thorax Flashcards
(difficulty breathing)
dyspnea
may describe their dyspnea as not being
able to “breathe or take a deep breath.”
Clients who have chronic obstructive pulmonary disease (COPD)
continuous coughing
smokers cough
are wheezing, frequent cough with or without mucous, shortness of breath, and chest tightness
asthma
(difficulty breathing when lying supine)
orthopnea
(severe dyspnea that awakens the person from sleep)
Paroxysmal nocturnal dyspnea
(periods of breathing cessation during sleep)
sleep apnea
reduces the heart muscle’s ability to pump blood.
myocardial ischemia/ cardiac ischemia
a condition in which the pleura — two large, thin layers of tissue that separate your lungs from your chest wall — becomes inflamed.
Pleuritis also known as pleurisy
this color of sputum is is often seen with common colds, viral infections, or bronchitis.
White or mucoid sputum
this sputum is often associated with bacterial infections
yellow or green
this sputum is seen with more serious respiratory conditions
blood in the sputum
sputum that is associated with tuberculosis or pneumococcal pneumonia
Rust colored
may be indicative of pulmonary edema.
Pink, frothy sputum
indicates narrowing of the airways due to spasm or obstruction.
Wheezing
caused by the reproductive cells (spores) of the fungus Histoplasma capsulatum.
Histoplasmosis
is seen with labored respirations (especially in small children) and is indicative of hypoxia
nasal flaring
low levels of oxygen in your body tissues. It causes symptoms like confusion, restlessness, difficulty breathing, rapid heart rate, and bluish skin.
hypoxia
is a lung condition that causes shortness of breath. In people with emphysema, the air sacs in the lungs (alveoli) are damaged. ne of the diseases that comprises COPD (chronic obstructive pulmonary disease).
emphysema
may be seen with clients with CODPD or CHF as a result of polycythemia
ruddy to purple complexion
may be seen if client is cold of hypoxic
cyanosis
pale or cyanotic nails may indicate
hypoxia
Early clubbing
180 degree angle
late clubbing
greater than 180 degree
The ratio of anteroposterior to transverse diameter
1:2
Ribs appearing horizontal at
an angle greater than 45 degrees with the spinal column are frequently the result of an
increased ratio between the anteroposterior–transverse diameter
(barrel chest)
(an increased curve of the
thoracic spine)
kyphosis
client leans forward and uses arms to support weight and lift chest to increase breathing capacity, referred to as the
tripod position
Pain over the intercoastal space
inflamed pleurae
pain over the ribs especially at costal chondral junctions
fractured ribs
also called subcutaneous emphysema, is a crackling
sensation (like bones or hairs rubbing against each other) that occurs when air passes through fluid or exudate
crepitus
(vibrations of air in the bronchial tubes transmitted to the chest wall). As you move your hand to each area, ask the client to say “ninety-nine.” Assess all areas for symmetry and intensity of
vibration.
palpate for fremitus
is best for assessing tactile fremitus because the area is especially sensitive to vibratory
sensation
ball of the hand
what is the normal measurement of examiners thumb during chest expansion exam?
5-10 cm
(collapse or incomplete
expansion) of the chest or lungs
atelectasis
air in the pleural space
pneumothorax
is the percussion tone elicited
over normal lung tissue
resonance
tones over the scapula
flat tones
is elicited in cases of trapped air such as in emphysema or
pneumothorax.
hyperresonance
how do you perform diaphragmatic excursion?
It is performed by asking the patient to exhale and hold it. The doctor then percusses down their back in the intercostal margins t7 (bone will be dull), starting below the scapula, until sounds change from resonant to dull (lungs are resonant, solid organs should be dull). That is where the provider marks the spot.
measurement of excursion
Excursion should be equal bilaterally and measure 3–5 cm in adults.
7-8 in well conditioned patients
present when fluid or solid tissue replaces air in the lung occupies the pleural space, such as in lobar pneumonia, pleural effusion, or tumor.
dullness
Three types of normal breath sounds may be auscultated
bronchial, bronchovesicular,
and vesicular
(formerly called rales)
crackles
formerly called rhonchi)
wheezes
how do you assess bronchophony?
Ask the client to repeat the
phrase “ninety-nine” while you auscultate the chest wall.
assess egophony
: Ask the client to repeat the letter “E” while you listen over the chest wall.
Whispered pectoriloquy
Ask the client to whisper the phrase “one–two–three” while you auscultate the chest wall.
is a markedly sunken sternum and adjacent cartilages (often referred to as funnel chest). It is a congenital malformation that seldom causes symptoms other
than self-consciousness.
Pectus excavatum
is a forward protrusion of the sternum causing the adjacent ribs to slope backward (often
referred to as pigeon chest;
pectus carinatum
what do you normally hear in liver?
dullness
what do you hear in stomach
tympany
what do you hear in the ICS
resonance
high, harsh or hollow sound, loud, short during inspiration long in expiration, usually in trachea and thorax
bronchial
Moderate Mixed, Same during
inspiration and expiration.Over the major bronchi—posterior:
between the scapulae; anterior:
around the upper sternum in the first and second intercostal spaces
Bronchovesicular
low, breezy, soft long isnpiration, short expiration in peripheral lung fields
vesicular
High-pitched, short, popping sounds heard during inspiration and not cleared with coughing; sounds are discontinuous and can be simulated by rolling
a strand of hair between
your fingers near your ear
fine crackles
Low-pitched, bubbling,
moist sounds that may
persist from early inspiration to early expiration; also described as softly separating Velcro.
coarse crackles
Low-pitched, dry, grating sound; sound is much like crackles, only more superficial and occurring
during both inspiration and expiration. Sound is the result of rubbing of two inflamed
pleural surfaces.
pleural friction rub
High-pitched, musical sounds heard primarily during expiration but may also be heard on inspiration. Air passes through constricted passages (caused
by swelling, secretions,
or tumor).
wheeze (sibilant)
Low-pitched snoring or moaning sounds heard primarily during expiration but may be heard throughout the respiratory cycle. These wheezes may clear with coughing
wheeze (snoring
is a harsh, honking wheeze with severe broncholaryngospasm, such as occurs with croup
stridor
12–20 breaths/min and
regular
normal breathing pattern
More than 24 breaths/min and
shallow
tachypnea
Less than 10 breaths/min and
regular
bradypnea
increased rate and increased
depth. Usually occurs with extreme exercise, fear, or anxiety. Causes of hyperventilation include disorders of the central nervous system, an overdose of the drug salicylate, or severe anxiety
hyperventilation
Rapid, deep, labored, A type of hyperventilation associated with diabetic ketoacidosis
kussmaul
Decreased rate, decreased
depth, irregular pattern, Usually associated with overdose of
narcotics or anesthetics
hypoventilation
Regular pattern characterized
by alternating periods of deep, rapid breathing followed by periods of apnea
cheyne-strokes respirations
Irregular pattern characterized
by varying depth and rate
of respirations followed by
periods of apnea
biot’s respiration
Significant disorganization
with irregular and varying
depths of respiration
ataxic
Increasing difficulty in getting
breath out
air trapping
