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Respiratory System Flashcards

1
Q

Where can you find the sternomanubrial angle?

A

in line with the 2nd rib

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2
Q

What is the main function of rib cage?

A

protection for lungs, heart, liver, esophagus, etc.

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3
Q

How many ribs articulate directly with the sternum?

A

Ribs 1-7

Only the first 7 ribs articulate directly with the sternum

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4
Q

Which ribs articulate with the costal cartilage?

A

ribs 8,9, and 10

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5
Q

Which ribs are the floating ribs? Do they articulate anything?

A

ribs 11 and 12

no, they don’t articulate anything

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6
Q

Which rib is an anatomical landmark for finding the distal tip of the scapula?

A

rib 7

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7
Q

Rib 12 is easily palpable from which anatomical side?

A

posterior

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8
Q

Rib 11 is easily palpable from which anatomical side?

A

laterally

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9
Q

What is the cervical spine range?

A

C1-C7

C1= atlas
C2= axis
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10
Q

If you have a pt flex their neck, which part of the cervical spine is the most prominent? What is another name for this spot?

A

C7 is also called vertebral prominence

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11
Q

Where can you find the midclavicular lines?

A

runs through the left and right clavicle, and in line with nipples all the way down to abdominal region

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12
Q

Where can you find the scapula lines?

A

runs through the left and right inferior angles of the scapula all the way down to the lower back

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13
Q

Where are the lungs in relation to the rib cage?

A

the lungs protrude 2-4 cm above the clavicle, above the inner 1/3 of clavicle

the inner 1/3 of clavicle is protecting the lung apex

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14
Q

How far down do the lungs reach normal/average ribs anteriorly? What about a bigger person?

A

lungs are huge, they cross rib 6 and go down to rib 7

in a bigger pt, the lungs may reach to rib 8

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15
Q

How far down do the lungs reach normal/average ribs posteriorly? What about a bigger person?

A

lungs can project down to rib 10

in a bigger pt, it may go down to rib 12

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16
Q

What does bifurcates mean?

A

divide into 2 branches or forks

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17
Q

The trachea bifurcates into primary bronchi. What is this point called?

A

Carina

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18
Q

Where can you find the tracheal bifurcation point, Carina?

A

right behind the angle of Louis and in front of T4

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19
Q

What is the primary muscle for inspiration?

A

the diaphragm

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20
Q

What are the secondary muscles for inspiration?

A

external intercostal muscles

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21
Q

T/F

We don’t really need to use muscles for expiration because its passive

A

true

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22
Q

What does the parietal pleura line?

A

the thoracic cage (serous membrane)

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23
Q

What does the visceral pleura line?

A

covers/folds over the lungs

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24
Q

When would your body need to recruit more muscles for inspiration/expiration?

A

vigorous exercise, COPD, etc.

