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Nurs 252 > Thorax And Lungs > Flashcards

Thorax And Lungs Flashcards

1
Q

What is the stimulus to breathe

A

Increase in CO2 (hypercapnia)

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2
Q

When do we do an acute assessment

A

-shortness of breath
-decreased O2 sat
-asthma attack
-pulmonary complications
-pulmonary embolism

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3
Q

Acute SOB assessment

A

-lungs auscultation
-simultaneously give O2, inhalers, reposition

-fatigue limits, base of lungs
-ask minimal questions: allergies, meds, pulmonary condition, trauma

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4
Q

What does the thoracic cage consist of

A

Sternum, 12 pairs of ribs, 12 thoracic vertebrae adn the diaphragm

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5
Q

(Anterior thorax landmark or posterior thorax landmark) the suprasternal notch

A

Anterior thorax

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6
Q

(Anterior thorax landmark or posterior thorax landmark) the twelfth rib

A

Posterior thorax

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7
Q

(Anterior thorax landmark or posterior thorax landmark) sternum

A

Anterior thorax

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8
Q

(Anterior thorax landmark or posterior thorax landmark) the sternal angle (angle of Louis)

A

Anterior thorax

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9
Q

(Anterior thorax landmark or posterior thorax landmark) vertebra promineus

A

Posterior thorax

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10
Q

(Anterior thorax landmark or posterior thorax landmark) Spinous processes

A

Posterior thorax

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11
Q

(Anterior thorax landmark or posterior thorax landmark) inferior border of the scapula

A

Posterior thorax

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12
Q

(Anterior thorax landmark or posterior thorax landmark) the costal angle

A

Anterior thorax

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13
Q

On the anterior chest use the

A

Midsternal and midclavicular lines

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14
Q

On the posterior chest use the

A

Vertebral and scapular lines

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15
Q

On the lateral chest use the

A

Anterior axillary and posterior axillary and mid axillary lines

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16
Q

Mediastinum

A

The middle section of the thoracic cavity
-contains: esophagus, trachea, heart and great vessels

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17
Q

What contains the lungs?

A

The right and left pleural cavities
-either side of the mediastinum

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18
Q

The apex of the lungs lies

A

3 or 4 cm above the inner third of clavicles

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19
Q

The base rests on the

A

Diaphragm
-about the firth intercostal space in the right midclavicular line and at the sixth rib in the left midclavicular line

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20
Q

Laterally the lungs extend form the

A

Apex of the axilla to the seventh or eighth rib

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21
Q

Posteriorly ___ marks the apex

A

C7

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22
Q

what usually corresponds to the base?

A

T10

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23
Q

The base descends to

A

T12

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24
Q

Right lung versus the left lung

A

Right- shorter, three lobes
Left- narrower, two loves

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25
Q

Lobes are separated by ___ that run ___

A

Fissures that run obliquely

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26
Q

Tactile fremitus

A

Using palmar surface of hand to feel for vibrations (air moving through lung tissue)

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27
Q

Pleurae

A

Forms an envelope between the lungs and the chest

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28
Q

Pleural cavit contains

A

A few milliliters of lubricating fluid

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29
Q

The cavity normally has a

A

Vacuum that holds the lungs tightly against the chest

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30
Q

The lubricating fluid prevents

A

Friction

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31
Q

The trachea lies anterior to the

A

Esophagus

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32
Q

Right bronchus versus the left bronchus

A

Right- shorter, wider, more vertical than left

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33
Q

Bronchial tree

A

Protects the alveoli from small particulate matter using mucus and cilia

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34
Q

Four major functions of respiratory system

A

-supplies oxygen
-removes carbon dioxide
-maintains homeostasis
-maintain heat exchange

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35
Q

The respiratory system develops in utero but does not function until

A

Brith

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36
Q

During pregnancy the growing uterus elevates the diaphragm by

A

4 cam

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37
Q

Suprasternal notch

A

Hollow u shaped depression just above the sternum, imbetween the clavicles

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38
Q

Sternum

A

Contains three parts: manubrium, body, xiphoid
-contains the manubriosternal angle

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39
Q

Manubriosternal angle

A

Part of the manubrium of the sternum
-walk fingers down until you feel a distinct bony ridge

40
Q

Sternal angle

A

Angle of Louis
-continuous with the second rib
-helpful to start counting ribs

41
Q

The angle of Louis also marks the

A

Tracheal bifurcation into the right/left main bronchi

42
Q

Costal angle

A

Right/left costal margins from an angle where they meet at the xiphoid process
-90 degrees or less

43
Q

Vertebra prominens

A

Start at the base of your neck, flex your head and feel fo rate most prominent bony protrusion there
-this is C7
-if there are two bony prominens, the upper one is C7, lower is T1

44
Q

Spinous processes

A

Spinous process align with their same numbered ribs only down to T4
-after T4 angle downward from their vertebral bodies

45
Q

Inferior border of the scapula

A

These are located symmetrically in each hemithorax
-lower tip is usually at the level of the seventh or eight rib

46
Q

Twelfth rib

A

Palpate midway between the spine and patients side to identify the free tip of the twelfth rib

47
Q

Chest reference lines

A

Midsternal line (imbetween both clavicles), midclavicular line (center of each clavicle), anterior axillary line (end of clavicle)

48
Q

Reference lines of the posterior chest wall

A

Vertebral line (down the spine), scapular line (extends through inferior angle of scapula when arms are at the side)

