Thorax And Lungs Flashcards
The thoracic cage includes?
Sternum, clavicle anteriorly, scapulae and 12 vertebrae posteriorly, and 12 pair of ribs
Function of upper airway?
Warms, moisturizes, and transport air to lower respiratory tract
Thoracic cavity includes?
Heart, lungs, thymus, distal part of trachea, and most of esophagus
What arteries supply blood to the chest?
Thoracic artery, subclavian artery, brachial artery and ancillary artery
Each lung has pulmonary arteries that supplies?
Deoxygenated blood for gas exchange
Spinous process of T1 usually correlates with?
First rib
Lower tip of scapula correlates with?
The 7th and 8th rib
Midsternal line
Center of the sternum
Midclavicular line
Extends down from the clavicle halfway between the sternoclavicular and acromioclavicular joints
Anterior Axillary line
Extends from the top of the axillary fold when the arms are at the side
Vertebral line
Lies over the center of the spinous processes of the vertebrae
Scapular line
Originates from the inferior angle of the scapula and is parallel to the vertebrae line
Posterior axillary
Drops from the apex of the axilla and parallel to anterior axilla line
Each rib is divided almost in half by what?
an oblique fissure that runs from 6th rib MCL anteriorly to the T3 spinous process posteriorly
How many lobes are in the left and right lung?
Right has three and left has two
Horizontal fissure
Divides the upper and middle lobes of the lungs
The right upper lobe and the right middle lobe is the same size as the?
Left upper lobe
The left lung is narrower than the right because?
The location of the heart on the left displaces lung tissue
Base
Refers to the very bottom of lung fields
Apex
Very top of lung
Lungs should be auscultation from?
Apex to base
Anteriorly, the apex of the lung extends approximately?
2-3 cm above inner third of clavicle
The base of lung rest on the?
Diaphragm at the 6th rib MCL and the 8th rib midaxillary
Posteriorly, apex is near C7 and base is at T10
Three rib spaces below inferior tip of the scapula
The right main bronchus is _______ compared to the left?
Shorter, wider and more vertical
The trachea and bronchioles contain how much dead space?
150 mL
The structure of the right bronchus make sit more susceptible to when an endotracheal tube is inserted ?
Aspiration and intubation if an endotracheal tube is inserted too far
Narrowed bronchioles may lead to?
Wheezing
Why do breath sounds differ in trachea and bronchi?
Trachea is much larger and has wider airways
As the airways narrows, sounds become?
Softer, finer and more difficult to auscultate
Alveoli
Primary units In lungs that absorb oxygen and excrete carbon dioxide
When fluid fills the alveoli, what can be heard?
Fine crackles
Excessive fluid in the alveoli may lead to?
Airway collapse and decreased breath sounds
Visceral pleura
Lines the lungs
Parietal pleura
Lines the thoracic wall, mediastinum, and diaphragm
The pleural space does what?
Lubricates two surfaces, seals lungs open with negative pressure
The main trigger for breathing?
Increased carbon dioxide in the blood, decreased oxygen or increased acidity
Approximately how much air enters the lung in each breath?
500-800 mL
Pregnant women
Lower ribs flare as fetus grows
Tidal volume increases
What does the fetus depend in for oxygen exchange?
The placenta
When does surfactant production begin?
32 weeks gestation
After the umbilical cord is cut, what does the baby do?
Take first breath
The chest in the newborn is round and consistent with what?
The size of the head up to the age of two
In older adults, decreased function of cilia leads to?
Pooling of secretions
How are the alveoli affected in older adults?
Less elastic and more rigid, and lungs may become “stiff”, respiratory strength decreases
If the patient has an acute shortness of breath, immediate assessments include?
Respiratory rate, pulse, blood pressure and oxygen saturation
Condition vs. Auscultation
Asthma
Wheezes
Condition vs. Auscultation
Atelectasis
diminished lung sounds in lower lobe
Condition vs. Auscultation
Bronchitis
occasional wheezing or fine crackles
Condition vs. Auscultation
COPD
Wheezes
Condition vs. Auscultation
Pneumonia
Wheezes, crackles or gurgles
Condition vs. Auscultation
CHF
Absent bases
Condition vs. Auscultation
Pleural Effusion
Absent over affected lung
Condition vs. Auscultation
Pulmonary Embolism
Clear or mild wheezes
Asthma
allergic hypersensitivity to allergens that produce broncho spasm
wheezes, mostly exhalation
Atelectasis
collapsed section of alveoli from immobility, obstruction, compression, or decreased surfactant
Emphysema
destruction of pulmonary capillary bed and alveoli creating large air sacs and bullae
barrel chest, cough, shortness of breath
Bronchitis
inflammation of bronchi that stimulate mucous glands. secretions may partially obstruct the airway
occasional wheezes, or fine crackles
Lobar pneumonia
alveoli become congested with bacteria and white cells causing consolidation
Pleural effusion
collection of fluid in the intrapleural space that compresses the lung tissue
pneumothorax or hemothorax
collapsed or blood filled lung
CHF
fluid overload and pulmonary congestion
TB
slow growing mycobacterium that may form lesions or cavities in the lung
Pulmonary embolism
blood clot in the lungs that causes shunting of the blood to atelactatic area
Flail chest
when multiple ribs are fractured, paradoxical movements of the chest may occur
Pectus Carinatum (pigeon chest)
sternum is depressed anteriorly, depressing the adjacent costal cartilages
Pectus Excavatum
funnel chest, depression in lower part of and adjacent to sternum. may compress heart and cause murmurs
Biot’s respiration
irregular rhythm, severe brain damage
Cheyne-stokes respiration
normally in children and elderly, also terminal illness, renal failure, overdose, increased cranial pressure, heart failure
hypoventilation
rate below 10 bpm narcotic or anesthetic overdose, increased intracranial pressure
bradypnea
rate below 10 bpm narcotic overdose, diabetic coma, increased intracranial pressure
hyperventilation
rate greater than 24 extreme anxiety or fear, exercise, increased intracranial pressure
Children begin to use their intercostal muscles to breathe by what age?
6 to 7
nasal flaring is common in newborns because?
nose is often congested
crepitus around clavicles in newborn arises concern because?
may indicate pneumothorax, especially following forceps delivery
acrocynosis
cyanosis of hands and feet
APGAR scoring system measures?
Heart rate, respiratory effort, relfex irritability, color
vesicular
sounds are soft, low pitched and found over fine airways near the site of exchange
bronchovesicular
sounds are found over major bronchi that have fewer alveoli
bronchial
sounds are loud, high pitched, and found over the trachea and neck
