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SRNAHealthAssessment > Thorax and Lungs > Flashcards

Thorax and Lungs Flashcards

1
Q

*****Suprastrenal Notch

A

Marks MIDPOINT OF TRACHEA

Optimal placement end of ET tube

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2
Q 
Sternal angle 
Starts with
Useful for counting to down
Localized findings \_\_\_\_\_
****What does the sternal angle Mark?
where dos it lie? 
Corresponds to \_\_\_\_\_\_\_\_\_\_\_
A 
Angle of Louis
Starts with 2nd rib
• Useful for counting to down 10th
• Localize findings horizontally
***** Marks TRACHEA BIFURCATION 
• Lies@levelofT4–T5
• Corresponds to upper border atria
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3
Q

*****What is the normal costal angle?

Disease state with increase costal angle?

A

Costal Angle normally <90° • >90° in emphysema

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4
Q

*****Spinous Processes

A

T1 – T4 align w/ same numbered ribs • T5 on - processes angle downward aligning w/ rib below

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5
Q

**Scapula Inferior Border •

lower tip at ________

A

Lower tips @ rib 7 or 8

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6
Q

*****Lines of reference

A

Midsternal Line
• Midclavicular Line
• Anterior Axillary Line

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7
Q

**Right lung____lobes and left lung ____lobes

A

3 lobes; 2 lobes

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8
Q

*****Reference lines cont’d

A

Vertebral Line
• Aka “mid-spinal line”
Scapular Line
• Extends thru inferior angle of scapula when arms are at the sides

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9
Q

*****Anterior Axillary Line

A

Extends down from anterior axillary fold

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10
Q

*****Midaxillary Line

A

• Extends down from axillary apex

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11
Q

**Posterior Axillary Line

A

• Extends down from post. Axillary fold

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12
Q
  • ***Lung Borders : Base

* ***Lung Borders :Apex

A

Rests on Diaphragm @ 6th rib midclavicular line

Extends 3-4 cm above inner 3rd clavicle

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13
Q

**Lobes Oblique fissures

A
  • cross 5th rib midaxillary

* Terminate @ 6th rib midclavicular

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14
Q

**Horizontal fissurea

A

Extends from 5th rib midaxillary up to 4th rib

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15
Q

***Thoracic Cavity - Posterior C7 marks ___

A

marks apex of lungs

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16
Q

**Thoracic Cavity - Posterior T10 marks ____

A

marks Bases of lungs

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17
Q

** Deep inspiration expands down to

A

T12

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18
Q

*****Upper lobes

• The rest is all Lower lobes

A

T1 – T3/T4

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19
Q

**2 Skeletal deformities limit thoracicc age excursion

A

• Scoliosis, Kyphosis

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20
Q

**AP:Transverse=__ indicates

A

1:1 • Barrel chest/horizontal ribs=chronic

Emphysema

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21
Q

**Hypertrophic Neck muscles

A

=COPD

** Cyanosis/Pallor/SkinLesions

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22
Q

**Tripod Position

A

COPD

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23
Q 
Posterior chest
****Check for \_\_\_\_\_\_
*****Place hands with \_\_\_\_\_\_@ what level ?
******Then do what?
****Unequal expansion indicates what?
FMPP
A

Symmetrical Expansion
THUMBS @T9
PINCH SMALL FOLD OF SKIN between thumbs

Marked atelectasis
Pneumonia
Fx ribs
Pneumothorax

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24
Q

*****Pain w/ deep breathing indicative

A

Pleuritis

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25
Q

***Check for palpable vibrations known as
ask the patient to do
WHAT PART OF THE HAND DO YOU USE?

A

• Check for Tactile Fremitus (palpable vibrations)
USE BALL OF HAND or ULNAR EDGE
Ask pt. to repeat “ninety-nine”
Resonant phrase generates strong vibrations

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26
Q

**Decreased Fremitus = (POPE) (4)

A

Pleural effusion
Obstructed bronchus
Pneumothorax,
Emphysema

27
Q

**Increased Fremitus =

A

consolidation – lobar pneumonia

28
Q

**Rhonchal fremitus =

A

thick bronchial secretions

29
Q

****Crepitus = Indicats 2

A

palpable crackling w/ air in Sub-Q space (SubQ Emphysema) or S/P open thoracic surgery

