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thorax and lungs Flashcards

1
Q

T7-8

A

interspace for thoracentesis

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2
Q

floating ribs

A

rib 11 and 12

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3
Q

articulate with costal cartilage above them

A

rib 8, 9, and 10

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4
Q

manubrium of sternum

A

attached to sternum

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5
Q

suprasternal notch

A

notch on top of the manubrium

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6
Q

xyphoid process

A

on the end of the sternum

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7
Q

right lung has how many lobes

A

3

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8
Q

left lung has how many lobes

A

2

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9
Q

apex of lungs found where

A

above clavicles

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10
Q

c7 and t1

A

landmarks

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11
Q

Five “A”s

A 
Ask about tobacco use
Advise to quit
Assess willingness
Assist to quit
Arrange follow-up and support
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12
Q

*Angle of Louis

A

sternal angle that joins the manubrium and sternum

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13
Q

Dyspnea

A

shortness of breath

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14
Q

*Wheezing

A

a continuous, course,whistling sound produced in the respiratory airways during breathing. Wheezes suggest narrowed airways, as in asthma, COPD, or bronchitis.

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15
Q

cough

A

a reflex response to stimuli that irritate receptors in the larynx, trachea, or large bronchi

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16
Q

hemoptysis

A

the expectoration of blood (or blood stained sputum) from the bronchi, larynx, trachea, or lungs

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17
Q

parasthesias

A

sensations of tingling or “pins and needle” around the lips or extremities

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18
Q

Hyperventilation

A

rapid, shallow breathing

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19
Q

How to assess breathing

A

Rate - total number in one minute
Rhythm - cadence, regular vs. irregular
Depth - observed volume of air
Effort - objective measure of stress

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20
Q

*Fremitus

A

palpable vibrations felt on the human body

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21
Q

Lung Resonation

A

on percussion the note like sound that are measures by intensity, pitch, and duration in order to objectively determine the lungs volume of air

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22
Q

*Crackles

A

Also called rales. Intermittent and brief explosive breath sounds. Usually leads to the Dx of cardiac or pulmonary conditions. Suggest abnormal lung tissue. Crackles may be from abnormalities of the lungs (pneumonia, fibrosis, early congestive heart failure) or of the airways (bronchitis, bronchiectasis)

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23
Q

*Rhonchi

A

a low-pitched breath sound with snoring quality. Rhonchi suggest secretions in large airways.

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24
Q

Normal Breathing

A

Normal Breathing 12 - 20 in adults

44 in infants

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25
Q

Slow breathing

A

Bradypnea

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26
Q

Bradypnea

A

Slow breathing. May be secondary to such causes as diabetic coma, drug induced respiratory depression, and increased intracrainal pressure.

27
Q

Sighing Respiration

A

Breathing punctuated by frequent sighs should be alert you to the possibility of hyperventilation syndrome - a common cause of dyspnea and dizziness. Occasional sighs are normal.

28
Q

Rapid Shallow Breathing

A

Tachypnea

29
Q

Tachypnea

A

Has a number of causes, including restrictive lung disease, pleuritic chest pain, and an elevates diaphragm

30
Q

Periods of deep breathing alternate with periods of apnea

A

Cheyne-Stokes Breathing

31
Q

Obstructive Breathing

A

Expiration is prolonged because narrow airways increase the resistance to airflow

32
Q

Causes of Obstructive breathing

A

Asthma, chronic bronchitis and COPD

33
Q

What rib does the Angle of Louis articulate with

A

rib 2

34
Q

2nd intercostal space

A

used during needle decompression for tension pneumothorax

35
Q

4th - 6th intercostal space

A

used for chest tube insertion

36
Q

Posterior Landmarks

A

c7 & t1; 12th rib; inferior tip of scapula (leads to the 7th rib)

37
Q

Pleximeter finger

A

Middle finger of your non-dominate hand. The finger that is struck during percussion.

38
Q

Plexor finger

A

The striking finger during percussion. Middle of your dominate hand.

39
Q

Chest expansion

A

Check chest expansion at the 10th rib

40
Q

bronchophony

A

Ask pt to say “99”. Normal sound is muffled and indistinct.

41
Q

egophony

A

ask pc to say “ee”. Normal is a muffled EE. Abnormal is a “ay” sound

42
Q

whispered pectoriloquy

A

Ask Pt to whisper “99”. You should not be able to hear it well.

43
Q

Number of auscultation fields

A

14 posterior fields

12 anterior fields

44
Q

Leading cause death preventable

A

Smoking

45
Q

Flu Shot Immunizations

A

For healthy people between 5 - 49 years
Two types
inactive vaccine
nasal spray containing a live virus

46
Q

General techniques : lungs & thorax

A
  1. Examine posterior while px is sitting & arms are folded. If px cannot sit then roll the px from one side to the other in the supine position slide 35
  2. Examine anterior while px is supine.
  3. IAPP
47
Q

Stridor

A

High pitched wheeze most likely from airway obstruction in the larynx or trachea

48
Q

AP diameter

A

AP diameter anteroposterior diameter

49
Q

AP diameter of chest

A

May increase with age, or COPD

50
Q

Auscultation of chest

A

Listen for

  1. sounds generated by breathing
  2. adventitious sounds
  3. if abnormalities are present listen to the transmitted sounds as the px speaks
51
Q

The px should breath via their _____ during auscultation

A

mouth

52
Q

Normal breathing sounds : Vesicular

A

soft and low pitched; usually heard over most of both lungs

53
Q

Normal breathing sounds : Bronchial

A

louder and higher in pitch; usually heard over the manubrium

54
Q

Normal breathing sounds : Bronchovesicular

A

intermediate intensity and pitch;

usually heard over the 1st and 2nd interspaces

55
Q

Test chest expansion from ___ rib

A

the 10th

56
Q

When percussing the lower posterior you should stand somewhat to the ____ rather than directly behind

A

side

57
Q

When comparing two percussion’s

A

Use the same percussion technique in both areas

58
Q

Five percussion notes

A 
Flatness - thigh
dullness - liver
resonance - healthy lung
hyperresonance - not normal, COPD lung
tympany - gastric air bubble, puffed cheek
59
Q

Percussion of the anterior chest - heart

A

the heart normally produces an area of dullness to the left of the sternum from the 3rd to 5th intercostals

60
Q

Palpation 4 potential uses

A
  1. Identification of tender areas
  2. Assessment of observed abnormalities
  3. Further assessment of chest expansion
  4. Assessment of tactile fremitus
61
Q

“Walk test”

A
  1. assesses the pulmonary function
  2. ask the px to walk 8 feet at patients pace, repeat and note a faster time
  3. normal 3.1 seconds; geriatrics 5.6 seconds
  4. Observe px rate; effort; breathing sounds
62
Q

Forced expiratory time

A

Test for COPD
use diaphragm of stethoscope over trachea;
time duration of audible expiration;
get 3 readings;
norm >8 seconds;
>60 y/old w/time of 6 - 8 seconds are twice as likely to have COPD
*Ask the patient to take a deep breath in and then breathe out as quickly and completely as possible with mouth open. Listen over the trachea with the diaphragm of a stethoscope and time the audible expiration. Try to get three consistent readings, allowing a short rest between efforts if necessary.

63
Q

Identification of fractured rib

A

Posterior/anterior compression;
squeeze palms on sternum and thoracic spine;
Rule out fracture vs. soft injury
With one hand on the sternum and the other on the thoracic spine, squeeze the chest. Is this painful, and where?

64
Q

Crackles wheezes or Rhonchi clears with cough with this infection

A

Bronchitis

advanced health assessment (13 decks)

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