Thorax and Lungs Flashcards
upper airway is
frontal sinuses to epiglottis
lower airway is
larynx and vocal cords to lungs
anterior reference lines
posterior reference lines
lateral reference lines
infant respiratory development
continuation of alveolar development
respiratory rate is higher
second-hand smoke can cause asthma, respiratory infections, and ear infections
pregnancy respiratory development
elevation of diaphragm
relaxation of chest ligaments=circumference of chest cage by 6 cm
increased tidal volume
older adult respiratory development
calcification of cartilage
thorax is less mobile
decrease muscle strength
less elasticity in lungs
skeletal changes
what is the most common chronic disease in children
asthma
respiratory health history questions
Cough, sputum production
Shortness of breath (when does that occur)
Wheezing, snoring
Chest pain with breathing
Orthopnea
History of respiratory infections
Smoking history
TB exposure or testing
CXR and why
Environmental exposure
Self-care behaviors
what are risk factors for respiratory problems
obesity
sedentary
genetics
surgical patients
inspection during assessment
shape and configuration of chest wall (90 degrees)
AP to transverse diameter (AP/Lateral…1:2)
respirations
use of accessory muscles, retractions (can see intercostal spaces) (should be no use of accessory muscles or retraction)
position of patient (relaxed)
level of consciousness
skin color and condition
facial expression
what are abnormal findings configurations of the thorax
Barrel chest
Pectus excavatum
Pectus carinatum
Scoliosis
Kyphosis
barrel chest
normal chest- 1:2
barrel chest- 1:1
pectus carinatum (pigeon chest)
pectus excavatum
abnormal findings respiratory patterns
Sigh- emotional dysfunction
Tachypnea
Bradypnea
Hyperventilation
Hypoventilation
Cheyne-Stokes respiration
Biot’s respiration
what is tachypnea
shallow and fast
respirations >24
can be caused by exercise, fever, pneumonia, low hemoglobin
bradypnea
shallow and slow
respirations<10
can be caused by narcotics, sedatives, diabetic coma
what is hyperventilation
fast deep breaths
can be caused by fever, anxiety, extreme exertion, diabetic ketoacidosis, increase of co2 and decrease of o2
hypoventilation
slow deep breaths
can be caused by overdose of narcotics or anesthesia
what is cheyne-stokes respiration
The pattern involves a period of fast, shallow breathing followed by slow, heavier breathing and moments without any breath at all, called apneas.
what is biot’s respiration
regular breathing pattern all the sudden becoming apnea (usually caused by brain injury)
symptoms of hypoxia
early:
restlessness
anxiety
tachycardia/tachypnea
late:
bradycardia
extreme restlessness
dyspnea (severe)
symptoms of hypoxia in peds
feeding difficulty
inspiratory stridor
nares flare
expiratory grunting
sternal retractions
what do you feel for when you palpate the chest wall
crepitus (due to leaking air) and chest tenderness
what to look for with tactile fremitus
vibration
(have them say “99”)
where are vesicular breath sounds heard best
at the base
what are adventitious lung sounds
abnormal
what are some discontinuous lung sounds
crackles (fine and course)
atelectactic
what are some continuous lung sounds
wheeze- sibilant
wheeze- sonorous rhonchi
stridor
pleural friction rub
how to assess egophony
have patient say “e” (sounds like “a”)
how to assess bronchophony
have patient say “99” (sounds like “99” clearly-normal is muffled)
how to assess whispered pectoriloquy
have patient whisper “1, 2, 3” (sounds like “1, 2, 3” clearly- normal is muffled)
assessment of common conditions
normal
pneumonia
asthma
pleural effusions (fluid)…heart failure, pneumonia
pneumothorax (hole in lung)
