Thorax and Lungs Flashcards
How many pairs of ribs are there
12
ribs 1-7
Directly to sternum
ribs 8-10
costal carilage
ribs 11-12
Floating
What is the viphoid process used to for
NG tubes
What should the costal angle be
<90
Who has >90 costal angles
Pregnant, obese
What allows the chest to expan
costal cartilage
Where do you start listening for lung sounds on the anteror
Under the clavical
Which lobes do you hear on the anterior side
Upper
Where will you hear crackles the most
Lower lobes
Which lobes do you hear more on the posterior side
Lower
What could it mean if a patient could point to their chest pain
Pulmonary embolism
What should you ask your pt about their cough
PRODUCTIVE, CACO
What should you ask about your pts SOB
Describe the dyspnea and at what extent they get SOB
What do you need to ask your pt about their smoking history
Do you CURRENTLY of have you EVER smoked cigareetes, vape pens, ect.
Tell me about the changes of younger kids lungs
SMALLER, IMMATURE, more VULNERABLE to disease, SECONDHAND smoke, NOSE breathing till 3 MONTHS, can’t HANDLE illness
Tell me about the changes of older peoples lungs
Decreased MUSCLE strength, RIGID, less ALVEOLI, post OP COMPLICATIONS, slow RECOVERY, INCREASED AP DIAMETER (normal finding)
What do you need when listening to lungs
Stethoscope and alcohol wipes
What is the order of assessment for lungs
Inspect, palpation, ausculation
What is the difference between tachypnea and hyperventilation
Rapid, and rapid and deep
What is intercostal muscle retractions
Muscles go in when pt breathes in
Where will you see muscle retraction for respirations in pediatrics and adults
ABDOMINAL and NECK
What does using accessory muscles lead to
Increasing the work of breahting for the patient, TIRED
What should you tell your pt to do if they are panick breathing
EXPAND their BELLY
What are the causes of bradypnea
Opioids, HEAD injury
What are the cuases of tachypnea
SEPSOS, INFECTION, ACIDOSIS, COPD
What are the causes of apnea
OBESITY, SMOKING, NARROWED airway, SLEEP apnea
What is the signs of orthopnea
SOB when LAYING down
What are the causes of orthopnea
HEART FAILURE, they sleep in RECLINERS
What are the causes of hyperventilation
ANXIETY attacks, exterme EXERTION, FEAR
What are Cheyne-strokes
Periods of inspiration and expiration with periods of APNEA
What are the causes of cheyne-stokes
END of life
What are kussmauls breathing
DEEP, RAPID breathin caused by DIABETIC KETOACIDOSIS
What does AP stands for
anteroposterior, front to back
What should the diameters be
AP LESS than transverse diameter
What does it mean if the AP is bigger than the transverse
COPD, BARREL chest
What is the normal AP diameter ratio
1:2
What is barrel chest associated with
Normal aging and COPD
What age does scoliosis happen
Young
What age does kuphosis happen
Old, HUNCH back
Where to look for cyanosis in darker skin people
ORAL mucose or NAIL beds
What can asymmetric expansion mean
BAD: PNEUMONIA, PNEUMOTHORAX, plaural EFFUSION, chest INJURY
What is tactile fremitus
NP skill, feels DULL extra AIR or FLUID
How to auscultate the lungs
Breathe through the MOUTH, on the SKIN, FIRMLY, FULL RESPIRATION
What can be some confusing sounds when listening to lungs
EXAMINER’S breathing, TUBING bumping, pt SHIVERING, HAIRY chest (press HARDER or WET hair), GOWN
What are bronchial sound
High, harsh, hollow, NECK
What are bronchovesicular sounds
Moderate, mixed, middle upper
What are vasicular sounds
Low, rustling, off to the sides
Tell me about fine crackles
High pitched, THIN secretions, heart FAILURE, PNEUMONIA, CF
Tell me about coarse crackles
VELCRO, LOW pitched, CAN NOT BE CLEARED WITH COUGHING ONLY SUCTIONING, THICK secretions, pulmonsry EDEMA, terminally ILL
Tell me about ronchi
SNORING, CAN BE CLEARED WITH COUGHING, ASTHMA, COPD, CF
What is the difference between coarse crackles and ronchi
Crackles: only SUCTIONING
Ronchi- COUGHING
Tell me about wheezing
WHALES, air SQUEEZED through compressed passageways, ASTHMA
Tell me about stridor
MEDICAL EMERGENCY (sometimes), UPPER airway obstruction, CROUP, acute EPIGLOTTITIS
