thorax and lungs Flashcards
what is the angle of louis
sternal angle adjacent to 2nd rib
inferior angle of scapula lies at what rib
rib 7
how many lobes does the right and left lung have
right has 3 lobes: RUL, RML, RLL
left has 2 lobes: LUL, LLL
where is the best place to auscultate the LLL
posteriorly
where is the best place to auscultate the right middle lung
anteriorly: lower right aspect of chest
where is the best place to auscultate the RLL
lateral side of chest and posterior
where does the apex of the lung lie
2-4 cm above the clavicle
what does the lower border of the lungs fall
- 6th rib midclavicular line
- 8th rib midaxillary line
- T10 posterior
major oblique fissure of lungs
divides each lung in half
minor (horizontal) fissure
- Right lung only
- runs close to 4th rib
at what level does the trachea bifurcate
level of the sternal angle anteriorly or T4 posteriorly
what are you inspecting for when looking at the chest
- body habitus
- A-P diameter, symmetry
- skin
- lesions, color
- breathing pattern
- rate, chest expansion, effort
- signs of distress
- retractions
- audible sounds
how do you check chest expansion
- place thumbs at level of 10th ribs, your fingers parallel to lateral rib cage
- slide hands medially
- ask patient to inhale deeply
- make note of how far your thumbs diverge as the thorax expands
technique for palpation of chest
- use pads of fingers and/or palm to press with moderate firmness
- purpose: checking for
- masses
- tender areas
areas for percussion and auscultation on posterior chest
Must hit lateral site on each site as well
locations for chest percussion and auscultation on anterior chest
** must hit 3 levels anteriorly
emphysematous lungs or a pneumothorax will give what percussion tone, intensity, pitch, and duration
- tone: hyper-resonant
- intensity: very loud
- pitch: low
- duration: long
healthy lungs give what will give what percussion tone, intensity, pitch, and duration
- percussion tone: resonant
- intensity: loud
- pitch: low
- duration: long
gastric bubble will give what percussion tone, intensity, pitch, and duration
- percussion tone: tympanic
- intensity: loud
- pitch: high
- duration: moderate
percussing over the liver will give what percussion tone, intensity, pitch, and duration
- percussion tone: dull
- intensity: soft-moderate
- pitch: moderate-high
- duration: moderate
percussion over muscle will give what percussion tone, intensity, pitch, and duration
- percussion tone: flat
- intensity: soft
- pitch: high
- duration: short
how does the pitch change when moving from higher up in lung anatomy (trachea) to lower (vesicular)
pitch moves from high to low when listening to trachea, bronchial, bronchovesicular, and vesicular areas
inspiration to expiration ratio when listening to tracheal, bronchial, bronchovesicular, and vesicular lung sounds
- tracheal 1:1
- bronchial: 1:3
- bronchovesicular: 1:1
- vesicular 3:1
how does the intensity of the lung sound change from moving from tracheal -> vesicular
- tracheal: very loud
- bronchial: loud
- bronchovesicular: moderate
- vesicular: soft
location of lung sounds:
tracheal
bronchial
bronchovesicular
vesicular
- tracheal: over trachea in neck
- bronchial: over manubrium
- bronchovesicular: ant: 1st and 2nd interspaces; post: interscapular
- vesicular: most of both lung fields
