Thorax & Respiratory System Flashcards
What does the diaphragm do during ins-piration?
contracts
What is the role of external intercostal muscle during inspiration?
increase the anteroposterior chest diameter
What are the primary muscles of respiration?
interior intercostals (decrease transverse chest diameter during expiration), SCM and trapezius are accessory muscles (used when there are pulmonary problems)
How many lobes do the lungs have?
right:three, left: 2 and a lingula
The trachea divides into right and left main bronchi at about what thoracic level?
T4 or T5 just below manubriosternal joint
The main bronchi divide into?
three branches on the right and two on the left
Which bronchus is winder, shorter, and more vertically placed leaving it more susceptible to aspiration of foreign bodies?
right bronchus
Which intercostal space are the male nipples typically located?
4th intercostal space
The manubriosternal junction is located at which intercostal space?
2nd intercostal space
Where are the lungs located in relation to the clavicles?
the apex is partially above the clavicles
How do fetuses have gas exchange?
through placenta (NOT the lungs)
How would you describe the chest of a newborn?
round (chest and head circumference are about the same until age 2)
Why do premature babies have lung issues?
because the lungs are the last thing to develop
What is the proper order of a chest examination?
inspection, palpation, percussion, auscultation
When inspecting a patient during a chest exam, what are you looking for
finger clubbing, breath odor, skin, nail and lip cyanosis or pallor, pursing lips, nostril flaring
What is the normal respiration rate in an adult?
12-20 breaths/minute
Respiratory rhythm in a resting adult is described as what kind of breathing?
kussmaul
What kind of respiration patter should a resting adult have?
cheyne-stokes, biot respirations
Retractions in the chest wall symmetry would indicate?
obstruction
What is the term for-on inspiration, the lower thorax is drawn in, and on expiration, the opposite occurs (thorax moves in a wave from bottom up)
paradoxic breathing
Name the three P structures in the body that might produce friction rubs?
pleura, paracardium, and peritineum
What could cause deviation of the trachea?
large thyroid, aortic aneurysm, collapsed lung (pneumothorax), cancer-tumor, goiter
What side would the diaphragm typically be higher on and from what structure?
the right from the liver
What would you want the measurement of diaphragmatic excursion to be in a health patient?
between 3-5 cm difference
Where would you expect to hear vesicular breathing?
over healthy lung tissue
where would you expect to hear bronchovesicular breath sounds?
over the major bronchi
where would you expect to hear bronchial breath sounds?
over the trachea
If bronchovesicular and bronchial breath sounds are abnormal, where would you expect to hear them?
over peripheral lung tissue
This breah sound is most often heard with large, relatively stiff-walled pulmonary cavity or tension pneumothorax with bronchopleural fistula
amorphic
This breah sound is commonly heard over a pulmonary cavity in which the wall is rigid
cavernous
When are crackles most likely heard?
during inspiration
What causes a wheeze?
a relatively high-velocity air flow through a narrowed or obstructed airway
What conditions would most likely produce a wheeze?
bronchospasm od asthma or acute or chronic bronchitis
These breath sounds are similar to a wheeze but are deeper, more rumbling, more pronounced during expiration, more likely to be prolonged and continuous, and less discreet than crackles
rhonchi (sonorous wheezes)
What causes rhonchi breath sounds?
passage of air through and airway obstructed by thick secretions, muscular spasm, new growth, or external pressure
Where would a friction run occur?
outside the respiratory tree
Which breath sound has the aka Hamman sign and is found with mediastinal emphysema?
mediastinal crunch
Extreme bronchophony where even a whisper can be heard clearly through the stethoscope is what kind of vocal resonance?
pectoriloquy
intensity of the spoken voice is increased and there is a nasal quality where e’s become stuffy nasal a’s in which vocal resonance?
egophony
What is the normal respiratory rate in an infant?
40-60 breaths/minute
Coughing is rare in infants, what is common?
frequent sneezing and hiccups
Infant flaring of alas nasi is an indicator of?
respiratory distress
Are children chest resonance more or less than adults?
more
Incomplete expansion of the lung at birth or the collapse of lung segment(s) at any age is called?
atelectasis
inflammation of the large airways is called?
bronchitis
small airway obstruction due to inflammation and hyper-reactive airways is called?
asthma
inflammatory process involving the visceral and parietal pleura, which becomes edematous and fibrinous is called?
pleurisy
excessive nonpurulent fluid in the pleural space is called?
pleural effusion
purulent exudative fluid collected in the pleural space is called?
empyema
What is the most common cause of pleural effusion?
CHF
presence of air or gas in the potential space of the pleural cavity is called?
pneumothorax
Presence of blood in the pleural cavity is called?
hemothorax
Generally refers to bronchogenic carcinoma, a malignant tumor that evolves from bronchial epithelial structures
lung cancer
Pneumothorax (collapse lung) MC?
marfan’s syndrome
What are the two biggest risk factors of bronchogenic carcinoma?
radon and smoking
well-defined, circumscribed mass defined by inflammation, suppuration, and subsequent central necrosis is a?
lung abscess (infxn)
inflammatory response of the bronchioles and alveoli to an infective agent (bacterial, fungal, or viral?
pneumonia
What lung pathology has a “cluster of grape” appearance?
Bronchiectasis
Hemothorax is associated with which pathology?
TB
Air inside OR outside the lung would cause what change to breath sounds and resonance?
decrease (air is an insulator)
When air is present inside or outside the lung, what happens to percussion?
increased
Mucus inside the lung does what to breath sounds and resonance?
increase
Mucus outside the lung does what to breath sounds?
decreases
Mucus inside or outside the lung causes what kind of noise during percussion?
a dud sounds (thud)
