Thorax And Lungs Flashcards
What is aspiration?
When something enters the bronchi that shouldn’t be there
How many lobes does the left lung have?
Have many lobes does the right lung have?
2 lobes
3 lobes
What is pleuritis?
When there is no lubricant between the visceral and parietal pleura
What type of pressure is responsible for keeping the lungs inflated?
Negative pressure
What is the Angle of Louis and why is it important?
Landmark of the 2nd rib and where the trachea meets the bronchi
What is the different between the right and left bronchi?
The right bronchi is thicker and shorter; the left bronchi is thinner
Which ribs attach to the sternum?
Ribs 1-7
Which ribs form the costal angle?
Ribs 7, 8, 9, 10
Which nerve innervates the diaphragm?
The phrenic nerve
How is the costal angle affected by emphysema?
Can be larger than 90 degrees
What is the vertebra prominens?
The most bony sour protruding at the base of the neck
What is the mediastinum?
The middle section of the thoracic cavity containing the esophagus, trachea, heart, great vessels
Which lung is shorter and why?
The right lung because of the liver
What is PEEP?
Positive end exploratory pressure. 5 cm of water pressure
Where is the trachea located and what is its function?
In front of the esophagus. It transports air to the bronchi
Where is the primary site of gas exchange?
Alveoli
What is a pneumothorax?
Collapse of a lung - can be partial or full
Is the review of systems subjective or objective data?
Subjective
What should you check for when inspecting the general appearance?
Glaring nostrils, supraclavicular retractions, agitated/restless
What are early signs of respiratory distress?
Tachypnea, use of accessory muscles, trying to achieve prone position, minor drop in O2 saturation, fast HR, mouth breathing
What should you inspect for?
Cyanosis, nails for clubbing, sputum, capillary refill
What is central cyanosis?
Circumoral blueness. Mouth, tongue, lips, buccal membrane
What is peripheral cyanosis?
Cyanosis in the extremities
What is emphysema?
When the lungs become boggy and have trouble pushing the air out after inspiration
What is kyphosis/lordosis/scoliosis?
“Hump back” or abnormal convexity of the spine/abnormal concavity of the lower spine/curvature of the spine
How do you check the configuration and contour of the thorax?
Check the anterior to posterior diameter
2 measurements of this should equal 1 across the chest
How does COPD affect the structure of the lungs?
In severe COPD, pts get air trapped in lungs and it pushes the rib caged out
Become barrel caged
What is pectus excavatum?
When the chest appears caved-in or sunken
What is pectus carinatum?
When the chest bulges out and has a birdlike appearance
What is apnea?
Lack of breathing
What is hyperventilation/tachypnea?
Breathing fast; RR >20
What is Kussmaul’s breathing?
Fast breathing, smells sweet, DKA
What is hypoventilation/respiratory depression?
RR <8; not blowing off all CO2
What is Cheyne Stokes breathing?
Dying sigh/irregular breathing
What should you palpate the trachea for?
Make sure it’s midline
What should you palpate the thorax for?
Crepitus/tenderness/tactile fremitus (99)
What is crepitus?
Subq emphysema
What is chest wall excursion?
Putting thumbs in the xiphoid process and watching to make sure both sides rise and fall at the same time
What is pleural effusion?
An area of fluid
What is pneumonia?
An infectious consolidation
Through what do solids travel better?
Solids
In what conditions can you find increased tactile fremitus?
Solid conductions
Pneumonia, tumor, pulmonary fibrosis
In what conditions can you find decreased tactile fremitus?
Pleural effusion (fluid), pneumothorax, COPD
During percussing, when do you hear dullness
Consolidation, atelectasis, pleural effusion
During percussing, when do you hear hyper-resonance?
Pneumothorax, emphysema, asthma
What do vesicular breathing sounds sound like?
Soft and low pitched
Fine rustling/swishing sound
When are vesicular breathing sounds heard?
On inspiration continuously without pause until expiration
Over all posterior lung fields and anterior peripheral fields
What do bronchial breathing sounds sound like?
Loud and high pitched
Tubular quality
Expiration louder than inspiration
When are bronchial sounds heard?
Only anteriorly over trachea and larynx
What are bronchovesicular breath sounds?
A combination of vesicular and bronchial sounds
What are bronchovesicular sounds made of?
Produced by vibrations of bronchial and alveoli vibrations
Where are bronchovesicular sounds heard best?
1/2 ICS, posteriorly between the scapula
When are decreased breath sounds heard?
Shallow breathing, pleural effusion, COPD, pneumothorax, asthma, atelectasis
When are increased breath sounds heard?
Consolidation-tumor, pneumonia
How are crackles produced?
By air passing through fluid in air spaces (CHF, pneumonia)
Usually on inspiration
What are rhonchi?
Deeper, rumbling sounds; low pitched, snoring quality
What is the etiology of rhonchi?
Larger airways are obstructed with mucus or tumor
Clears with coughing
What is wheezing?
High pitched, musical, whimsical sounds
Decrease in bronchioles or bronchi
How is wheezing produced?
Produced by a narrow airway
What is stridor?
Increased musical wheeze heard over the trachea on inspiration
Medical emergency
What is a friction (pleural) rub?
Coarse, dry, grating sound
Sounds liken cupping hand over the ear and scratching the back of the hand
What is the etiology of a friction rub?
Inflamed pleural surfaces rub
How do you differentiate between friction rub and cardiac origin?
Have them hold their breath; if it continues, it’s cardiac in origin. If it stops, it’s lung origin
What is characteristic of a normal broncophony sound?
Muffled sound
Abnormal: hear a clear “99”
What is characteristic of a normal whispered pectoriloquay?
No noise or very faint
Abnormal: hear “99”
What is characteristic of a normal egophony?
“E”
Abnormal: A
