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Health Assessment > Test2-Thorax and Lungs-MJ > Flashcards

Test2-Thorax and Lungs-MJ Flashcards

1
Q

What do we need to be careful for when giving CPR?

A

Careful not to break off the xiphoid process

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2
Q

What happens if we break off the xiphoid process when we give CPR to a patient?

A

The xiphoid process can puncture the liver if it breaks off

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3
Q

Why is the sternal angle like “x marks the spot”?

A

There is a lot of “treasure underneath this location”– RAT PLANT
We only need to focus on the R and the first T
Rib 2 and Tracheal biforcation

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4
Q

The normal thorax is __ times wide as it is deep.

A

2X

AP diameter= 1:2

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5
Q

Where would a round thorax be normal?

A

An infant

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6
Q

How long does it take before a newborn breathes out of its mouth?

A

3 months; the newborn only breathes out of its nose until 3 months, then it will start to breathe out of its mouth

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7
Q

In newborns, why is there an abdominal bulge with each respiration?

A

The diaphragm is working extra hard because newborns do not have accessory muscles yet

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8
Q

Why do breath sounds in newborns sound loud and harsh? Is this normal?

A

Yes, it is normal because babies have very thin chest walls

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9
Q

What are the 4 changes in the aging adult?

A
  • Coastal cartilage calcification
  • Decreased elasticity of the lungs
  • Decreased vital capacity, increased residual volume
  • Less ventilation of the bases
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10
Q

What is vital capacity?

A

The amount of air you can breath out when trying

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11
Q

When the vital capacity decreases, what increases?

A

Risidual volume

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12
Q

What are the 8 signs of respiratory distress?

A 
Accessory muscles 
Grunting
Head bobbing
Nasal flaring
Retractions
See-saw respirations
Tachypnea
Tripod position
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13
Q

Where is respiratory distress most often seen in?

A

Pediatrics

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14
Q

Since infants don’t have as many muscles, they are having to use their accessory muscles to compensate for the lack of the primary ones. Head-bobbing in an infant is an example of this. Is this serious or not?

A

Yes, this is when you take your baby to the ER!

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15
Q

What respiratory distress symptom is this: Sucking in of the chest since air can’t get into the lungs

A

Retractions

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16
Q

Where can retractions easily be seen?

A

Children

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17
Q

What are the 5 airways retractions?

A
  • Supraclavicular retractions
  • Suprasternal retractions
  • Intercoastal retractions
  • Substernal retractions
  • Subcoastal retractions
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18
Q

What are the four types of respirations mentioned in the PPT?

A

Apnea
Biots
Cheyne-stokes
Kussmauls

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19
Q

What respiration is this: cessation of breathing

A

Apnea

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20
Q

What respirations are irregular with NO predictable breathing patterns?

A

Biots

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21
Q

What injuries could you see biot respirations in?

A

Brain injuries-head trauma, heat stroke, encephalitis, meningitis

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22
Q

What respirations are irregular, predictable breathing patterns?

A

Cheyne-stokes

~25 sec apnea, 30 sec hypernea, etc, etc

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23
Q

What injuries could you see cheyne-stokes in?

A

Heart failure, overdose, infants

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24
Q

What are Kussmaul respirations?

A

Very deep tachypnea–they are trying to get rid of CO2

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25
Q

If someone is breathing with Kussmaul respirations, what else could you expect to be low in the body?

A

pH is likely too low as well

26
Q

What is orthopnea?

A

Difficulty breathing when supine

27
Q

What is paroxysmal nocturnal dyspnea?

A

Awakening from sleep with SOB and needing to be upright to achieve comfort

28
Q

What question do you ask a patient when you have a patient who has orthopnea?

A

Ask this: “How many pillows do you sleep with under your head?”

29
Q

When you are palpating the trachea, what are the 3 steps you do to see if the trachea is midline?

A
  1. Place index finger in the sternal notch
  2. Slip finger to each side of the trachea
  3. The space should be symmetric
30
Q

What are some signs of marked tracheal deviation?

A

Cachexia

Jungular vein distention

31
Q

If the symmetry of respiratory excursion is not symmetrical, what could that mean?

A

The patient has pneumonia

32
Q

What are the 4 percussion notes from the PPT that we need to be aware of?

A

Tympany
Resonance
Dullness
Flatness

33
Q

What pitch does tympany percussions make?

A

Tympany makes high pitched sounds

34
Q

Where would you hear tympany percussion sounds?

A

Over air-filled viscus (the stomach, the intestine)

35
Q

What pitch does resonant percussion sounds make?

A

Resonant makes low pitched sounds

36
Q

Where would you hear resonant percussion sounds?

A

Over normal lung tissue

37
Q

What pitch does dull percussion sounds make?

A

High pitch

38
Q

Where would you hear dull percussion sounds?

A

Relatively dense organs-spleen or liver

39
Q

What pitch does flat percussion sounds make?

A

High pitch

40
Q

Where would you hear flat percussion sounds?

A

When no air is present, over thigh muscles or bone or over tumor

41
Q

Out of the 4 percussion sounds, which 3 produce high pitched sounds.

A

The 3 percussion sounds that make a high pitched noise are TYMPANY, DULL, and FLAT.

42
Q

Why are high pitched percussion sounds heard with tympany, dull, and flat percussions sounds?

A

Denser more solid structures gives softer, higher, sorter sounds because it DOES NOT vibrate easily

Remember:
Tympany= over stomach and intestine
Dull= over dense organ (liver, spleen)
Flat= When no air is present, over thigh muscles, bone, or over tumor

^ All of those are dense structures

43
Q

Why are low pitched percussion sounds heard over the lungs?

A

Low pitched sounds are heard over the lungs because a structure with more AIR produces a louder, deeper, and longer sound because it VIBRATES FREELY

44
Q

Percussion of the anterior chest: Where does the tone change?

A

Over the diaphragm and part of the stomach

45
Q

If you are percussing the anterior chest, testing for cardiomegalgy, where would you begin percussing more loudly?

A

Around the heart—no specificity and selectivity

46
Q

What are the 2 discontinuous lung sounds?

A

Crackles

Pleural friction rub

47
Q

Is there any musical tone to discontinuous sounds?

A

No, just noise

48
Q

Crackles are very short. When do you usually hear them?

A

Crackles usually are heard on INSPIRATION, but they can be heard on expiration too

49
Q

What does a pleural friction rub sound like?

A

Grinding/grating

50
Q

What are the 3 continuous lung sounds?

A

Wheeze
Rhonchi
Stridor

51
Q

Is there any musical tone to continuous lung sounds?

A

Yes, there is muscle nature

52
Q

What is the sound heard with wheezing?

A

High pitch

53
Q

What is the sound heard with rhonchi?

A

Low pitch, like snoring

54
Q

Which continuous lung sound is an emergency?

A

Stridor

55
Q

What do you do if you are trying to hear the lung sounds in someone with a hairy chest?

A

Push the diaphragm down firmly

56
Q

Is it rare to hear crackles in inspiration and expiration?

A

Yes, they are normally heard only on inspiration, but it CAN be heard during both–just is rare!

57
Q

Continuous or discontinuous lung sound: Wheeze?

A

Continuous

58
Q

Continuous or discontinuous lung sound: Crackles

A

Discontinuous

59
Q

Continuous or discontinuous lung sound: Pleural friction rub?

A

Discontinuous

60
Q

Continuous or discontinuous lung sound:

Stridor?

A

Continous

61
Q

Continuous or discontinuous lung sound: Rhonchi?

A

Continous

Health Assessment (26 decks)

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