30
Q

-

A

too much air

Emphysema
Pneumothorax

31
Q 
*****Dull note means 
4 conditions (TAPP)
A

abnormally dense

• Pneumonia
• Pleural effusion
- Atelectasis
• Tumor

32
Q

If theres no excursion means

A

pleural effusion or atelectasis of lower lobes

33
Q

*****Normally 3 types of sounds: (breath)

A
  • Bronchial (“Tracheal”) B (short ins than exP)
  • Bronchovesicular BV (same)
  • Vesicular V (Periphery) insp longer than ex
34
Q

**Decreased breath sounds due to

FOMSE

A 
DECREASED:
 Obstructed Bronchial tree 
• Fb
• Mucous plug 
• Secretions
Emphysema
• Lungs already hyperinflated =decreases noise
35
Q

**For DECREASED breath sounds OTHER obstruction to sound can be because of

A

Pleurisy/pleural thickening
• Air (pneumothorax)
• Fluid (pleural effusion)

36
Q

**Adult avg chst excursion

A

3-5 cm

37
Q

**INCREASED breath sounds include

CCP :

A

INCREASED: Consolidation
Pneumonia
Compression (fluid in intrapleural space)

38
Q

**Adventitious Sounds Crackles “rales”

A

Fine–high pitched popping–not cleared by coughing.
• Stiimulate sound by rolling strand of hair b/t fingers near ear
• Or moisten thumb & index finger & separate them near your ear
• Course crackles – (opening a Velcro fastener)

39
Q

**Pleural Friction Rub –

A

coarse & low pitched, 2 pieces of leather

• Rubbed together close to ear

40
Q

**Wheeze (Rhonchi)

A
  • High pitched, musical squeaking – air squeezes thru constricted airway • Asthma if ONE EXPIRATION , OBSTRUCTION if on INSPIRATION
  • Low pitched – musical snoring, moaning • Obstruction
41
Q

**Stridor –CEO

A

High pitched, inspiratory, crowing •
CROUP
EPIGLOTITS
OBSTRUCTION

42
Q

Normal voice transmission through chest wall is

A

soft, muffled, indistinct

43
Q

**Pathology causes normal voice transmission to be

A

• Makes words/sounds Louder, Clear and Distinct

44
Q

***Hypertrophic abd. Muscles can indicate

A

chronic emphysema

45
Q

*** Strained/Tired face

A

COPD

46
Q

*****Drowsiness

A

Cerebral hypoxia

47
Q

** Clubbing distal fingers can indicate

A

Chronic Resp. Ds.

48
Q

***Cutaneous ANGIOMAS on chest can indicate

A

liver ds / portal HTN

49
Q

**Unequal expansion can indicate

A

obstructed or collapsed lung

50
Q

***Accessory being muscles used can indicate

A

acute airway obstruction / massive atelectasis

51
Q

***During anterior exam ______lag indicates

A

Expansion lag indicates

• atelectasis, pneumonia

52
Q

***marks apex of lungs

A

Posterior C7

53
Q

***Marks bases of lungs

A

Posterior T10

54
Q

***Lungs extend from_____down to ______

A

Axilla Apex down to 7th rib

55
Q

**Avoid percussing

A

over bone

56
Q

**Pleural friction fremitus indicates

A

pleural inflammation

57
Q

**What should be the DEPTH OF PERCUSSION

A

5-7 cm

58
Q

****LESION _________wide are ________

A

<2-3cm are NOT DETECTABLE BY PERCUSSION

59
Q

**What do you do to DETERMINE diaphragm excursion

A

PERCUSSION

60
Q

**You percuss to do What

A

Determine diaphragm excursion

61
Q

**Anterior Chest
______Chest for _______
Use _______along _______

A

Palpate CHEST FOR symmetric expansion

THUMBS; Costal margins

62
Q

***what is a normal Ex time?

A

4 seconds

63
Q

***Force exp > ______= ___Disease, what do you do ?

A

6 seconds
-Obstructive
Refer for PFTs

64
Q

**C7 is the

A

VERTEBRA PROMINENS

SRNAHealthAssessment (20 decks)

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