Seidel's Chp 14 Flashcards
Which chest structure contains all the thoracic viscera except the lungs? A. Manubrium B. Mediastinum C. Sternum D. Xiphoid E. Pleural cavities
B. Mediastinum
The mediastinum, situated between the lungs, contains all the thoracic viscera except the lungs. The manubrium and xiphoid are parts of the sternum. The pleural cavities enclose the lungs.
Which bronchial structure(s) is (are) most susceptible to aspiration of foreign bodies? A. Left mainstem bronchus B. Terminal bronchioles C. Right mainstem bronchus D. Right respiratory bronchioles E. Left respiratory bronchioles
C. Right mainstem bronchus
The right mainstem bronchus has a more downward slope and is less angled than the left bronchus. Therefore, it is more likely to be a site of aspiration and is a more likely site for endotracheal tubes that are advanced too far.
When auscultations the apex of the lung, you should listen A. Even with the second rib B. 4cm above the first rib C. Higher on the right side D. On the convex diaphragm surface E. Directly over the clavicles
B. 4cm above the first rib
The apices of the lungs are 4 cm above the first rib.
You are documenting a rash between the 8th and 9th ribs on the lateral border. This intercostal space will be documented in terms of the
A. Rib immediately above it
B. Rib immediately below it
C. Number of centimeters it is positioned below the clavicle
D. Number of inches it is positioned below the clavicle
E. Relationship to the sternum
A. Rib immediately above it
To begin counting the ribs and the intercostal spaces, you begin by palpating the reference point of the A. Distal point of the xiphoid B. Manubriosternal junction C. Suprasternal notch D. Acromion process E. Clavicle
B. Manubriosternal junction
The angle of Louis, the junction of the manubrium and the sternum, corresponds to the second rib, the reference point for counting ribs and intercostal spaces.
Fetal gas exchange is mediated by the A. Pleura B. Heart C. Amniotic fluid D. Placenta E. Lungs
D. Placenta
the lungs contain no air, and the alveoli are collapsed.
The foramen ovale (atria) should close by A. 24 weeks of gestation B. The initiation of labor C. Within minutes of birth D. 4 weeks of age E. 12 months of age
C. Within minutes of birth
The decrease in pulmonary pressures within the first minutes of life leads to closure of the foramen ovale.
Increased oxygen tension in the arterial blood of a newborn infant causes A. Closure of the ductus arteriosus B. Hyperinflation of the lungs C. Passive respiratory movements D. Reopening of the foramen ovale E. The pulmonary arteries to contract
A. Closure of the ductus arteriosus
The anteroposterior diameter of the chest is normally approximately the same as the transverse diameter in which age group? A. Infants B. School-age children C. Adolescents D. Young adults E. Older adults
A. Infants
To accommodate the enlarging uterus of pregnancy, the chest changes result in A. Intercostal muscle atrophy B. Lower of the resting diaphragm C. Decreased alveoli expansion D. Decreased diaphragmatic movment E. Increased costal angle
E. Increased costal angle
The costal angle progressively increases from approximately 68.5 degrees to 103.5 degrees in later pregnancy. The resting diaphragm rises, yet diaphragmatic movement increases, the alveolar ventilation and tidal volume increase, and the muscles do not atrophy.
The characteristic barrel chest of an older adult is caused by a combination of factors, including
A. Skeletal changes of aging
B. Increased muscular expansion of the chest wall
C. Less fibrous alveoli
D. Increased vital capacity
E. Increased lung resiliency
A. Skeletal changes of aging
Skeletal changes associated with aging include an emphasis of the dorsal curve of the thoracic spine that contributes to a barrel chest.
Nancy is a 16 year old young woman who presents to the clinic with complaints of severe, acute chest pain. Her mother reports that Nancy, apart from occasional colds, is not prone to respiratory problems. What potential risk factor is most important to assess concerning Nancy’s present problem? A. Anorexia symptoms B. Illegal drug use C. Last menses D. Signs of rheumatic fever E. Sexual activity
B. Illegal drug use
Illegal drug use, particularly of cocaine, is especially important to prioritize as a social history question for all adolescents and adults who complain of severe chest pain. Cocaine use can lead to tachycardia, hypertension, coronary arterial spasm with infarction, and pneumothorax.
A patient describes shortness of breath that gets worse when he sits up. Which term documents this? A. Platypnea B. Orthopnea C. Tachypnea D. Bradypnea E. Hyopnea
A. Platypnea
Dyspnea that increases in the upright posture is called platypnea. Orthopnea is dyspnea that worsens with lying down, tachypnea is increased respiratory rate, and bradypnea is decreased respiratory rate. Hypopnea refers to abnormally shallow respirations.
