Thorax and Lungs Flashcards
the manubriosternal angle is
a. the articulation of the manubrium and the body of the sternum
b. a hollow U shaped depression just above the sternum
c. Also known as the breastbone
d. a term synonymous with costochondral junction
A
select the correct description of the left lung
a. narrower than the right lung with 3 lobes
b. narrower than the right lung with 2 lobes
c. wider than the right lung with two lobes
d. shorter than the right lung with 3 lobes
B
you assess a patient who reports a cough. the characteristic timing of the cough of chronic bronchitis is described as
a. continuous throughout the day
b. productive cough for at least 3 months of the year for 2 consecutive years
c. occurring in the afternoon or evening because of exposure to irritants at work
d. occurring in the early morning
B
which of the following assessments best confirms symmetric chest expansion
a. placing hands on the posterolateral chest wall with thumbs at level of t9 or t10 and then sliding the hands up to pinch a small fold of skin between the thumbs
b. inspection of the shape and configuration of the chest wall
c. placing the palmar surface of the fingers of one hand against the chest and having the person repeat the words “ninety-nine”
d. percussion of the posterior chest
A
you are auscultating breath sounds on a patient. which of the following best describes how to proceed?
a. hold the bell of the stethoscope against the chest wall, listen to the entire right field and then the entire left field
b. hold the diaphragm of the stethoscope against the chest wall, listen to one full respiration in each location, being sure to do side to side comparisons
c. listen from the apices to the bases of each lung field using the bell of the stethoscope
d. select the bell or diaphragm, depending on the quality of sounds heard, listen for one respiration in each location, moving from side to side
B
select the best description of bronchiovesicular breath sounds
a. high-pitched, of longer duration on inspiration than expiration
b. moderate pitched, inspiration equal to expiration
c. low pitched inspiration greater than expiration
d. rustling sound, like the wind in the trees
B
apex
3 to 4 cm above the inner third of the clavicles
base
rests on the diaphragm
lateral left
sixth rib, midclavicular line
lateral right
fifth intercostal
posterior apex
c7
normal chest
elliptic shape with an anteroposterior to transverse diameter in the ratio of 1:2
barrel chest
anterioposterior=transverse diameter
precuts excavatum
sunken sternum and adjacent cartilages
precuts carinatum
forward protrusion of the sternum with ribs sloping back at either side
scoliosis
lateral s shaped curvature of the thoracic and lumbar spines
kyphosis
exaggerated posterior curvature of thoracic spine
on examining a patient’s nails, you note that the angle of the nail base is >160 degrees and that the nail base feels spongy to palpation. these findings are consistent with:
a. acute respiratory distress syndrome
b. normal findings for the nails
c. congenital heart disease and COPD
d. atelectasis
C
on auscultating a patient, you note a coarse, low-pitched sound during both inspiration and expiration. this patient reports pain with breathing. these findings are consistent with:
a. fine crackles
b. wheezes
c. atelectatic crackles
d. pleural friction rub
D
to use the technique of ego phony, ask the patient to:
a. take several deep breaths and then hold for 5 seconds
b. say ‘eeeeee’ each time the stethoscope is moved
c. repeat the phrase “ninety-nine” each time the stethoscope is moved
d. whisper a phrase as auscultation is performed
B
when examining for tactile fremits, it is important to:
a. ask the patient to breathe quickly
b. ask the patient to cough
c. palpate the chest symmetrically
d. use the bell of the stethoscope
C
pulse oximetry measures:
a. arterial oxygen stauration of hemoglobin
b. venous oxygen saturation of hemoglobin
c. combined saturation of arterial and venous blood
d. carboxyhemoglobin levels
A
a pleural friction rub is best detected by
a. observation
b. palpation
c. auscultation
d. percussion
C
a patient has a barrel-shaped chest, characterized by
a. equal anteroposterior transverse diameter and ribs being horizontal
b. anteroposterior transverse diameter of 1:2 and an elliptic shape
c. anteroposterior transverse diameter of 2:1 and ribs being elevated
d. anteroposterior transverse diameter of 3:7 and ribs sloping back
A
after examining a patient, you note: fever, increased respiratory rate, chest expansion decreased on eft side, dull to percussion over left lower lobe, breath sounds louder with fine crackles over left lower lobe. these findings are consistent with
a. bronchitis
b. asthma
c. pleural effusion
d. lobar pneumonia
D