Test2-Thorax and Lungs-MJ

Question 1

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

Answer 1

Careful not to break off the xiphoid process

Question 2

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

Answer 2

The xiphoid process can puncture the liver if it breaks off

Question 3

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

Answer 3

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

Question 4

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

Answer 4

2X

AP diameter= 1:2

Question 5

Where would a round thorax be normal?

Answer 5

An infant

Question 6

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

Answer 6

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

Question 7

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

Answer 7

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

Question 8

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

Answer 8

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

Question 9

What are the 4 changes in the aging adult?

Answer 9

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

Question 10

What is vital capacity?

Answer 10

The amount of air you can breath out when trying

Question 11

When the vital capacity decreases, what increases?

Answer 11

Risidual volume

Question 12

What are the 8 signs of respiratory distress?

Answer 12

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

Question 13

Where is respiratory distress most often seen in?

Answer 13

Pediatrics

Question 14

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?

Answer 14

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

Question 15

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

Answer 15

Retractions

Question 16

Where can retractions easily be seen?

Answer 16

Children

Question 17

What are the 5 airways retractions?

Answer 17

• Supraclavicular retractions
• Suprasternal retractions
• Intercoastal retractions
• Substernal retractions
• Subcoastal retractions

Question 18

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

Answer 18

Apnea
Biots
Cheyne-stokes
Kussmauls

Question 19

What respiration is this: cessation of breathing

Answer 19

Apnea

Question 20

What respirations are irregular with NO predictable breathing patterns?

Answer 20

Biots

Question 21

What injuries could you see biot respirations in?

Answer 21

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

Question 22

What respirations are irregular, predictable breathing patterns?

Answer 22

Cheyne-stokes

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

Question 23

What injuries could you see cheyne-stokes in?

Answer 23

Heart failure, overdose, infants

Question 24

What are Kussmaul respirations?

Answer 24

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

Question 25

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

Answer 25

pH is likely too low as well

Question 26

What is orthopnea?

Answer 26

Difficulty breathing when supine

Question 27

What is paroxysmal nocturnal dyspnea?

Answer 27

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

Question 28

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

Answer 28

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

Question 29

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

Answer 29

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

Question 30

What are some signs of marked tracheal deviation?

Answer 30

Cachexia | Jungular vein distention

Question 31

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

Answer 31

The patient has pneumonia

Question 32

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

Answer 32

Tympany Resonance Dullness Flatness

Question 33

What pitch does tympany percussions make?

Answer 33

Tympany makes high pitched sounds

Question 34

Where would you hear tympany percussion sounds?

Answer 34

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

Question 35

What pitch does resonant percussion sounds make?

Answer 35

Resonant makes low pitched sounds

Question 36

Where would you hear resonant percussion sounds?

Answer 36

Over normal lung tissue

Question 37

What pitch does dull percussion sounds make?

Answer 37

High pitch

Question 38

Where would you hear dull percussion sounds?

Answer 38

Relatively dense organs-spleen or liver

Question 39

What pitch does flat percussion sounds make?

Answer 39

High pitch

Question 40

Where would you hear flat percussion sounds?

Answer 40

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

Question 41

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

Answer 41

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

Question 42

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

Answer 42

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

Question 43

Why are low pitched percussion sounds heard over the lungs?

Answer 43

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

Question 44

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

Answer 44

Over the diaphragm and part of the stomach

Question 45

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

Answer 45

Around the heart---no specificity and selectivity

Question 46

What are the 2 discontinuous lung sounds?

Answer 46

Crackles | Pleural friction rub

Question 47

Is there any musical tone to discontinuous sounds?

Answer 47

No, just noise

Question 48

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

Answer 48

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

Question 49

What does a pleural friction rub sound like?

Answer 49

Grinding/grating

Question 50

What are the 3 continuous lung sounds?

Answer 50

Wheeze Rhonchi Stridor

Question 51

Is there any musical tone to continuous lung sounds?

Answer 51

Yes, there is muscle nature

Question 52

What is the sound heard with wheezing?

Answer 52

High pitch

Question 53

What is the sound heard with rhonchi?

Answer 53

Low pitch, like snoring

Question 54

Which continuous lung sound is an emergency?

Answer 54

Stridor

Question 55

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

Answer 55

Push the diaphragm down firmly

Question 56

Is it rare to hear crackles in inspiration and expiration?

Answer 56

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

Question 57

Continuous or discontinuous lung sound: Wheeze?

Answer 57

Continuous

Question 58

Continuous or discontinuous lung sound: Crackles

Answer 58

Discontinuous

Question 59

Continuous or discontinuous lung sound: Pleural friction rub?

Answer 59

Discontinuous

Question 60

Continuous or discontinuous lung sound: | Stridor?

Answer 60

Continous

Question 61

Continuous or discontinuous lung sound: Rhonchi?

Answer 61

Continous