Thorax & Lungs I Flashcards
@ what level is the horizontal fisure locatated laterally
Located from mid axillary line to the 4th/5th rib ant
@ what level does the oblique line from on the left side
T3 level too 6th rib ant
At the lateral aspect how low do the ribs go
8th rib
full inspiration post goes down to what rib level
down to 10th rib
What is the normal breathing rate
14-20 breaths/min
What is tachypnea and causes
Rapid shallow breathing
- COPD (mc)
- Pleuric chest pain
- elevateed diaphram
What is hyperpenea and causes
Rapid deep breathing
- Exercise
- Anxiety
- Acidosis
Bradypnea and causes
Slow breathing
- Diabetic coma
- drug induced
What is cheyne stokes breathing, causes and what pop can have this normally
Periods of deep breathing alternate with periods of apnea (>10sec)
- heart failure
- Uremia
- Brain damage
Kids<4 can have this pattern normally
What is ataxic (biots) breathing
Unpredicatable irregularity
- Brain damage at medullary level
- Drug induced respiratory depression
What is indicitive of obstructive breathing and causes
Manifested by prolonged expiration
- astma
- COPD
- chronic bronchitis
What is most chest pain related to
GI related (40% of time)
What are some cardinal s/s of lung pathology
- chest pain
- dyspnea/laboured breathing
- wheezing
- cough
- hemoptysis (coughing up blood)
What is orthopnea vs paroxysmal nocturnal dyspnea
orthopnea- shortness of breath when flat (due to heart isues, obesity; relieved by sitting)
Paroxysmal nocturnal dyspnea- Severe shortness of breath at night that still happens in sitting pos
What are some risk factors to lung issues
- cardiac/lung disorders
- Smoking hx
- Birth control use
- travel
- recent fx, sig injury
- fam hx
What are the main steps in respiratory exam
- Inspection
- Palpation (chest exp/ tactile fremitus)
- Percussion (diaphragmatic excursion)
- Auscultation
- Special techniques
what side will the trachea deviate to in a lung problem
deviation to side of less pressure
Why does club finger occur
poor o2 to extremities (pts with COPD)
what is friction rub
inflammed pleura rubbing against eachother
Where to palpate for chest expansion ant and post
thumbs on midline
Post- 10th rib post
ant- along costal margins
How to measure tactile fremitus (how many spots ant/post, what does pt say)
4 post (3 parspianal, 1 mid axil) 3 ant (2 parasten, 1 mid axil)
get pt to say 99 or 1-1-1
What does increased + decreased tactile fremitus indicate
increased- consolidation of lung tissue (increased vib)
decreased- Obstruction, Pleural effusion, pneumothorax, COPD
How to percuss + what does it help determine
Helps determine whether the underlying tissues are air filled, fluid filled or solid
Plexormeter finger- hyperextended middle finger
Plexor finger- Partially flexed middle finger
What are the percussion locations is post and ant thorax
Post- 7 areas (5 parastenally, 2 mid axillary)
Ant- 6 areas (4 parasternally, 2 mid axillary)
What are the normal and other sounds that can be heard with percussion
Resonant- hallow (normal)
Dull- Thud like (liver/heart)
Hyperresonant- drum like (abnormal)
Tympanic- booming (abnormal
Where will you hear heart dullness
in 3rd to 5th left intercostal spaces medial to mid clavicular line
@ what levels do you check for diaphragmic excursion and how do you perform the movement
Dull is the level (can determine where the diaphragm is)
Take breath in and see how low u go when it is dull again. , then full breath out and move back up to where its resonant
T8-T11