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25
Where is the pleural cavity found? What is the cavity filled with? What is the purpose of this fluid?
it's the space found between the parietal and visceral pleura pleural cavity is filled with serous fluid the fluid is there to reduce friction
26
Inspiration is always active breathing, however, if a pt has COPD, poor posture, or pneumonia, the respiratory system may need to recruit additional muscles for inspiration. What are these additional muscles?
accessory muscles, recruits the SCM and the scalene muscles
27
Expiration is typically passive, however active expiration is possible in patients with COPD, deep breathing exercises, stressful situations, etc. What muscles are recruited for active expiration?
abdominal muscles will help increase pressure to force air out
28
List a few examples of what a cough might indicate:
``` left sided heart failure congestion URI COPD smoking lungs bronchitis asthma ```
29
What is hemoptysis? What is it indicative of?
cough with blood streaks indicative of ulcers, TB, CF, etc.
30
What is dyspnea?
difficult/labored breathing, SOB
31
What does wheezing sound like?
a whistling sound
32
What is tachypnea?
breathing too fast
33
What is paroxysmal nocturnal dyspnea?
SOB occasionally during sleep
34
What is orthopnea?
discomfort when breathing while lying down flat
35
Chest pain is indicative of...
heart attack, angina, or pleurisy
36
Define pleurisy
inflammation of lung tissue (pleural membranes) caused from infections such as the flu
37
Respiratory system uses which tools for a PE?
all 4: inspection, palpation, auscultation, and percussion
38
Define diaphoresis
excessive, abnormal sweating
39
What is the normal/average respiratory rate?
10-14/min (....she also said 12-20 prior) average is approx 12/min
40
Where should you be looking when checking for cyanosis?
lips and nails
41
What is the tripod position? Who does the tripod position?
pt sitting leaning forward with hands on knees often used for patients with obstructive diseases to help them force air out also seen in patients who have orthopnea, they cannot lay flat so they need to be reclined examples of such patients: COPD, emphysema, etc
42
What are the 5 chest configurations?
1) normal 2) barrel chest 3) kyphosis 4) pectus excavatum 5) pectus carinatum
43
What does a barrel chest mean? Who does it commonly affect?
the chest diameter increased anteriorly and posteriorly results in flattening of diaphragm, commonly seen in COPD patients ***
44
What is kyphosis?
increased front-to-back curve of the spine that interferes with chest/lung movements often seen together with scoliosis
45
What is pectus excavatum?
"funnel chest", affects breathing ** depressed/compressed chest and sternum congenital (born with)
46
What is pectus carinatum?
"pigeon chest" protrusion of the chest does not affect breathing **
47
How do you perform a chest excursion?
find the 10th rib and pinch up the skin between the thumbs, have pt take deep breath and see how your hands move along their back it should be symmetrical breathing asymmetrical breathing is lateralized to one side
48
What is lateralized breathing indicative of?
respiratory disease
49
Describe tactile fremitus assessment
place ulnar side of hand against pt upper back have pt say 99 you should hear/feel vibrations
50
If you perform tactile fremitus on a pt and the vibrations sound LOUD, what does this indicate?
lung consolidation, there is fluid in the lungs
51
If you perform tactile fremitus on a pt and the vibrations sound muffled/quiet, what does this indicate? What does this mean?
pleural effusion there is excess serous fluid in the pleural cavity and displaced the lungs upward
52
What is the difference between lung consolidation and pleural effusion in terms of location of fluid
lung consolidation is when the air in lungs is replaced with something else (such as pus, blood, etc) pleural effusion is when there in excess fluid in pleural cavity
53
How should pt be seated when percussing their lungs?
have pt cross arms in front of chest and grab their own shoulders (it expands the lungs)
54
If you percuss a solid organ, such as the liver, what should it sound like?
dull and short
55
If you percuss the lungs, which are filled with air, what should they sound like?
resonance (sounds like an echo)
56
If you percuss a hollow organ, such as the stomach, what should it sound like?
high-pitched, called the tympanic sound
57
What sound do lungs filled with fluid make to percussion?
dull loud thud
58
When you percuss a pt with emphysema, what will you hear?
hyper-resonance (drum sound)
59
What happens in the lungs of a pt who has emphysema?
walls of alveoli are lost which means there is decreased surface area and decreased gas exchange causing breathlessness (lungs become hollow)
60
What is the proper technique for lung percussion?
wrist movement with 1 finger taping on distal phalanx of 3rd finger
61
What are normal breath sounds called and what do they sound like?
vesicular breath sounds | soft + low pitched
62
How do you auscultate the lungs? Hint: how many locations do you listen to?
minimum of 3 places anteriorly | minimum 3 places posteriorly
63
What are you listening for when you auscultate the lungs?
wheezing (airways partially blocked) rales/crackles (pulmonary edema) rhonchi (secretions in airways) bronchial breath sounds (pneumonia)
64
What do rales/crackles in the lungs sound like?
when you rub your hair together next to your ears
65
What do rhonchi in the lungs sound like?
a slurping sound
66
If you hear bronchial breath sounds what are the 3 tests you should do in office?
1. egophony test 2. bronchophony test 3. whispered pectoriloquy
67
What is the egophony test?
auscultate and have pt say "e, e, e, e" | if it sounds like "a, a, a, a" = fluid in lungs/egophony present
68
What is the bronchophony test?
auscultate and have pt say "99" if 99 is heard clearly/loudly = abnormal/fluid present if 99 sounds indistinct/muffled = normal
69
What is the whispered pectoriloquy test?
auscultate and have pt whisper "1, 2, 3, 4..." | if whisper sounds loud, there there is fluid in lungs
70
What do bronchial breath sounds sound like?
scuba mask underwater
71
bronch(o)-
pertaining to: bronchus ex: bronchitis def: inflammation of the bronchus
72
-capnia
pertaining to: carbon dioxide ex: hypercapnia def: excessive carbon dioxide in the blood
73
chondro-
pertaining to: cartilage ex: chondroma def: hyperplastic growth of cartilage
74
costo-
pertaining to: ribs ex: costochondritis def: inflammation of the rib cage
75
muc(o)-
pertaining to: mucus ex: mucolytic def: agent that dissolves mucus
76
phren(o)-
pertaining to: diaphragm ex: phrenohepatic def: pertaining to the diaphragm and liver
77
pleur(o)-
pertaining to: pleura ex: pleuritic def: pertaining to inflammation of the pleura
78
-pne(o)-
pertaining to: breath ex: dyspnea def: difficulty in breathing, SOB
79
pneumo-
pertaining to: lungs ex: pneumonectomy def: surgical removal of lung tissue
80
spiro-
pertaining to: to breathe ex: spirogram def: a tracing of respiratory movements
81
-stern(o)-
pertaining to: sternum ex: costosternal def: pertaining to the ribs and sternum
82
List vital sign findings, inspection, palpation, percussion, and auscultation information for emphysema
vital sign findings: stable inspection: increased anteroposterior diameter, use of muscles, thin individual palpation: decreased tactile fremitus percussion: increased resonance, decreased excursion of diaphragm auscultation: decreased lung sounds, decreased vocal fremitus
83
List vital sign findings, inspection, palpation, percussion, and auscultation information for pneumonia
vital sign findings: tachycardia, fever, tachypnea inspection: possible cyanosis palpation: increased tactile fremitus percussion: dullness auscultation: bronchial breath sounds
84
List vital sign findings, inspection, palpation, percussion, and auscultation information for pleural effusion
vital sign findings: tachypnea, tachycardia inspection: often normal, lag on affected side palpation: decreased fremitus, trachea shifted to other side percussion: dullness auscultation: absent breath sounds

Physical Diagnostics (13 decks)

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