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Physical Assessment > Thorax & Lungs SG > Flashcards

Thorax & Lungs SG Flashcards

This chapter presents the structure and function of the thorax and lungs, methods of examination of the respiratory system, normal lung sounds, characteristics of adventitious lung sounds, and accurate recording of the assessment.

1
Q

Alveoli

A

functional units of the lung;
tiny air sacs in the lungs where O2 & CO2 are exchanged with the blood (via capillaries)

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2
Q

Angle of Louis

A

the point where the top part (manubrium) of the breastbone meets the body of the breastbone, at the lvl of the 2nd rib

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3
Q

apnea

A

a temporary stop in breathing

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4
Q

asthma

A

a lung condition where certain allergens cause the airways to become inflamed, tighten up (bronchospasm), & make it hard to breathe
- it often includes wheezing & SOB

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5
Q

atelectasis

A

a condition where part of the lung (specifically the alveoli) collapses & cant expand properly

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6
Q

bradypnea

A

slow breathing (<10 breaths/min), but still w/ regular rhythm

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7
Q

bronchiole

A

the smaller airways in the lungs that come the larger bronchi

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8
Q

bronchitis

A

inflammation of the larger airways (bronchi) often causing them to be partially blocked due to too much mucus

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9
Q

bronchophony

A

the muffled, unclear sound of the voice heard thru a stethoscope over healthy lungs

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10
Q

bronchovesicular

A

nml breath sounds heard over the central part of the chest (the bronchi) where breathing in & out sounds are about equal in duration + moderate in pitch

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11
Q

what is the carina

A

the ridge inside the windpipe (trachea) where it splits into the R & L main bronchi

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12
Q

Chronic obstructive pulmonary disease (COPD)

A

a group of lung diseases (emphysema, chronic bronchitis) that block airflow & make it hard to breathe

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13
Q

cilia

A

tiny hairlike structures that line the airways & help move mucus out of the lungs

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14
Q

consolidation

A

when part of the lung tissue becomes solid, often due to infection (as in pneumonia)

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15
Q

crackles

A

abnormal popping sounds heard when listening to the lungs during breathing IN
- often associated with fluid in the lungs

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16
Q

crepitus

A

a crackling feeling felt on the SKIN when air escapes from the lungs & get trapped under the skin

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17
Q

dead space

A

parts of the airway where air passes thru but doesn’t participate in gas exchange (like the trachea, bronchi)

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18
Q

dyspnea

A

difficulty or trouble breathing

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19
Q

emphysema

A

a type of COPD where the alveoli in the lungs get too big & lose their ability to return to their nml size, making it hard to breathe

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20
Q

fissure

A

the natural divisions b/n the lobes of the lungs

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21
Q

fremitus

A

a vibration felt on the chest when someone speaks - which can be felt with the hands

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22
Q

friction rub

A

a rough, grating sound heard when listening to the lungs
- c/b inflammation of the LINING of the lungs (pleurae)

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23
Q

hypercapnia/hypercarbia

A

too much CO2 in the blood

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24
Q

hyperventilation

A

breathing that is faster & deeper than nml

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25
Q

hypoxemia

A

lower than nml o2 lvls in the blood

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26
Q

intercostal space

A

the space b/n the ribsk

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27
Q

kussmaul respirations

A

deep & rapid breathing
- seen w/ diabetic ketoacidosis

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28
Q

orthopnea

A

diff breathing when lying flat

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29
Q

paroxysmal nocturnal dyspnea

A

suddenly waking up at night with difficulty breathing

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30
Q

percussion

A

tapping on the chest to figure out the size & density of the underlying organs

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31
Q

pleural effusion

A

a buildup of fluid between the layers of tissue lining the lungs & chest

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32
Q

stridor

A

a loud, high-pitched sound during breathing
- usually heard when theres a blockage in the UPPER airway

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33
Q

tachypnea

A

rapid, shallow breathing (>24 breaths/min)

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34
Q

vesicular

A

soft, LOW-pitched breath sounds heard over the OUTER parts of the lungs

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35
Q

wheeze

A

a HIGH pitched, musical sound heard when air moves thru the narrowed airways
- can also refer to a lower-pitched (snoring-like) sound

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36
Q

xiphoid process

A

the small, sword-shaped tip at the bottom of the breastbone

37
Q

Elsevier SG

Describe the most important points about the health history for the respiratory system.

38
Q

Elsevier SG

A patient reports a history of cigarette smoking that includes smoking 2 packs per day (ppd) from 1990 to 2012, then 1 ppd from 2013 until quitting in 2022. Calculate the number of pack years smoked.

39
Q

Describe the pleura and its function.

A

To reduce friction during respiration, allowing the lungs to expand and contract smoothly within the thoracic cavity.

40
Q

List the structures that compose the respiratory dead space.

41
Q

Summarize the mechanics of respiration.

42
Q

List the elements included in the inspection of the respiratory system.

43
Q

List and describe common thoracic deformities.

44
Q

Define the diff types of adventitious breath sounds.

45
Q

How many degrees is the normal costal angle? ___________________

46
Q

When comparing the anteroposterior diameter of the chest with the transverse diameter, what is the expected ratio? What is the significance of this?

47
Q

What is the tripod position?

48
Q

List 3 factors that affect the normal intensity of the tactile fremitus.

49
Q

Describe the 3 types of normal breath sounds.

Include Name, Location, & Description

50
Q

Fill in the labels indicated on the following illustration

51
Q

Study the lobes of the lungs and label their landmarks on the following

52
Q

Study the lobes of the lungs and label their landmarks on the following two illustrations.

