Thorax & Lungs- 19 Flashcards
Anterior Thoracic Landmarks:
Suprasternal notch
Manubriosternal Angle (Angle of Louis)
Costal Angle
Suprasternal Notch: U-shaped depression just above sternum between clavicles
Manubriosternal Angle: articulation of manubrium/sternum-bump at 2nd ribline
Costal Angle: right and left costal margins form an angle where they meet at the xiphoid process (usually 90 degrees or less)
What does the Angle of Louis mark the site of?
Tracheal bifurcation- into left/right main bronchi
Posterior Thoracic Landmarks:
Vertebra Prominens
Spinous Processes
Inferior Border of Scapula
Twelfth Rib
Vertebra Prominens: flex head, find more prominent bony spur at base of neck
Spinous processes: stack to form spinal column
Inferior border of scapula: have pt take a deep breath to find
Twelfth rib: palpate midway between spine and a person’s spine to identify the free tip
List and know the reference lines on
anterior chest
Posterior chest?
Lateral chest
Midsternal line
Midclavicular line
Scapular line
Vertebral line
Anterior axillary, posterior axillary, midaxillary
___________ lines outside of lungs, dipping into fissures
Visceral pleura
The _____ main bronchus is shorter, wider, and more vertical than the ____ main bronchus
Right
Left
Explain dead space
Trachea and bronchi- space that is filled with air but uninvolved in gas exchange
150 mL in adult
Define: Acinus
functional unit of bronchioles, alveolar ducts, alveolar sacs, and alveoli
What are the 4 major functions of the respiratory system?
Supply oxygen for energy production
Remove CO2 (waste product of energy reactions)
Maintain acid-base homeostasis of arterial blood
Maintaining heat exchange
What kinds of feedback loops influence respirations?
Humoral regulation
CO2/O2 level changes in blood
Hydrogen ion level
What is the normal stimulus to. breathe for most of us?
Hypercapnia- increase of CO2 in blood
Explain the intercostal’s roles in breathing
External-elevates ribs for inspiration
Internal- depresses ribs for expiration
What are some normal findings regarding the lungs in aging adults?
Decreased vital capacity
Increased residual volume
Histologic changes cause decreased gas exchange
List 3 health conditions related to culture and genetics?
Lung Cancer-2nd most common diagnosed cancer
TB- more than 1/3 of the world
Asthma- most common chronic childhood disease, poverty level
List some subjective data collected regarding the thorax/lungs
Cough
Shortness of Breath (SOB)
Chest pain with breathing
Respiratory Infection history
Smoking history
Environmental exposure
Patient-centered care
When should the lung function questionnaire be used?
For aging adults with a history of chronic obstructive pulmonary disease, lung cancer, or TB
Explain tactile fremitus
What can influence it?
Palpable vibrations cause by the patient speaking- “say 99 or blue moon”
Mucus, fluids, etc can influence it
How is tactile fremitus assessed?
Using palm/base of hand to palpate from side to side down the back
Describe normal findings when percussing lung fields
Resonance is low-pitched, clear, hollow sound that predominates in health lung tissue in adult
How should breath sounds be auscultated?
Diapragm, firm pressure, one full respiration in each location
Bilateral comparison
What are the 3 types of lung sounds normally heard in adults/older children?
Bronchial (Tracheal/Tubular)
-trachea/larynx, harsh/hollow/tubular
Bronchivesicular
-Over major bronchi, mixed quality
Vesicular
-Peripheral lung fields, rustling/wind on leaves sounds
Explain AP vs Lateral diameter
AP: diameter should be less than the lateral diameter
Explain Barrel chest
AP and lateral diameter of chest are equal
Slope of ribs is more parallel
Costal angle- more than 90 degrees
Can indicate COPD
Pectus Carinatum
Pigeon chest
Sternum bulges outward
