Thorax and Lungs - Lab

Question 1

What are the primary muscles of respiration?

Answer 1

diaphragm and the intercostal muscles

Question 2

What three things are you looking for when observing respirations?

Answer 2

respiratory rate, rhythm, and effort

Question 3

What words are used to describe the effort of respirations?

Answer 3

easy, labored, relaxed

Question 4

What is the normal number of respirations per minute?

Answer 4

12 - 20

Question 5

harsh, high-pitched sound caused by laryngeal or tracheal obstruction

Answer 5

stridor

Question 6

bluish, purplish color caused by insufficient oxygen levels in the blood

Answer 6

cyanosis

Question 7

flaring nostrils, pursed lips and use of accessory muscles are signs of what?

Answer 7

pulmonary or cardiac difficulties

Question 8

During your assessment of tactile fremitus, you noticed increased sense of vibration, what is it suggestive of?

Answer 8

fluids/ secretions or a solid mass

Question 9

During your assessment of tactile fremitus, you noticed diminished or absent sense of vibration, what is it suggestive of?

Answer 9

excess air in the lungs caused by obstruction, emphysema, significant effusion or collapse of lung tissue

Question 10

What part of your hands should you use when assessing a patient’s tactile fremitus?

Answer 10

palmar surfaces

Question 11

During percussion of the chest, tones are loud in intensity, low in pitch, long in duration, and hollow in quality

Answer 11

resonant tones

Question 12

During percussion of the chest, tones are soft in intensity, high in pitch, short in duration, and very dull in quality

Answer 12

flat tones

Question 13

During percussion of the chest, tones are medium in intensity, medium to high in pitch, medium duration, and a dull thud quality

Answer 13

dull tones

Question 14

During percussion of the chest, tones are loud in intensity, high in pitch, medium in duration, and drum like in quality

Answer 14

tympanic tones

Question 15

During percussion of the chest, tones are very loud in intensity, very low in pitch, longer in duration, and booming in quality

Answer 15

hyperresonant tones (abnormal)

Question 16

Do you use direct or indirect to percuss the chest?

Answer 16

indirect

Question 17

When performing diaphragmatic excursion, when do you percuss down the back and up the back?

Answer 17

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)

Question 18

What is the normal excursion range?

Answer 18

3-5 cm

Question 19

Why would the right lung be higher than the left?

Answer 19

the liver

Question 20

Would you use the bell or the diaphragm of the stethoscope to auscultate the chest?

Answer 20

diaphragm (high-pitched sounds)

Question 21

These sounds are the highest in pitch and intensity

Answer 21

bronchial sounds

Question 22

These sounds are low-pitched, low intensity sounds of healthy lungs

Answer 22

vesicular sounds

Question 23

These sounds are usually moderate in pitch and intensity and heard over the major bronchi

Answer 23

bronchovesicular sounds

Question 24

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

Answer 24

crackles

Question 25

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

Answer 25

rhonchi

sonorous wheeze

Question 26

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

Answer 26

wheezes

sibilant wheeze

Question 27

These adventitious breath sounds are heard in both inspiration and expiration, are dry, crackly, grating low-pitched sounds. Usually indicative of inflammation

Answer 27

friction rubs

occur outside the respiratory tree

Question 28

What is being tested by having the patient say ‘99’. Voice is louder than normal but no necessarily intelligible

Answer 28

bronchophony (found in presence of consolidation)

Question 29

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

Answer 29

egophony (found in lobar consolidation from pneumonia)

Question 30

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

Answer 30

whistpered pectoriloquy (found with consolidation)

Question 31

What are the three abnormal breathing patterns?

Answer 31

1) Cheyne-Stokes
2) Kussmaul’s respirations
3) Grunting respirations

Question 32

What is this abnormal breathing pattern?

very deep, gasping, and rapid breathing, seen in metbolic acidosis

Answer 32

Kussmauls’ respirations

Question 33

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

Answer 33

Cheyne-Stokes

Question 34

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

Answer 34

Grunting respirations