Thorax and lungs Flashcards
Movement of air back and forth from the alveoli to the outside
environment.
o Gas exchange across the alveolar-pulmonary capillary membranes.
o Circulatory system transport of oxygen to, and carbon dioxide from, the
peripheral tissues?
RESPIRATION
Chest or thorax, a cage of bone, cartilage, and muscle?
Sternum
o Manubrium
o Xiphoid process
o Twelve pairs of ribs connected to the thoracic vertebrae and to the
sternum by the costal cartilages
Primary muscles of respiration
?
Diaphragm
Increase the anteroposterior chest diameter during inspiration
?
External Intercostal muscle
Increase the anteroposterior chest diameter during inspiration?
External Intercostal muscle
The diaphragm is the principle muscle of respiration
o However, the scalene & intercostal muscles assist the
diaphragm…their contraction creates a taller & wider thorax. o The lung exhales passively due to relaxation of the diaphragm & intrinsic
elastic recoil?
MUSCLE OF RESPIRATION
the diaphragm descends and accessory muscles swing ribs
up & out to increase CHEST VOLUME?
INSPIRATION
as the lung was expanding, its elastic tissue was stretched. When the diaphragm relaxes, the lung tissue recoils, and the alveoli
collapse some which raises the airway pressure above atmospheric, so air
flows out of the lung?
EXPIRATION
Primary muscles of respiration: Decrease the transverse chest diameter during expiration?
INTERIOR INTERCOSTAL MUSCLE
Primary muscles of respiration: Brought into play when there are pulmonary problems and
compromise?
STERNOCLEIDOMASTOID AND TRAPEZIUS MUSCLE
The_____ and elastic connective tissue together form the
fibroelastic membrane, a flexible membrane that closes the posterior surface of
the trachea, connecting the C-shaped cartilage?
TRACHEALIS MUSCLE
branches from the tertiary bronchi. Bronchioles, which are about
1 mm in diameter, further branch until they become the tiny terminal
bronchioles, which lead to the structures of gas exchange?
BRONCHIOLE
or respiratory tree) is the collective term used for these
multiple-branched bronchi. The main function of the bronchi, like other
conducting zone structures, is to provide a passageway for air to move into and
out of each lungs?
BRONCHIAL TREE
An ___ is a tube composed of smooth muscle and connective tissue, which opens into a cluster of alveoli?
ALVEOLAR DUCT
An____ is one of the many small, grape-like sacs that are attached to the
alveolar ducts?
ALVEOLUS
An ___ is a cluster of many individual alveoli that are responsible for
gas exchange?
ALVEOLAR SAC
It refers to the magnitude of change in lung volume as a result of the
change in pulmonary pressure?
LUNG COMPLIANCE
Peripheral clues may suggest pulmonary or cardiac difficulties: FINGERS
CLUBBING
Peripheral clues may suggest pulmonary or cardiac difficulties: BREATH
ODOR
Respiration:
Rate
o Quality
o Pattern
o Count rate while palpating
Peripheral clues may suggest pulmonary or cardiac difficulties: Skin, nails, and lips
CYANOSIS OR PALLOR
Peripheral clues may suggest pulmonary or cardiac difficulties: LIPS
PURSUING
Peripheral clues may suggest pulmonary or cardiac difficulties: NOSTRILS
FLARING
Normal Breathing?
12-20 breath/min and
regular
More than 20 breaths/
min and shallow. May be a normal response
to fever, anxiety, or
exercise. Can occur with
respiratory insufficiency, alkalosis, pneumonia, or
pleurisy?
Tachypnea
Less than 10 breaths/ min and regular? May be normal in well- conditioned athletes. Can
occur with medication-induced depression of
respiratory center, diabetic
coma, neurologic damage?
BRADYPNEA
Increased rate and
increased depth?
Usually occurs with
extreme exercise, fear, or anxiety. Cause by
hyperventilation include
disorders of the central
the nervous system, an
overdose of the drug
salicylate or severe
anxiety?
HYPERVENTILATION
Rapid, deep, labored A type of hyperventilation
associated with diabetic
ketoacidosis?
KUSSMAUL RESPIRATION
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
May result from severe
congestive heart failure, drug overdose, increased
intracranial pressure or
renal failure?
CHEYNE- STOKES RESPIRATION
Irregular pattern
characterized by varying
depth and rate of
respirations followed by
period of apnea
May be seen with
meningitis or severe brain
damage?
BIOT’S RESPIRATION
Significant disorganization
with irregular and varying
depths of respiration
A more extreme
expressions of biot’s
respirations indicating
respiratory compromise?
ATAXIC
Increasing difficulty in
getting breath out
In chronic obstructive
pulmonary disease air is
trapped in the lungs
during forced expiration?
AIR TAPPING
Palpable, coarse, grating vibration, usually on inspiration?
FRICTION RUB
Crackly or crinkly sensation, can be both palpated and heard
Indicates air in the subcutaneous tissue
o Rupture somewhere in the respiratory system
o Infection with a gas-producing organism?
