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Nurs 203 > Thorax and Lungs assessment > Flashcards

Thorax and Lungs assessment Flashcards

1
Q

The Thoracic Cage

  • How many ribs
  • Where do they attach
  • What are  Costochondral junctions and intercostal spaces
  • What kind of cavity is the thorax
  • What does it surround and what are the components
A

Ribs- 12 pairs:

  • 1-7 attach directly to sternum via cartilage
  • 8-10 attach indirectly to sternum via cartilage
  • 11-12 do NOT attach to the sternum (floating ribs)
  • Costochondral junctions– where ribs & costal cartilage join
  • Intercostal spaces- spaces between the ribs (each intercostal space is numbered by the rib below it)

The thorax is a closed cavity

The thoracic ‘cage’ surrounds this cavity
Important components include:
-Sternum
-Ribs
-Vertebrae
-Diaphragm
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2
Q

Vertebrae

  • How many are there
  • what does it support
A
  • 12 thoracic vertebrae

- Lumbar supports the stress on lower back

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3
Q

Diaphragm

  • What is it
  • What kind of muscle and what does it separate
A
  • Floor of thoracic cavity

- Dome-shaped muscle that separates the thoracic & abdominal cavities

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4
Q

Anterior thoracic bony landmarks

-What are the 4 significant landmarks

A
  1. Suprasternal notch
  2. Sternum
  3. Sternal Angle
  4. Costal Angle
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5
Q

 Suprasternal notch

-describe it

A

U-shaped depression above the sternum

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6
Q

Sternum (breastbone) 3 parts:

A

Manubrium (below notch)
Body
Xiphoid Process

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7
Q

Sternal Angle (a.k.a. Angle of Louis):

  • Where does it articulate
  • Where it is located
  • what are the two spots it marks
A

Articulation of manubrium + sternal body

Between 2nd ribs

Marks:

  • Site of tracheal bifurcation into right & left main bronchi
  • Upper border of atria of heart
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8
Q

Costal Angle:

  • Where does it angle
  • What is the usual degree and when is it abnormal (what is it called)
A

1.Angle where right & left costal margins meet at xiyphoid process

  1. Usually 90° or less
    - Increases when rib cage is chronically overinflated (i.e. emphysema)
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9
Q

Posterior thoracic landmarks

  • What is the difficulty to palpate compared to the anterior
  • what are the four landmarks
A

Can be more difficult to palpate due to muscles & soft tissues surrounding landmarks

Significant landmarks include:

  1. Vertebra Prominens
  2. Spinous Processes
  3. Inferior border of scapula
  4. Twelfth rib
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10
Q

Vertebra Prominens

  • Spinous process of
  • Where is it best felt
  • If you feel two what could it be
A

 At base of neck, head flexed, most prominent bony protrusion

If you feel 2 equally prominent bumps: upper= C7, lower= T1

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11
Q

Spinous Processes

  • How does it project
  • What do you count
  • What is it aligned to
A

Count down each spinous process

Align with the same numbered ribs only down to T4
-After that they angle downward & overlie the vertebral body & rib below

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12
Q

Inferior Border of the Scapula:

  • Located how
  • Where is the lower tip
  • What is it important for
A

Located symmetrically

Lower tip is usually at the level of the 7th-8th rib

Important to know when auscultating

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13
Q

12th Rib

-How do you palpate it

A

 Palpate midway between the spine & the pt’s side to find the free tip

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14
Q

References Lines ANT chest

  • What are the lines for
  • name the 3 lines
A

 Use reference lines to pinpoint findings vertically on the chest

Midsternal- runs down the center of the sternum
Midclavicular- runs down the centre of the clavicle (typically close to the nipple)
Anterior Axillary- extends down from the anterior axillary fold

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15
Q

Reference Lines: POSTERIOR Chest

-Name the two

A

 Vertebral- runs down the center of the vertebral column

 Scapular- extends through the inferior angle of the scapula when arms are at the sides of the body

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16
Q

Reference Lines: LATERAL Chest 3

A

 Anterior Axillary- extends down from the anterior axillary fold
 Posterior Axillary – extends down from the posterior axilla fold
 Midaxillary- runs down from the apex of the axilla & lies between & parallel to the other 2 lines

17
Q

Sections of the Thoracic Cavity: 3

A

1) Mediastinum– contains the esophagus, trachea, heart, and great vessels
2) Right Pleural Cavity– contains right lung
3) Left Pleural Cavity– contains left lung
- Separate, so if one lung gets blocked other lung would still work

18
Q

Lung Borders:

Name the 2 and their 3 components where they’re located

A

2) Apex:
1) Anterior chest: 3-4 cm above clavicles
2) Posterior chest: C7
3) Laterally: Apex of

Axilla

3) Base:
1) Anterior chest: 6th rib midclavicular line
2) Posterior chest: T10-T12
3) Laterally: 7-8th rib

19
Q

The Lungs: ANTERIOR

  • What lobes are mostly there
  • What are the lobes the lungs are divided into
  • Lengths?
  • What should be noted
A

Anterior is mostly UPPER and MIDDLE lobes

Left lung- 2 Lobes:

  • LUL= Left Upper Lobe
  • LLL= Left Lower Lobe
  • Narrower than the right d/t the heart

Right lung- 3 lobes:

  • RUL= Right Upper Lobe
  • RML= Right Middle Lobe
  • RLL= Right Lower Lobe
  • Shorter than the left d/t the liver

Note locations of fissures

20
Q

The Lungs: POSTERIOR

  • Posterior is mostly?
  • What can you auscultate 2 and where are they located
A

Posterior is mostly LOWER lobes

UPPER Lobes: T1-T3
LOWER Lobes: T3-T10(exp.) or T12 (insp.)
-Middle lobe does NOT project onto the posterior chest at all

21
Q

The Lungs: POSTERIOR

  • Mostly what lobes 2
  • What can you auscultate and where are they located
  • What lobe does not project into the post. Chest
A

Posterior is mostly LOWER lobes

UPPER Lobes: T1-T3
LOWER Lobes: T3-T10(exp.) or T12 (insp.)

Middle lobe does NOT project onto the posterior chest at all

22
Q

The Lungs: LATERAL Right

-What lobes and where is it located 3

A

Right UPPER lobe- Apex down to the horizontal fissure at the 5th rib (midaxilla)

Right MIDDLE lobe- Horizontal fissure (down and anteriorly) towards the 6th rib (midclavicular)

Right LOWER lobe- 5th-8th rib (midaxilla)

23
Q

The Lungs: LATERAL Left

-What lobes and where are they located

A

 Left UPPER lobe- Apex to 5th rib (midclavicular)

 Left LOWER lobe- Extends to 8th (lateral) – or 7th

24
Q

The lungs

-What are the three important points

A

 The left lung has NO middle lobe
 The anterior chest contains mostly middle & upper lobes (with very little lower lobe)
 The posterior chest contains almost all lower lobe

Nurs 203 (15 decks)

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