Thorax Flashcards
Extending from the base of the neck superiorly to the level of diaphragm inferiorly
Thorax
The lungs, distal portion of the trachea, and the bronchi are located in the thorax and constitute the
lower respiratory system
The outer structure of the thorax is referred to as the
thoracic cage
contains the respiratory components.
thoracic cavity
is constructed of the sternum, 12 pairs of ribs, 12 thoracic vertebrae, muscles, and cartilage.
The thoracic cage
lies in the center of the chest anteriorly and is divided into three parts:
The sternum, or breastbone- the manubrium, the body, and the xiphoid process.
The manubrium connects laterally with the clavicles (collarbones) and the ____ of ribs.
first two pairs
A U-shaped indentation located on the superior border of the manubrium is an important landmark known as the
suprasternal notch
A few centimeters below the suprasternal notch, a bony ridge can be palpated at the point where the manubrium articulates with the body of the sternum. This landmark, often referred to as the ______, is also the location of the second pair of ribs and becomes a reference point for counting ribs and intercostal spaces.
sternal angle (or angle of Louis)
The spinous process of the seventh cervical vertebra (C7), also called the _____, can be easily felt with the client’s neck f lexed.
vertebra prominens
The lower tip of each scapula is at the level of the _______ rib when the arms are at the client’s side
seventh or eighth
The ____ runs from the apex of the axillae to the level of the 12th rib.
mid-axillary line
The______extends from the anterior axillary fold along the anterolateral aspect of the thorax,
anterior axillary line
runs from the posterior axillary fold down the posterolateral aspect of the chest wall
posterior axillary line
The thoracic cavity consists of the ______ and the lungs, and is lined by the pleural membranes. The ______ refers to a central area in the thoracic cavity that contains the trachea, bronchi, esophagus, heart, and great vessels.
mediastinum
is a flexible structure that lies anterior to the esophagus, begins at the level of the cricoid cartilage in the neck, and is approximately 10 to 12 cm long in an adult
The trachea
C-shaped rings of _______compose the trachea; they help to maintain its shape and prevent its collapse during respiration.
hyaline cartilage
are at an oblique position in the mediastinum and enter the lungs at the hilum.
Both bronchi
The ______is shorter and more vertical than the left main bronchus, making aspirated objects more likely to enter the right lung than the left.
right main bronchus
The bronchi and trachea represent _____in the respiratory system, where air is transported but no gas exchange takes place.
“dead space”
the trachea and bronchi are lined with mucous membranes containing_____. These hair-like projections help sweep dust, foreign bodies, and bacteria that have been trapped by the mucus toward the mouth for removal.
cilia
The bronchi repeatedly bifurcate into smaller passageways known as ______.
bronchioles
Eventually the bronchioles terminate at the alveolar ducts, and air is channeled into the alveolar sacs, which contain the
alveoli
The ____ are two cone-shaped, elastic structures suspended within the thoracic cavity
lungs
The apex of each lung extends slightly above the clavicle. The base is at the level of the _____.
diaphragm
At the point of the mid-clavicular line on the anterior surface of the thorax, the lung extends to approximately the
sixth rib
Laterally lung tissue reaches the level of the
eighth rib
posteriorly the lung base lies at about the
tenth rib
Anteriorly the horizontal fissure separating the right upper lobe from the middle lobe extends from the ____ in the right mid-axillary line to the ______or _____ at the ______.
fifth rib, third intercostal space - fourth rib,right sternal border
Posteriorly oblique fissures extend on both the right and left lungs from the level of T3 to the ____ at the
sixth rib, mid-clavicular line.
In the healthy adult, during deep inspiration the lungs extend down to about the ______ anteriorly and the ____ posteriorly
eighth intercostal space anteriorly, twelfth intercostal space posteriorly.
During expiration, the lungs rise to the _____anteriorly and ____posteriorly
fifth or sixth intercostal space, tenth
The thoracic cavity is lined by a thin, double-layered serous membrane referred to as the
pleura
The ____ line the chest cavity, and the ____ covers the external surfaces of the lungs.
parietal pleura, visceral pleura
The ___ lies between the two pleural layers.
pleural space
____ is accomplished through contraction of the diaphragm.
Vertical expansion
occurs as intercostal muscles lift the sternum and elevate the ribs, resulting in an increase in anteroposterior diameter.
Horizontal expansion
As a result of this enlargement of the chest cavity, a slight negative pressure is created in the lungs in relation to the atmospheric pressure, resulting in an inflow of air into the lungs. This process, called
inspiration
is mostly passive in nature and occurs with relaxation of the intercostal muscles and the diaphragm. As the diaphragm relaxes, it assumes a domed shape. The resultant decrease in the size of the chest cavity creates a positive pressure, forcing air out of the lungs.
Expiration
change according to cellular demands— often without awareness on the part of the individual. Such involuntary control of respiration is the work of the medulla and pons, located in the brainstem.
Breathing patterns
the strongest stimulus to breathe is an increase of carbon dioxide in the blood ____
hypercapnia
A decrease in oxygen _____ also increases respiration but is less effective than a rise in carbon dioxide levels.
hypoxemia
continuous coughing
smoker’s cough
Blood in the sputum
hemoptysis
Nasal flaring is seen with labored respirations (especially in small children) and is indicative of
hypoxia
Client leans forward and uses arms to support weight and lift chest to increase breathing capacity, referred to as the
tripod position
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
Unequal fremitus is usually the result of _____ (which increases fremitus) or bronchial obstruction, air trapping in emphysema, pleural effusion, or _____ (which all decrease fremitus).
consolidation, pneumothorax
Unequal chest expansion can occur with severe ______ (collapse or incomplete expansion)
atelectasis
____ is the percussion tone elicited over normal lung tissue
Resonance
Adventitious lung sounds, such as _____ (formerly called rales) and ____ (formerly called rhonchi)
crackles, wheezes
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
configuration results in a more horizontal position of the ribs and costal angle of more than 90 degrees. This often results from long-standing emphysema.
Barrel-chest
High. Harsh or hollow. Loud. Short during inspiration, long in expiration. Trachea and thorax
Bronchial
Moderate. Mixed. Moderate. 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 in inspiration, short in expiration. 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.
Crackles (fine)
Low-pitched, bubbling, moist sounds that may persist from early inspiration to early expiration; also described as softly separating Velcro.
Crackles (coarse)
of pulmonary fibrosis are heard louder and closer to stethoscope, usually do not change location, and are more common in clients with long-term COPD.
Velcro rales
Low-pitched, dry, grating sound; sound is much like crackles, only more superficial and occurring during both inspiration and expiration.
Pleural friction rub
High-pitched, musical sounds heard primarily during expiration but may also be heard on inspiration.
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 (sonorous)
is a harsh, honking wheeze with severe broncholaryngospasm, such as occurs with croup.
Stridor
