thorax and lungs

Question 1

what is the angle of louis

Answer 1

sternal angle adjacent to 2nd rib

Question 2

inferior angle of scapula lies at what rib

Answer 2

rib 7

Question 3

how many lobes does the right and left lung have

Answer 3

right has 3 lobes: RUL, RML, RLL

left has 2 lobes: LUL, LLL

Question 4

where is the best place to auscultate the LLL

Answer 4

posteriorly

Question 5

where is the best place to auscultate the right middle lung

Answer 5

anteriorly: lower right aspect of chest

Question 6

where is the best place to auscultate the RLL

Answer 6

lateral side of chest and posterior

Question 7

where does the apex of the lung lie

Answer 7

2-4 cm above the clavicle

Question 8

what does the lower border of the lungs fall

Answer 8

• 6th rib midclavicular line
• 8th rib midaxillary line
• T10 posterior

Question 9

major oblique fissure of lungs

Answer 9

divides each lung in half

Question 10

minor (horizontal) fissure

Answer 10

• Right lung only
• runs close to 4th rib

Question 11

at what level does the trachea bifurcate

Answer 11

level of the sternal angle anteriorly or T4 posteriorly

Question 12

what are you inspecting for when looking at the chest

Answer 12

• body habitus
  
  • A-P diameter, symmetry
• skin
  
  • lesions, color
• breathing pattern
  
  • rate, chest expansion, effort
  • signs of distress
    
    • retractions
    • audible sounds

Question 13

how do you check chest expansion

Answer 13

1. place thumbs at level of 10th ribs, your fingers parallel to lateral rib cage
2. slide hands medially
3. ask patient to inhale deeply
4. make note of how far your thumbs diverge as the thorax expands

Question 14

technique for palpation of chest

Answer 14

• use pads of fingers and/or palm to press with moderate firmness
• purpose: checking for
  
  • masses
  • tender areas

Question 15

areas for percussion and auscultation on posterior chest

Answer 15

Must hit lateral site on each site as well

Question 16

locations for chest percussion and auscultation on anterior chest

Answer 16

** must hit 3 levels anteriorly

Question 17

emphysematous lungs or a pneumothorax will give what percussion tone, intensity, pitch, and duration

Answer 17

• tone: hyper-resonant
• intensity: very loud
• pitch: low
• duration: long

Question 18

healthy lungs give what will give what percussion tone, intensity, pitch, and duration

Answer 18

• percussion tone: resonant
• intensity: loud
• pitch: low
• duration: long

Question 19

gastric bubble will give what percussion tone, intensity, pitch, and duration

Answer 19

• percussion tone: tympanic
• intensity: loud
• pitch: high
• duration: moderate

Question 20

percussing over the liver will give what percussion tone, intensity, pitch, and duration

Answer 20

• percussion tone: dull
• intensity: soft-moderate
• pitch: moderate-high
• duration: moderate

Question 21

percussion over muscle will give what percussion tone, intensity, pitch, and duration

Answer 21

• percussion tone: flat
• intensity: soft
• pitch: high
• duration: short

Question 22

how does the pitch change when moving from higher up in lung anatomy (trachea) to lower (vesicular)

Answer 22

pitch moves from high to low when listening to trachea, bronchial, bronchovesicular, and vesicular areas

Question 23

inspiration to expiration ratio when listening to tracheal, bronchial, bronchovesicular, and vesicular lung sounds

Answer 23

• tracheal 1:1
• bronchial: 1:3
• bronchovesicular: 1:1
• vesicular 3:1

Question 24

how does the intensity of the lung sound change from moving from tracheal -> vesicular

Answer 24

• tracheal: very loud
• bronchial: loud
• bronchovesicular: moderate
• vesicular: soft

Question 25

location of lung sounds:

tracheal

bronchial

bronchovesicular

vesicular

Answer 25

• tracheal: over trachea in neck
• bronchial: over manubrium
• bronchovesicular: ant: 1st and 2nd interspaces; post: interscapular
• vesicular: most of both lung fields