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Assessment (Test #2) > Thorax & Lungs > Flashcards

Thorax & Lungs Flashcards

1
Q

Ventilation

A

movement of air in and out of the lungs

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2
Q

What are the primary functions of the pulmonary system?

A

Ventilation (movement of air in and out of the lungs)

External respiration (diffusion of gases across the alveolar-capillary membrane)

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3
Q

acinus

A

a functional respiratory unit that consists of the bronchioles, alveolar ducts, alveolar sacs, and the alveoli.

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4
Q

Describe the color of sputum for pulmonary edema

A

pink frothy

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5
Q

Describe the color of sputum for Bacterial infections

A

yellow or green

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6
Q

Describe the color of sputum for tuberculosis & pneumococcal pneumonia

A

rust colored

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7
Q

Describe the color of sputum for cold, bronchitis & viral infections

A

white or clear

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8
Q

The sudden onset of breathing difficulty that develops during sleep and often causes the patient to either sit straight upright in bed or stand up.

A

paroxysmal nocturnal dyspnea

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9
Q

Difficulty breathing when lying down (often measured in the number of pillows the patient needs to sleep comfortably)

A

orthopnea

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10
Q

What are “pack years”?

A

the number of packs the patient smokes per day by the number of years the person has smoked

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11
Q

sequelae

A

consequences of a disease

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12
Q

What are two common respiratory-related health-screening activities?

A

Chest x-ray

TB test

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13
Q

What two immunizations are important for older adults, in particular, to consider?

A

Pneumococcal vaccine

Influenza vaccine

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14
Q

People who work in coal mines have an increased risk of:

A

pneumoconiosis

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15
Q

Patient with COPD display what type of breathing in efforts to maintain positive expiratory pressures in the lung?

A

pursed-lip breathing

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16
Q

Patients w/ COPD sit in which position to maximize their lung volume?

A

tripod position

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17
Q

Patients w/ COPD may use what to overcome airway obstruction and atelectasis?

A

accessory muscles

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18
Q

respiratory excursion

A

the movement of the diaphragm that occurs during inspiration

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19
Q

Tactile Fremitus

A

palpable vibration

Sounds generated from the larynx are transmitted through patent bronchi and through the lung parenchyma to the chest wall, where you feel them as vibrations

test for vibrations bilaterally using the phrase “ninety nine” (except between the scapulae, where the bronchial bifurcation is closer on the right side, which makes the vibrations stronger)

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20
Q

Decreased fremitus

A

occurs when anything obstructs transmission of vibrations (e.g., obstructed bronchus, pleural effusion or thickening, pneumothorax, or emphysema). Any barrier that comes between the sound and your palpating hand will decrease fremitus.

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21
Q

Increased fremitus

A

occurs with compression or consolidation of lung tissue (e.g., lobar pneumonia). This is present only when the bronchus is patent and when the consolidation extends to the lung surface. Note that only gross changes increase fremitus. Small areas of early pneumonia do not significantly affect fremitus

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22
Q

Rhonchal fremitus

A

is palpable with thick bronchial secretions.

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23
Q

Pleural friction fremitus

A

is palpable with inflammation of the pleura

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24
Q

Crepitus

A

a coarse, crackling sensation palpable over the skin surface. It occurs in subcutaneous emphysema when air escapes from the lung and enters the subcutaneous tissue, as after open thoracic injury or surgery

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25
Q

Abnormal asymmetry of diaphragmatic of excursion is usually due to one of which two problems?

A

Atelectasis or Pleural effusion

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26
Q

What body position does the patient assume during posterior auscultation of the back?

A

leaning slightly forward

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27
Q

Patient instructions before auscultating the posterior thorax

A

“Cross your arms and breath deeply in and out when you feel my stethoscope touch your skin”

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28
Q

Bradypnea (breaths per minute)

A

slower than 10 breaths per minute

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29
Q

Normal (breaths per minute)

A

12-20 breaths per minute

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30
Q

Tachypnea (breaths per minute)

A

> 24 breaths per minute

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31
Q

Hyperventilation (breaths per minute)

A

> 20 breaths per min. w/ DEEP breathing

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32
Q

Sighing (type of breathing)

A

normal breaths w/ frequently interspersed DEEP breaths

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33
Q

Cheyne-Stokes (type of breathing)

A

varying speeds of increasing deep interspersed w/ a period of apnea

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34
Q

Kussmaul (type of breathing)