53
Q

Label the normal location of the three types of breath sounds on the posterior and anterior chest walls.

54
Q

Label the normal location of the three types of breath sounds on the posterior and anterior chest walls.

55
Q

what makes up the thoracic cage?

A
  1. sternum
  2. ribs
  3. thoracic vertebrae
56
Q

what is the significance of the sternal angle

A

The sternal angle (also known as the Angle of Louis) is an important anatomical landmark for several reasons:

**1. Tracheal bifurcation: **It marks the point where the trachea divides (or bifurcates) into the right and left main bronchi, which are the large airways that lead into the lungs.
**2. Rib counting: **The sternal angle is in line with the second rib, making it a useful reference point for counting ribs during physical exams or medical procedures.

57
Q

what are the posterior throacic landmarks?what at

A
  1. vertebra prominens
  2. spinous processes
  3. interior border of the scapula
  4. 12th rib

  • Vertebra prominens: This is the most prominent bump at the base of the neck; (C7)
  • Inferior border of the scapula: The lower tip of the shoulder blade (scapula), which usually lies at the level of the 7th or 8th rib.
58
Q

What is the midclavicular line used for?

A

its a vertical reference line used to pinpoint findings on the chest

59
Q

what are the divisions of the thoracic cavity?

A
  1. Mediastinum:
  2. Pleural cavities:

  • Mediastinum: The central area of the thoracic cavity that contains the heart, great blood vessels, esophagus, trachea, and other structures.
  • Pleural cavities: Two spaces on either side of the mediastinum, each containing one lung, surrounded by a thin layer of pleura (a membrane that protects and cushions the lungs).
60
Q

Where is the apex of the lung located?

A

it extends slightly above the clavicle

61
Q

how many lobes does the R lung have?

A

3 lobes:
1. superior lobe
2. middle lobe
3. inferrior lobe

62
Q

what is an acinus?

A

the functional respiratory unit of the lung where gas exchange takes place

63
Q

mechanics of respiration:

what are the 4 major functions of the respiratory system?

A
  1. supplying o2
  2. removing co2
  3. maintaining acid-base balance
  4. maintaining heat exchange
64
Q

mechanics of respiration:

how is respiration controlled?

A

by
1. the respiratory center in the brainstem
2. humoral regulation (primarily by co2 levels)

65
Q

mechanics of respiration:

what is the main muscle of inspiration?

A

the diaphragm

66
Q

mechanics of respiration:

what happens during expiration?

A

the diaphragm & external intercostal muscles relax
= decreasing thoracic cavity volume + increasing intrathoracic pressure
= force air out of the lungs

67
Q

developmental competence:

why are infants vulnerable to respiratory problems?

A

they have smaller airways & less developed immune systems

68
Q

developmental competence:

how does pregnancy affect the respiratory system?

A
  • the diaphragm elevates
  • chest cage dimensions increase
  • breathing becomes deeper & more frequent
69
Q

developmental competence:

what are some age-related changes in the respiratory system of older adults?

A
  • decreased chest wall mobility
  • respiratory muscles strength decline
  • diminished lung elasticity
70
Q

Genetics and Environment

what is the leading cause of cancer death in the US

71
Q

Genetics and Environment

how is tuberculosis transmitted?

A

thru the air when an infected person coughs/sneezes

72
Q

Genetics and Environment

what is asthma

A

a chronic inflammatory disorder of the airways characterzied by:
* airway inflammation
* bronchospasm
* mucus production
* leading to airflow obstruction & respiratory symptoms

73
Q

subjective data collection

what are some important questions to ask about a cough?

A
  1. onset
  2. character
  3. frquency
  4. severity
  5. sputum production
  6. associated symptoms
74
Q

subjective data collection

what should u ask about a px’s history of respiratory infection?

A
  1. frequency
  2. severity
  3. type of infections
75
Q

subjective data collection

what additional history should be obtained for infants & children?

A
  1. prenatal history
  2. birth history
  3. feeding history
  4. developmental milestones
76
Q

objective data collection

how should a px be positioned for a respiratory exam

A

sitting upright

77
Q

objective data collection

what should be INSPECTED during the respiratory exam?

A
  1. thoracic cage: shape & configuration
  2. RR & Rhythm
  3. skin color & condition
  4. accessory muscle use
  5. facial expression
  6. LOC
78
Q

objective data collection

what does tactile remitus assess

A

the transmission of vibrations thru the chest wall

79
Q

objective data collection

what percussion note is heard over nml lung tissues?

80
Q

objective data collection

what are the 3 nml breath sounds & where are they heard?

A
  1. bronchial: over the trachea
  2. bronchovesicular: over major bronchi
  3. vesicular: over peripheral lung fields
81
Q

measurement of pulmonary function status

what does forced expiratory time measure?

A

airflow obstruction

82
Q

measurement of pulmonary function status

what are the key measurements in spirometry?

A
  1. forced vital capacity (FVC)
  2. forced expiratory volume in 1 second (FEV1)
  3. FEV1/FEV ratio
83
Q

measurement of pulmonary function status

what does pulse oximetry measure

A

arterial o2 saturation

84
Q

measurement of pulmonary function status

what is the purpose of the 6 minute walk test?

A

to measure functional capacity in ppl with pulmonary & cardiac disorders

85
Q

Health Promotion and Patient Teaching

wat are the risks of 2nd hand smoke exposure?

A
  1. increased risk of resp infections
  2. asthma
  3. lung cancer
  4. heart disease
86
Q

documentation & critical thinking

what should be documented after a respiratory exam?

A
  1. subjective & objective data
  2. assessment
  3. plan

Physical Assessment (4 decks)

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