CREPITUS
Pulsations
Tenderness
Bulges/depressions
Masses
Unusual movement/positions
Elasticity of rib cage
Immovability of sternum
Rigidity of thoracic spine?
THORACIC MUSCLES/ SKELETON
Loss of symmetry in the movement of the thumbs suggests a problem on one or
both sides?
THORACIC EXPANSION
Palpable vibration of the chest wall that results from speech or other
verbalizations Note the position of the trachea?
TACTILE FREMITUS
Auscultation with a stethoscope provides important clues to the condition of the
lungs and pleura. All sounds can be characterized in the same manner as the percussion notes?
INTENSITY
PITCH
QUALITY
DURATION
Characteristics of breath sounds: inspiratory sounds last longer than expiratory one?
VESICULAR
Characteristics of breath sounds: Inspiratory and expiratory sounds are about equal?
BRONCHO-VESICULAR
Characteristics of breath sounds: expiratory sounds last longer than inspiratory ones?
BRONCHIAL
Characteristics of breath sounds: Inspiratory and expiratory sounds are about equal?
TRACHEAL
Adventitious Breath Sounds: Occurs outside the respiratory tree
Dry, crackly, grating, low-pitched sound and is heard in both
expiration and inspiration
Caused by inflamed, roughened surfaces rubbing together?
FRICTION RUB
Adventitious Breath Sounds: Found with mediastinal emphysema
Variety of sounds—loud crackles, clicking and gurgling sounds are
synchronous with the heartbeat and not particularly so with
respiration?
MEDIASTINAL CRUNCH (HAMMAN SIGN)
Adventitious Breath Sounds: Abnormal respiratory sound heard more often during inspiration
and characterized by discrete discontinuous sounds
Fine: high pitched, and relatively short in duration
Coarse: low pitched, and relatively longer in duration?
Crackles (formerly called rales)
Breath sounds: Heard over the major bronchi and are typically moderate in
pitch and intensity?
BRONCHOVESICULAR
Adventitious Breath Sounds: Deeper, more rumbling, more pronounced during expiration, more
likely to be prolonged and continuous, and less discrete than
crackles. Caused by the passage of air through an airway obstructed by
thick secretions, muscular spasm, new growth, or external
pressure?
Rhonchi (sonorous wheezes)
Adventitious Breath Sounds: Continuous, high-pitched, musical sound (almost a whistle) heard
during inspiration or expiration
Caused by a relatively high-velocity airflow through a narrowed or
obstructed airway
May be caused by the bronchospasm of asthma (reactive airway
disease) or acute or chronic bronchitis?
WHEEZES
Breath sounds: : Low-pitched, low-intensity sounds heard over healthy lung tissue?
VESICULAR
Breath sounds: Highest in pitch and intensity *Ordinarily heard only over the
trachea
Both bronchovesicular and bronchial breath sounds abnormal if they are heard
over the peripheral lung tissue?
BRONCHIAL
Breath sounds: o Breathing that resembles the noise made by blowing across the mouth of
a bottle
o Most often heard with a large, relatively stiff-walled pulmonary cavity or a
tension pneumothorax with bronchopleural fistula?
AMPHORIC
Breath sounds: o Sounding as if coming from a cavern
o Commonly heard over a pulmonary cavity in which the wall is rigid?
CAVERNOUS
Spoken voice transmits sounds through the lung fields that may be heard with
the stethoscope. The following auditory changes may be present in any condition that
consolidates lung tissue?
VOCAL RESONANCE
Greater clarity and increased loudness of spoken sounds?
BRONCHOPHONY
Extreme bronchophony where even a whisper can be heard clearly
through the stethoscope?
PECTORILOQUY
Intensity of the spoken voice is increased and there is a nasal
quality*e’s become stuffy broad a’s?
EGOPHONY
Thoracic Deformities and Configuration: generally refers to a broad, deep chest found on a patient. A
person with ___ will usually have a naturally large ribcage, very
round (i.e., vertically cylindrical) torso, large lung capacity, and can potentially
have great upper body streng
BARREL CHEST
Thoracic Deformities and Configuration: is a congenital
chest wall deformity in which several ribs and the sternum grow abnormally, producing a concave, or caved-in, appearance in the anterior chest wall?
Pectus excavatum, also known as sunken or funnel chest
Thoracic Deformities and Configuration: is a malformation of the chest
characterized by a protrusion of the sternum and ribs. It is distinct from the
related malformation pectus excavatum?
Pectus carinatum, also called PIGEON CHEST
Thoracic Deformities and Configuration: is a sideways curvature of the spine that occurs most often during the
growth spurt just before puberty. While scoliosis can be caused by conditions
such as cerebral palsy and muscular dystrophy, the cause of most scoliosis is
unknown?
SCOLIOSIS
Thoracic Deformities and Configuration: is a spinal disorder in which an excessive outward curve of the spine
results in an abnormal rounding of the upper back. The condition is sometimes
known as “round back” or—in the case of a severe curve—”hunchback”?
KYPHOSIS
