thorax and lungs hape Flashcards
horizontal bony ridge where the manubrium joins the body of the sternum
sternal angle or the angle of Louis.
2nd intercostal space
needle insertion for decompression of a tension pneumothorax.
intercostal space
between the 4th and 5th ribs for chest tube insertion.
level of the 4th rib
for the lower margin of a well-placed endotracheal tube on a chest x-ray.
why should needles and tubes be placed only at superior rib margins?
Neurovascular structures run along the inferior margin of each rib
intercostal space between 7th / 8th rib
landmark for thoracentesis with needle insertion immediately superior to the 8th rib.
triangle of safety
an anatomical region in the midaxillary line formed by the lateral border of the pectoralis major muscle anteriorly, lateral border of the latissimus dorsi posteriorly, and the nipple line (4th or 5th intercostal space) inferiorly. This triangle represents a “safe position” for chest tube insertion.
why is aspiration pneumonia more common in the right middle and lower lobes?
because the right main bronchus is more vertical. For this same reason, if an endotracheal tube is advanced too far during intubation, it will more likely enter the right mainstem bronchus.
difference between transudate and exudate pleural effusions
may be transudates, seen in heart failure, cirrhosis, and nephrotic syndrome, or exudates, seen in numerous conditions including pneumonia, malignancy, pulmonary embolism, tuberculosis, and pancreatitis.
when does Irritation of the parietal pleura produce pleuritic pain?
with deep inspiration in viral pleurisy, pneumonia, pulmonary embolism, pericarditis, and collagen vascular diseases.
what are common or concerning symptoms during the thorax/lung exam
-Shortness of breath (dyspnea) and wheezing Cough
-Blood-streaked sputum (hemoptysis)
-Chest pain
-Daytime sleepiness, snoring and disordered sleep
what is a key component of important chronic obstructive pulmonary disease (COPD) classification systems that guide patient management.2–4
degree of dyspnea combine with spirometry
what patients may have episodic dyspnea during both rest and exercise and also hyperventilation, or rapid shallow breathing?
anxious patients
what occurs in partial lower airway obstruction from secretions and tissue inflammation in asthma, or
from a foreign body
wheezing
can signal left-sided heart failure.
cough
most common cause of cough
upper respiratory infections
when is chronic cough seen?
postnasal drip, asthma, gastroesophageal reflux, chronic bronchitis, and bronchiectasis
mucoid sputum
translucent, white, or gray and seen in viral infections and cystic fibrosis
purulent sputum
yellow or green—often accompanies bacterial pneumonia.
when is foul smelling sputum present?
anaerobic lung abscess, thick tenacious sputum in cystic fibrosis
Before using the term “hemoptysis,” try to confirm the source of the bleeding
Blood or blood-streaked material may originate in the nose, mouth, pharynx, or gastrointestinal (GI) tract and is easily mislabeled. If vomited, it probably originates in the GI tract. Occasionally, however, blood from the nasopharynx or the GI tract is aspirated and then coughed out.
Blood originating in the stomach is usually darker than blood from the respiratory tract and may be mixed with food particles.
what is reported in one in four patients with panic and anxiety disorders
chest pain
