Thorax And Lungs

Question 1

What is aspiration?

Answer 1

When something enters the bronchi that shouldn’t be there

Question 2

How many lobes does the left lung have?

Have many lobes does the right lung have?

Answer 2

2 lobes

3 lobes

Question 3

What is pleuritis?

Answer 3

When there is no lubricant between the visceral and parietal pleura

Question 4

What type of pressure is responsible for keeping the lungs inflated?

Answer 4

Negative pressure

Question 5

What is the Angle of Louis and why is it important?

Answer 5

Landmark of the 2nd rib and where the trachea meets the bronchi

Question 6

What is the different between the right and left bronchi?

Answer 6

The right bronchi is thicker and shorter; the left bronchi is thinner

Question 7

Which ribs attach to the sternum?

Answer 7

Ribs 1-7

Question 8

Which ribs form the costal angle?

Answer 8

Ribs 7, 8, 9, 10

Question 9

Which nerve innervates the diaphragm?

Answer 9

The phrenic nerve

Question 10

How is the costal angle affected by emphysema?

Answer 10

Can be larger than 90 degrees

Question 11

What is the vertebra prominens?

Answer 11

The most bony sour protruding at the base of the neck

Question 12

What is the mediastinum?

Answer 12

The middle section of the thoracic cavity containing the esophagus, trachea, heart, great vessels

Question 13

Which lung is shorter and why?

Answer 13

The right lung because of the liver

Question 14

What is PEEP?

Answer 14

Positive end exploratory pressure. 5 cm of water pressure

Question 15

Where is the trachea located and what is its function?

Answer 15

In front of the esophagus. It transports air to the bronchi

Question 16

Where is the primary site of gas exchange?

Answer 16

Alveoli

Question 17

What is a pneumothorax?

Answer 17

Collapse of a lung - can be partial or full

Question 18

Is the review of systems subjective or objective data?

Answer 18

Subjective

Question 19

What should you check for when inspecting the general appearance?

Answer 19

Glaring nostrils, supraclavicular retractions, agitated/restless

Question 20

What are early signs of respiratory distress?

Answer 20

Tachypnea, use of accessory muscles, trying to achieve prone position, minor drop in O2 saturation, fast HR, mouth breathing

Question 21

What should you inspect for?

Answer 21

Cyanosis, nails for clubbing, sputum, capillary refill

Question 22

What is central cyanosis?

Answer 22

Circumoral blueness. Mouth, tongue, lips, buccal membrane

Question 23

What is peripheral cyanosis?

Answer 23

Cyanosis in the extremities

Question 24

What is emphysema?

Answer 24

When the lungs become boggy and have trouble pushing the air out after inspiration

Question 25

What is kyphosis/lordosis/scoliosis?

Answer 25

“Hump back” or abnormal convexity of the spine/abnormal concavity of the lower spine/curvature of the spine

Question 26

How do you check the configuration and contour of the thorax?

Answer 26

Check the anterior to posterior diameter | 2 measurements of this should equal 1 across the chest

Question 27

How does COPD affect the structure of the lungs?

Answer 27

In severe COPD, pts get air trapped in lungs and it pushes the rib caged out Become barrel caged

Question 28

What is pectus excavatum?

Answer 28

When the chest appears caved-in or sunken

Question 29

What is pectus carinatum?

Answer 29

When the chest bulges out and has a birdlike appearance

Question 30

What is apnea?

Answer 30

Lack of breathing

Question 31

What is hyperventilation/tachypnea?

Answer 31

Breathing fast; RR >20

Question 32

What is Kussmaul's breathing?

Answer 32

Fast breathing, smells sweet, DKA

Question 33

What is hypoventilation/respiratory depression?

Answer 33

RR <8; not blowing off all CO2

Question 34

What is Cheyne Stokes breathing?

Answer 34

Dying sigh/irregular breathing

Question 35

What should you palpate the trachea for?

Answer 35

Make sure it's midline

Question 36

What should you palpate the thorax for?

Answer 36

Crepitus/tenderness/tactile fremitus (99)

Question 37

What is crepitus?

Answer 37

Subq emphysema

Question 38

What is chest wall excursion?

Answer 38

Putting thumbs in the xiphoid process and watching to make sure both sides rise and fall at the same time

Question 39

What is pleural effusion?

Answer 39

An area of fluid

Question 40

What is pneumonia?

Answer 40

An infectious consolidation

Question 41

Through what do solids travel better?

Answer 41

Solids

Question 42

In what conditions can you find increased tactile fremitus?

Answer 42

Solid conductions | Pneumonia, tumor, pulmonary fibrosis

Question 43

In what conditions can you find decreased tactile fremitus?

Answer 43

Pleural effusion (fluid), pneumothorax, COPD

Question 44

During percussing, when do you hear dullness

Answer 44

Consolidation, atelectasis, pleural effusion

Question 45

During percussing, when do you hear hyper-resonance?

Answer 45

Pneumothorax, emphysema, asthma

Question 46

What do vesicular breathing sounds sound like?

Answer 46

Soft and low pitched | Fine rustling/swishing sound

Question 47

When are vesicular breathing sounds heard?

Answer 47

On inspiration continuously without pause until expiration | Over all posterior lung fields and anterior peripheral fields

Question 48

What do bronchial breathing sounds sound like?

Answer 48

Loud and high pitched Tubular quality Expiration louder than inspiration

Question 49

When are bronchial sounds heard?

Answer 49

Only anteriorly over trachea and larynx

Question 50

What are bronchovesicular breath sounds?

Answer 50

A combination of vesicular and bronchial sounds

Question 51

What are bronchovesicular sounds made of?

Answer 51

Produced by vibrations of bronchial and alveoli vibrations

Question 52

Where are bronchovesicular sounds heard best?

Answer 52

1/2 ICS, posteriorly between the scapula

Question 53

When are decreased breath sounds heard?

Answer 53

Shallow breathing, pleural effusion, COPD, pneumothorax, asthma, atelectasis

Question 54

When are increased breath sounds heard?

Answer 54

Consolidation-tumor, pneumonia

Question 55

How are crackles produced?

Answer 55

By air passing through fluid in air spaces (CHF, pneumonia) | Usually on inspiration

Question 56

What are rhonchi?

Answer 56

Deeper, rumbling sounds; low pitched, snoring quality

Question 57

What is the etiology of rhonchi?

Answer 57

Larger airways are obstructed with mucus or tumor | Clears with coughing

Question 58

What is wheezing?

Answer 58

High pitched, musical, whimsical sounds | Decrease in bronchioles or bronchi

Question 59

How is wheezing produced?

Answer 59

Produced by a narrow airway

Question 60

What is stridor?

Answer 60

Increased musical wheeze heard over the trachea on inspiration Medical emergency

Question 61

What is a friction (pleural) rub?

Answer 61

Coarse, dry, grating sound | Sounds liken cupping hand over the ear and scratching the back of the hand

Question 62

What is the etiology of a friction rub?

Answer 62

Inflamed pleural surfaces rub

Question 63

How do you differentiate between friction rub and cardiac origin?

Answer 63

Have them hold their breath; if it continues, it's cardiac in origin. If it stops, it's lung origin

Question 64

What is characteristic of a normal broncophony sound?

Answer 64

Muffled sound | Abnormal: hear a clear "99"

Question 65

What is characteristic of a normal whispered pectoriloquay?

Answer 65

No noise or very faint | Abnormal: hear "99"

Question 66

What is characteristic of a normal egophony?

Answer 66

"E" | Abnormal: A