at level T9 or T10, pinching a small fold of skin between thumbs

Fremitus is a palpable vibration, touch back with palmar base of fingers and ask patient to repeat “ninety-nine”

Start at lung apices and move to intercoastal spaces and do this for light palpation of entire chest wall.

34
Q

Percussion of Posterior Thoracic Cavity

A

Percuss across the apices of the scapulae and across the tops of the shoulders before moving the intercoastal spaces.

Sound should be resonance on lung tissue not hyperresonance and flat on scapulae

Percuss diaphragmatic excursion.

  • Ask client to exhale forcefully and hold the breath.
  • Percuss starting from the scapular line and down towards the intercoastal spaces until the tone changes from resonance to dull
  • Mark this with a marker and repeat on the other side
  • Then ask the client to inhale and hold the breath
  • Repeat and mark this with a marker. The measurement should be 3 - 5 cm or 7 to 8cm
35
Q

Auscultation of Posterior Thoracic Cavity

A

Auscultate from the apex at C7 and down the intercoastal spaces until you reach T10 comparing both sides.
Normal breath sounds should be heard

36
Q

Normal lung sounds

A

Tracheal - Over trachea

Bronchial - Over the manubrium

Broncho vesicular: Next to sternum, between scapulae

Vesicular - Rest of the lung

37
Q

Adventitious Sounds

A

Crackles

  • Fine
  • Coarse

Rhonchi

  • Wheezes
  • Ronchi
  • Stridor
  • Friction rub
38
Q

Crackles (fine)

A

Occurrence: End of inspiration

Quality: High pitched, short, crackling

Causes: Collapsed or fluid filled alveoli

39
Q

Crackles (coarse)

A

Occurrence: End of inspiration

Quality: Loud, moist, low-pitched, bubbling

Causes: Collapsed or fluid filled alveoli

  • Bronchitis
  • Pneumonia
  • Fibrosis
  • CHF
40
Q

Wheezes (musical)

A

Occurrence: Expiration, inspiration when severe

Quality: High pitched, continuous

Causes: Blocked airflow

  • Asthma
  • COPD
  • Foreign object
41
Q

Ronchi (sonorous)

A

Occurrence: Expiration/ inspiration, change or disappear w/ cough

Quality: Low pitched, continuous, snoring, rattling

Causes: Fluid- blocked airflow

42
Q

Stridor

A

Occurrence: inspiration

Quality: Loud, high-pitched crowing

Causes: Obstructed upper airway

43
Q

Pleural friction rub

A

Occurrence: Expiration/ inspiration

Quality: Low pitched, grating rubbing

Causes: Pleural inflammation

44
Q

Inspection of Anterior Thoracic Cavity

A

Assess jugular venous pulse

  • Client positioned lying down in supine with torso elevated to 30 degrees
  • Pulsations may be visible

Inspect shape and configuration

  • Anteroposterior less than the transverse diameter
  • Ribs pulled downward and symmetrical to intercoastal spaces
  • Sternum straight and midline

Inspect color and for lesions

Normal respirations 1-2

45
Q

Palpation of Anterior Thoracic Cavity

A

Any tenderness, warmth or sensations, especially at costochondral junction of ribs

Crepitus which is abnormal

Tactical fremitus by patient repeatedly saying ninety nine

Chest expansions
- Hands on anterolateral wall with thumb along the costal margins, pointing towards xiphoid process

46
Q

Percussion of Anterior Thoracic Cavity

A

Start at the apices of the lungs and continue along the intercostal spaces across and down to compare both sides

  • Sound should be resonance over lung tissue
  • Dull over the breast tissue, heart and liver.
  • Tympany over gastric space
47
Q

Auscultation of Anterior Thoracic Cavity

A

Normal breath sounds

No adventitious sounds

48
Q

Tachypnea

A

More than 24 breaths/min and regular

49
Q

Bradypnea

A

Less than 10 breaths/min and regular

50
Q

Hyperventilation

A

Increased rate and increased depth

51
Q

Kussmaul

A

Rapid, deep, labored

52
Q

Hypoventilation

A

Decreased rate, decreased depth, irregular pattern

53
Q

Cheyne-Stokes

respiration

A

Regular pattern characterized by alternating periods of deep, rapid breathing followed by periods of apnea

54
Q

Biot’s respiration

A

Irregular pattern characterized by varying depth and rate of respirations followed by periods of apnea

Health Assessment (11 decks)

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