Bradypnea may accompany A. Pneumothorax B. An excellent level of cardiovascular fitness C. Ascites D. A pulmonary embolus E. Anxiety
B. An excellent level of cardiovascular fitness
Bradypnea, a rate slower than 12 breaths/min, may result from cardiorespiratory fitness. The other choices accompany tachypnea.
A 34 year old man is being seen for complaints of dull pain between the shoulder blades that is more intense with deep breathing and coughing. Upon auscultation of the chest, you suspect that you will hear A. Rhonchi B. Expiratory wheeze C. Crackles D. Pleural friction rub E. Crepitus
A. Rhonchi
This patient is describing the bronchi as the source of the pain; the trachea divides at T4–5, between the shoulder blades. The adventitious bronchial sound expected is rhonchi. Wheezing might be expected if the patient had productive coughing or dyspnea; a pleural friction rub usually causes sudden stabbing pain over the pleuritic site. Crepitus can be both palpated and heard; it indicates air in the subcutaneous tissue and is usually found anteriorly and toward the axilla.
The most appropriate lighting source to highlight chest movement is (are) A. Bright tangential lighting B. Daylight from a window C. Flashlight in a dark room D. Fluorescent ceiling lights E. A wood’s lamp
A. Bright tangential lighting
Both pleural effusion and lobar pneumonia are characterized by \_\_\_\_\_ percussion. A. Tympany heard with B. Dullness heard on C. Resonance heard on D. Hyperresonance heard on E. Occasional hyperresonance heard on
B. Dullness heard on percussion
Pleural effusion and lobar pneumonia are more dense than air, with an expected finding of dullness to percussion. Tympany is expected over hollow organs such as the stomach; resonance and hyperresonance are heard over air-filled areas.
Which finding suggests a minor structural variation? A. Barrel chest B. Clubbed fingers C. Pectus carinatum D. Retractions E. Tachypnea
C. Precuts carinatum
Ms. R, age 74, has no known health problems or diseases. You are doing a preventative health care history and examination. Which symptom is associated with an intrathoracic infection? A. Barrel chest B. Cor pulmonale C. Pectus excavated D. Pectus carinatum E. Malodorous breath
E. Malodorous breath
In barrel chest, the ratio of the anteroposterior diameter to the transverse (lateral) diameter is A. .7 to .75 B. 1.0 C. 1.3 to 1.5 D. 1.5 to 2 E. Greater than 2
B. 1.0
The patient that you are examining is complaining of pain near the spine. While palpating the spinous process at T7 and medially to the inferior border of the right scapula, the patient feels more pain. When viewing the chest radiograph, you will carefully look at which rib? A. Right sixth rib B. Right seventh rib C. Right eighth rib D. Left seventh rib E. Left eighth rib
C. Right eighth rib
Although each rib articulates with the corresponding vertebra, the palpated spinous process dips down so that the rib you feel in apparent association with the spinous process is actually the number of that process plus 1.
The best Tim to observe and count respirations is
A. While the patient is answering questions
B. While weighing the patient
C. After palpating the pulse
D. When the patient is sleeping
E. After a short walk
C. After palpating the pulse
Respiratory patterns change as the patient speaks and sleeps. Attempting to count during weighing would make the patient self-conscious and affect the respiratory rate. Counting respirations after you palpate the pulse does not make the patient self-conscious because the patient expects you to be counting the pulse.
As you take vital signs on Mr. B, age 78 years, you note that his respiration’s are 40 breaths/min. He has been resting, and his mucosa is pink. Concerning Mr. B’s respiration’s you would
A. Document his rate as normal
B. Do nothing because his color is pink
C. Note that his rate is below normal
D. Report that he has an above average rate
E. Ignore one abnormal result
D. Report that he has an above average rate
The normal adult respiratory rate is 12 to 20 breaths/min, with a ratio of respirations to heartbeats of 1:4. Always note any variations in respiratory rate.
In which patient situation would you expect to assess tachypnea? A. Patient with depression B. Patient who abuses narcotics C. Patient with metabolic acidosis D. Patient with myasthenia gravis E. Patient with metabolic alkalosis
C. Patient with metabolic acidosis
In metabolic acidosis, the body compensates by increasing the respiratory rate to blow off the excess carbon dioxide. The other choices cause respiratory depression.
