Thorax & Lungs Flashcards
Where exchange of oxygen and carbon dioxide takes place
alveolar sac
Assessing the Lungs
General inspection(visualize pt’s respiratory status)
Chest expansion(if both sides expand equally)
Tactile Fermitus
Chest percussion
Lung auscultations
Abnormal findings
Barrel chest (common in people w/COPD) Pectus excavatum Pectus carnatum Scoliosis Kyphosis
wider in diameter than normal chest
Barrel chest
sternum caved in
pectus excavatum
sternum sticks out
pectus carinatum
“hunch back” (associated with old age & osteoporosis)
kyphosis
lateral curvature of the spine (left to right curvature is abnormal)
scoliosis
Abnormal Respiratory Patterns
Hyperventilation (Kussmaul)
Cheyne-Stokes respirations
Biot respirations
this respiration pattern is typically associated with extremely high blood sugar (DKA); increased in both rate and depth
hyperventilation (kussmaul)
the respiration pattern where the client will breathe light, then deeper and deeper, then back to light, then eventually stop breathing.
Cheyne-Stokes
this respiration pattern is irregular; no pattern at all. usually caused from brain/head injury; also seen in alot of icu patients when they are dying
Biot respirations
rapid, shallow breathing
Tachypnea
slow breathing
Bradypnea
an irregular shallow pattern caused by an overdose of narcotics or anesthetics
hypovetilation
Signs of Respiratory Distress
- Assessory muscles (using extra muscles you don’t normally use to breathe; the whole torso moves)
- Grunting
- Head bobbing (head wiggling with each breath-typically in kids)
- Nasal flaring
- Retractions
- Tachypnea
- Tripod position
position used in those who are trying to breath (lean forward w/hands on knees propping themselves up)
Tripod position
Chest Expansion assessment
checking for symmetrical chest expansion with the patient’s breaths
Tactile Fermitus assessment
using the heel of your hand, have patient say “99” as you move from side to side checking for equal vibrations
During tactile fermitus assessment, if the vibrations on each side from patient’s voice is unequal or different this could be a sign of what?
a mass or fluid
Lung Auscultation
listening to each breath with a stethoscope
What are some conditions which might cause unequal chest expansion?
marked atelectasis, lobar penumonia, pleural effusion, thoracic trauma such as fractured ribs or pneumothroax
what does the word fremitis mean?
palpable vibration
why should you avoid assessing for tactile fremitis over a patient’s scapula?
bone damps out sound transmission
If someone has lobar pneumonia, would you expect increased or decreased fremitus over that area?
increased
If someone has a pneumothroax, would you expect increased or decreased fremitus over that area?
decreased
what is the predominate percussion sound you should expect to hear over the lungs fields?
normal resonant
what might an area of hyperresonance indicate?
too much air is present such as emphysema or pneumothorax
what might an area of dullness indicate?
pneumonia, pleural effusion, atelectasis, or tumor
should you use the bell or diaphragm of your stethoscope when auscultating lungs sounds?
diaphragm
what should you do if your client has a particularly hairy chest?
press harder with the stethescope or wet the hair with a damp cloth
Are you supposed to auscultate on top of clothing?
no
ask your client to breathe through his or her ____.
mouth
How hard should your client breathe?
client should breathe normally
What is the name of the sound you should hear when auscultating peripheral lung fields?
vesicular
when you are auscultating the posterior chest, which lobes are you primarily listening to?
lower lobes