A

Rapid, deep, labored breaths

35
Q

Biot (type of breathing)

A

irregularly interspersed periods of apnea in a disorganized sequence of breaths

36
Q

Ataxic (type of breathing)

A

significant disorganization w/ irregular and varying depths of respiration

37
Q

Fine Crackles

A

Discontinuous, high-pitched, short crackling, popping sounds heard during inspiration that are not cleared by coughing

you can simulate this sound by rolling a strand of hair between your fingers near your ear or by moistening your thumb and index finger and separating them near your ear

38
Q

Coarse Crackles

A

Loud, low-pitched, bubbling and gurgling sounds that start in early inspiration and may be present in expiration

may decrease somewhat by suctioning or coughing but will reappear shortly

sounds like opening a Velcro fastener

39
Q

Sibilant Wheeze

A

High-pitched, musical squeaking sounds that sound polyphonic (multiple notes as in a musical chord)

predominate in expiration but may occur in both expiration and inspiration

40
Q

Sonorous Wheeze

A

Low-pitched; monophonic single note, musical snoring, moaning sounds

heard throughout the cycle, although they are more prominent on expiration;

may clear somewhat by coughing

41
Q

What is egophony and why is it used?

A

The patient says “ee” during auscultation….

Normal lung tissue does not transmit sound well and produces a characteristic muffled “aa” sound.

Consolidated lung tissue, on the other hand, produces a clear and distinct “ee” sound because of its higher density.

-used to determine resonance

42
Q

Asthma is characterized by…

A

inflammation, bronchiolar edema and viscous mucus

43
Q

Lobar pneumonia is characterized by…

A

infection of lung parenchyma and consolidation of alveoli

44
Q

Tuberculosis is characterized by…

A

Gohn lesions with potential for cavitation and necrosis

45
Q

Pneumothorax is characterized by…

A

free air in the pleural space causing collapse of lunge tissue

46
Q

Broncitis is characterized by…

A

excessive mucus and inflammation of the bronchi

47
Q

Emphysema is characterized by…

A

permanent enlargement of air sacs and rupture of intraalveolar walls

48
Q

Atelectasis is characterized by…

A

a collapsed shrunken section of alveoli

49
Q

are costochondral junctions palpable?

A

no p.411

50
Q

angle of louis

A

is the articulation of the manubrium and body of the sternum, and it is continuous with the second rib, is it useful place to start counting ribs

also marks the site of tracheal bifurcation into the right and left main bronchi; it corresponds with the upper border of the atria of the heart, and it lies above the fourth thoracic vertera on the back.

51
Q

mediastinum

A

middle section of the thoracic cavity containing the esophagus,trachea,heart and great vessels.

the right and left pleural cavities are on either side of the mediastinu, they contain the lungs.

52
Q

the highest point of the lungs

A

apex

53
Q

the lower border of the lungs

A

base; rest on the diaphragm at about the 6th rib in the midclavicular line.

54
Q

posteriorly, the location of ___ marks the apex of lung tissue, and __ usually corresponds to the base. deep inspirations expands the lungs, and their lower border drops to the level of ___.

A

c7, t10, t12

55
Q

the __lung is shorter than the __ lung because of the underlying ___.

A

right, left, liver

56
Q

the ___ lung is narrower than the ___ lung because the heart bulges to the ___.

A

left, right, left

57
Q

how many lobes do the right and left lung have and how are they arranged?

A

left- 2 lobes
right- 3 lobes
these lobes are not arranged in horizontal bands like dessert layers in a parfait glass. rather, they are stack in diagonal sloping segments are and seperated by fissures that run obliquely throughout the chest.

58
Q

what are the special note of the three points that commonly confuse beginning examiners?

A
  1. the left lung has no middle lobe
  2. the anterior chest contains mostly upper and middle lobe with very little lower lobe.
  3. the posterior chest contains almost all lower lobe.
59
Q

the _____ pleura lines the outside of the lungs, dipping down into the fissures. it is continuous with the ____ pleura lining the inside of the chest wall and diaphragm.

A

visceral , parietal

60
Q

the pluera extend about 3 cm below the level of the lungs, forming the ____. this is a potential space; when it abnormally fills with air or fluid, it compromises lung expansion.

