Thorax and Lungs - Lab Flashcards
What are the primary muscles of respiration?
diaphragm and the intercostal muscles
What three things are you looking for when observing respirations?
respiratory rate, rhythm, and effort
What words are used to describe the effort of respirations?
easy, labored, relaxed
What is the normal number of respirations per minute?
12 - 20
harsh, high-pitched sound caused by laryngeal or tracheal obstruction
stridor
bluish, purplish color caused by insufficient oxygen levels in the blood
cyanosis
flaring nostrils, pursed lips and use of accessory muscles are signs of what?
pulmonary or cardiac difficulties
During your assessment of tactile fremitus, you noticed increased sense of vibration, what is it suggestive of?
fluids/ secretions or a solid mass
During your assessment of tactile fremitus, you noticed diminished or absent sense of vibration, what is it suggestive of?
excess air in the lungs caused by obstruction, emphysema, significant effusion or collapse of lung tissue
What part of your hands should you use when assessing a patient’s tactile fremitus?
palmar surfaces
During percussion of the chest, tones are loud in intensity, low in pitch, long in duration, and hollow in quality
resonant tones
During percussion of the chest, tones are soft in intensity, high in pitch, short in duration, and very dull in quality
flat tones
During percussion of the chest, tones are medium in intensity, medium to high in pitch, medium duration, and a dull thud quality
dull tones
During percussion of the chest, tones are loud in intensity, high in pitch, medium in duration, and drum like in quality
tympanic tones
During percussion of the chest, tones are very loud in intensity, very low in pitch, longer in duration, and booming in quality
hyperresonant tones (abnormal)
Do you use direct or indirect to percuss the chest?
indirect
When performing diaphragmatic excursion, when do you percuss down the back and up the back?
percuss DOWN the back when the patient takes a deep breath and hold, change in tone from resonance to dull
percuss UP the back when the patient has exhaled fully, change in tone from dull to resonance
(inhale = down, exhale = up)
What is the normal excursion range?
3-5 cm
Why would the right lung be higher than the left?
the liver
Would you use the bell or the diaphragm of the stethoscope to auscultate the chest?
diaphragm (high-pitched sounds)
These sounds are the highest in pitch and intensity
bronchial sounds
These sounds are low-pitched, low intensity sounds of healthy lungs
vesicular sounds
These sounds are usually moderate in pitch and intensity and heard over the major bronchi
bronchovesicular sounds
These adventitious breath sounds are usually heard during inspiration, discontinuous, lasting short period of time, often differentiated as fine, medium or course. These sounds do not clear with coughing. Caused by disruption of air passage through the small airways
crackles
These adventitious breath sounds are heard usually with expiration, deeper, rumbling, continuous and prolonged. These sounds may clear with coughing. Usually suggestive of airway obstruction by thick secretions, muscular spasm, or external pressure
rhonchi
sonorous wheeze
These adventitious breath sounds are often heard continuously during inspiration or expiration, as high-pitched musical-like sounds. A higher pitch will indicated a worse obstruction
wheezes
sibilant wheeze
These adventitious breath sounds are heard in both inspiration and expiration, are dry, crackly, grating low-pitched sounds. Usually indicative of inflammation
friction rubs
occur outside the respiratory tree
What is being tested by having the patient say ‘99’. Voice is louder than normal but no necessarily intelligible
bronchophony (found in presence of consolidation)
What is being test by having the patient say ‘ee’. The sound is usually a muffled long ‘e’ sound. When the ‘ee’ is heard as ‘ay’, this is present
egophony (found in lobar consolidation from pneumonia)
What is being tested by having the patient whisper ‘1,2,3’. The sound is normally faint and indistinct. This condition is present when the sound is heard louder and clearer
whistpered pectoriloquy (found with consolidation)
What are the three abnormal breathing patterns?
1) Cheyne-Stokes
2) Kussmaul’s respirations
3) Grunting respirations
What is this abnormal breathing pattern?
very deep, gasping, and rapid breathing, seen in metbolic acidosis
Kussmauls’ respirations
What is this abnormal breathing pattern?
alternating periods of apnea and hyperpnea, periodic breathing
Clinical Significance: 30% of patient with congestive heart failure and also seen in many neurologic disorders, hemorrhage, infarction, tumors, meningitis, and head trauma involving the brain stem or higher levels of the CNS
Cheyne-Stokes
What is this abnormal breathing pattern?
short and explosive sounds, more common in children but also in adults as a sign of respiratory muscle fatigue. It is an attempt to slow expiration and allow for maximal gas exchange
Grunting respirations