49
Q

Reference lines of the lateral chest

A

-anterior axillary line (extends down form anterior axillary fold)
-posterior axillary line (down from posterior axillary fold)
-midaxillary line (down from apex of axilla, parallel to other two)

50
Q

Acinus

A

Functional respiratory unit that consist of the bronchioles, alveolar ducts, alveolar sacs and alveoli

51
Q

Hypercapnia vs hypoxemia

A

Hypercapnia- increase of carbon dioxide in the blood (the normal stimulus to breathe)

Hypoxemia- decrease of oxygen in the blood (also increases respirations but is less effective)

52
Q

Surfactant

A

Complex liquid substance needed for sustained inflation of air sacs
-at 32 weeks there is a sufficient amount

53
Q

When does the respiratory system begin function

A

At birth

54
Q

Prenatal exposure to cigarettes can cause

A

-chronic hypoxia
-low birth weight
-sensitized fetal brain to nicotine (inc risk of addition at a later age)

55
Q

Postnatal exposure to tobacco smoke

A

-otitis media
-sudden infant death syndrome
-lower respiratory tract infections
-asthma

56
Q

An enlarging uterus elevates the diaphragm how many cm?

A

4 cm

57
Q

Physiologic dyspnea

A

An increased awareness of the need to breathe
-pregnancy
-not associated with cough, wheezing or exercise

58
Q

What reduces the mobility of the thorax?

A

The costal cartilage becomes calcified and decrease in elastic properties within the lungs (more rigid)

59
Q

In older adults there is a increase in small airway closure, and this causes

A

-Decreased vital capacity (maximum amount of air exhaled after maximum filling)

-increased residual volume (amount of air remaining in lungs after forceful expiration)

60
Q

Hemoptysis

A

Coughing up blood

61
Q

Orthopnea

A

Shortness of breath associated with a position
-supine piston

62
Q

Paroxysmal nocturnal dyspnea

A

Awakening in the night unable to breathe, and Alicia ting this by changing position (sitting upright)

63
Q

Important to note the ___ the patient takes the breathe

A

Position

64
Q

Assessing ___ color and condition may assist with amount of oxygen patient is receiving

A

Skin

65
Q

Symmetrical expansion

A

Placing hands on the posterolateral chest wall, with your thumbs at level of T9/10
-as patient breathes hands should move symmetrically

66
Q

Shortness of breath symptoms in babies

A

Headbobbing, suprasternal, intercostal contractions, abdominal breathing, subcostal

67
Q

Shortness of breath symptoms

A

1-2 word answers, panting, tripod position, I CANT BREATHE

68
Q

Initial assessment (acute)

A

Loss of consciousness, skin color (cyanosis = hypoxemia), rhythm, RR,

69
Q

Intital assessment (chronic)

A

Clubbing, chest wall changes

70
Q

Palpation

A

-symmetry (size, shape, expansion)
-lesions, lumps, masses
-subcutaneous emphysema
-tactile fremitus

71
Q

Subcutaneous emphysema

A

Air trapped under skin, bubbly feeling
-leak in the system (injury, surgery, chest tube)

72
Q

Tactile fremitus

A

Palpable Vibration of chest wall
-sound thru lung tissue

73
Q

Lung consolidation

A

Increases risk of fremitus
-air in healthy lung replaced with something else
-increased density

74
Q

Hyper resonance in lungs

A

More air than should be

75
Q

Dull sound in lungs

A

Fluid in lungs, consolidation

76
Q

Bronchiovesicular

A

Even intake and output
-found around sternum, and upper spinal processes on back

77
Q

Bronchial

A

Shorter intake, longer outtake
-anterior neck region around trachea

78
Q

Vesicular

A

Long intake, short outtake
-around lung area p/a

79
Q

Adventitculous sounds

A

-crackles (fine, coarse)
-wheezes
-rhonchi

80
Q

When are crackles normal?

A

After laying down/napping
-alvolectic crackles (alveoli popping back open)

***disapears after a couple breaths

81
Q

Asthma is heard

A

In both lungs q

82
Q

Pregnant women

A

Costal angle increases, rib injury —>

83
Q

Resonance

A

Low pitched, clear hollow sound
-healthy lung tissue

84
Q

Chest physiotherapy

A

Encourages breakup and movement of lung secretions
-for sticky secretions
-cystic fibrosis

85
Q

Kyphosis

A

Outward curvature of the thoracic spine

86
Q

Pectins excavatum vs carinatum

A

Excavatum - sunken sternum

Carinatum- forward protrusion

87
Q

Decreased tactile fremitus

A

Any obstructs transmission of vibrations

88
Q

Increased tactile fremitus

A

Increased density of lung tissue
-better conduction for vibrations

89
Q

Pleural friction fremitus

A

Inflammation of parietalor visceral pleura
-coarse grating sound when rubbing together

90
Q

Atelectasis

A

Collapsed or shrunken section of the alveoli as a result of airway obstruction

91
Q

Lobar pneumonia

A

Infection of the lung parenchyma leaves alveolar membrane edema and porous, full of fluid, bacteria, RBC and WBC

92
Q

Emphysema

A

Destruction of pulmonary connective tissue
-enlargement of air sacs

93
Q

Pleural effusion

A

Collection of excess fluid in trapleural space

94
Q

Pneumothorax

A

Partial or complete lung collapse due to free air in the pleural space

95
Q

Acute respiratory distress syndrome

A

Acute pulmonary insult damages alveolar capillary membrane

96
Q

Acute respiratory distress syndrome

A

Acute pulmonary insult damages alveolar capillary membrane

Nurs 252 (13 decks)

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