Respiratory System

Question 1

How are lungs divided?

Answer 1

Both lungs are divided in half by oblique fissure
Right lung is further divided by the horizontal fissure
Left: upper & lower lobe
Right: upper. middle, lower

Question 2

List out the parts of the sterum

Answer 2

(from up to down)
suprasternal notch
manubrium
sternal angle (angle of louis) (2nd rib)
xiphoid process

Question 3

how to locate oblique and horizontal fissure?

Answer 3

Oblique: (posterior) T3 of the spinous process
(anterior) 6th rib at midclavicular line
Horizontal: 5th rib at midaxillary line & 4th rib

Question 4

Respiratory system examination sequence & client’s position?

Answer 4

Inspection
Palpation
Percussion
Auscultation
Client should be sitting

Question 5

Describe shape of chest + anteroposterior diameter: transverse diameter

Answer 5

Symmetric thorax; elliptical shape with downwards sloping ribs
anteroposterior: transverse diameter 1:2 - 5:7

Question 6

3 types of abnormal chest shapes

Answer 6

Barrel chest: anteroposterior: transverse is 1:1
Pigeon chest: narrow transverse, protruding sternum
Funnel chest: depressed (concave) sternum

Question 7

3 types of abnormal spines

Answer 7

kyphosis: excessive curvature of thoracic spine
lordosis: excessive curvature of lumbar spine (usually in kids <5)
scoliosis: lateral deviation

Question 8

Tactile fremitus is felt best at _______

Answer 8

2nd/ 3rd intercostal space posteriorly

Question 9

What is the normal percussion sound in adults & children

Answer 9

Resonance (adults)
Hyperresonance (children)

Question 10

Bronchial (tracheal) breath sounds
(pitch, amplitude, duration, quality, location)

Answer 10

Pitch: High
Amplitude: Loud
Duration: Insp < exp
Quality: Harsh, hollow, tubular
Location: trachea & larynx

Question 11

Bronchovesicular breath sounds
(pitch, amplitude, duration, quality, location)

Answer 11

Pitch: moderate
amplitude: moderate
Duration: insp = exp
Quality: mixed
Location: major bronchi with fewer alveoli -
posterior, between scapulae esp on right; anterior, around upper sternum in first & second ICS

Question 12

Vesicular breath sounds
(pitch, amplitude, duration, quality, location)

Answer 12

Pitch: low
Amplitude: soft
Duration: insp > exp
Quality: rustling, like to sound of wind in trees
Location: peripheral lung fields; smaller bronchioles & alveoli

Question 13

5 adventitious breath sounds

Answer 13

Crackles, rhonchi, wheezing, stridor, pleural friction rubs

Question 14

Characteristics & cause of crackles

Answer 14

non-musical noises during inspiration in small airways
caused by fluid filled in alveoli

Question 15

Characteristics & cause of rhonchi

Answer 15

low-pitched musical & continuous noises during expiration in large airways (bronchioles/ bronchi)
caused by air passing airways with constriction

Question 16

Characteristics & cause of wheezing

Answer 16

high-pitched, musical, continuous sounds during expiration in small airways
caused by air rapidly passing through constricted airways

Question 17

Characteristics & cause of stridor

Answer 17

loud musical sound during inspiration
caused by obstruction of central airway

Question 18

Characteristics & cause of pleural friction rubs

Answer 18

low-pitched, non-musical sounds during inspiration & expiration
caused by rubbing tgt of inflamed & roughened pleural surfaces during respiration