A

costodiaphragmatic recess

61
Q

the trachea lies ___ to the esophogus and is _____cm long in adults. it begins at the level of the _____ in the neck and bifurcates just below the ____ into the right and left main bronchi.

A

anterior, 10 to 11, cricoid cartilage, sternal angle.

62
Q

the bronchi are lined with cilia, which?

A

sweep particles upward where they can be swallowed and expelled.

63
Q

what are the 4 major functions of the respiratory system?

A
  1. supplying the o2 to the body for energy production
  2. removing co2 as a waste product of energy reactions
  3. maintaining homeostasis (acid-base balance) of arterial blood.
  4. maintaing heat exchange (less important in humans).
64
Q

hypoventilation (slow, shallow breathing) causes co2 to _____, and hyperventilation (fast, deep breathing) causes co2______.

A

build up in the blood, to be blown off .

65
Q

hypercapnia

A

increase of co2 in the blood

66
Q

hypoxemia

A

decrease of o2 in the blood.

67
Q

the normal stimulus to breathe for most of us is _______.

A

increase of co2 in the blood, or hypercapnia.

68
Q

respiratory muscle strength declines age the age ____ and continues to decrease into the _____.

A

50s, 70s

69
Q

biocultural differences in the ______ significantly influence pulmonary functioning as determined by vital capacity and forced expiratory volume.

A

size of the thoracic cavity

70
Q

acute cough last _____; chronic cough last ______.

A

less than 2 to 3 weeks. over 2 months

71
Q

condition with characteristics timing of cough: 1. continuous thoughout the day (_______). 2. afternoon/evening (______). 3. night-(______) 4. early morning (_____)

A

continuous throughout the day - acute illnesses (e.g, respiratory infection)
afternoon/evening- may reflect exposure to irritants at work
night- postnasal drip, sinusitis
early morning- chronic brinchial inflammation of smokers.

72
Q

chronic bronchitis presents with a history of productive cough for ____ of the year for __ years in a row.

A

3 months, 2 years

73
Q 
some conditions have a characteristic cough:
myoplasma pneumonia ?
 early heart failure?
croup?
colds, bronchitis,pneumonia?
A

hacking
dry
barking
congested

74
Q

Some gases produce specific symptoms:

Carbon monoxide –
Sulfur dioxide–

A

Dizziness,headache,fatigue

Cough,congestion

75
Q

in older adults…. precisely localized sharp pain (points to it with one finger)— consider?

A

fractured rib or muscle injury

76
Q

The ratio of the anterooms terror to transverse diameter is from ______. If it is not within that range then patient is considered _____. This condition occurs with _______.

A

1:2 to 5:7 , “barrel chest”, chronic emphysema from hyperinflation of the lungs

77
Q

Symmetric chest expansion

A

Slide your hand medially to pinch up a small fold of skin between your thumbs. Ask the person to take a deep breath. Your hands serve as mechanical amplifiers. As the person inhales, your thumbs should move apart symmetrically.

Unequal chest expansion occurs with marked atelectasis, lobar pneumonia, pleural effusion, with thoracic trauma, such as fractured ribs; or with pneumothorax.

78
Q

Fremitus, the vibrations should feel the same in the corresponding area on each side with the exception of?

A

Just between the scapula, fremitus may feel stronger on the right side than on the left side because the right side is close to the bronchial bifurcation.

79
Q

Low pitched, clear, hollow sound that predominates in healthy lung tissue in the adult

A

Resonance

80
Q

The resonant note may be modified somewhat in athlete with muscular chest wall and in the heavily obese adult with subcutaneous fat produces _____.

A

Scattered dullness

81
Q

Bronchial (tracheal)

A

Normal breath sounds

Pitch=high 
Amplitude=loud 
Duration= inspiration <expiration
Quality= harsh, hollow tubular
Normal location= trachea and larynx
82
Q

Bronchovesicular

A 
Pitch..high 
Amplitude.. Moderate
Duration..inspiration =expiration 
Quality .. Mixed
Normal location ..toward the middle by the sternum on posterior and anterior.... P.428
83
Q

Vesicular

A

Pitch..low
Amplitude..soft
Duration.. Inspiration>expiration
Quality..rustling, like the sound of the wind in the trees
Normal location… Over peripheral lung fields where air flows through smaller bronchioles and alveoli

84
Q

________will enhance the voice sounds making the words more distinct.

A

Consolidation or compressions the lung tissue

Assessment (Test #2) (4 decks)

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