Week 5: Thorax And Lungs Flashcards
Anterior thoracic landmarks
•Suprasternal notch
•Sternum
•Sternal angle
•Costal angle
Posterior thoracic landmarks
•Vertebra prominens
•Spinous processes
•Inferior border of scapula
•Twelfth rib
The mediastinum of the thoracic cavity contains?
Esophagus, trachea, heart, great vessels
Lobes of the lungs
Anterior, posterior and lateral
Four functions of respiratory system
•Control of respiration
•Changing chest size during respiration
•Inspiration
•Expiration
Developmental considerations for infants and children
•Surfactant
•Changes to circulatory system at birth
•Vulnerability related to small size and imma
Developmental considerations for pregnant individuals
•Enlarging uterus elevates diaphragm; decreases vertical diameter of thoracic cage, compensated by increase in horizontal diameter
Developmental considerations for older adults
•Lungs more rigid and harder to inflate
•Decrease in vital capacity
•Increase in residual volume
•Decrease in number of alveoli
•Increased shortness of breath on exertion
•Increased risk for postoperative complications
Subjective data
•Cough
•Shortness of breath
•Chest pain with breathing
•History of respiratory infections
•Smoking history
•Environmental expos
Normal breath sounds in the posterior chest for adults and older child
•Bronchial, sometimes called tracheal or tubular
•Bronchovesicular
•Vesicular
Bronchial breath sounds description
•BRONCHIAL (TRACHEAL)
•High pitch
•Loud
•Inspiration < expiration
•Harsh, hollow, tubular
•Location – Over the trachea and larynx
Bronchovesicular breath sound description
•Moderate pitch
•Moderately loud
•Inspiration = expiration
•Mixed
•Location - Over major bronchi, where fewer alveoli are located: posterior, between scapulae (especially on right); anterior, around upper sternum in first and second intercostal spac
Vesicular breath sound description
•Low pitch
•Soft loudness
•Inspiration > expiration
•Rustling, like the sound of the wind in the trees
•Location - over peripheral lung fields, where air flows through smaller bronchioles and alveoli
Adventitious sounds
Added sounds that are not normally heard in lungs. Caused by moving air colliding with secretions in tracheobronchial passageways or by popping open of previously deflated airways.
Atelectatic crackles
a type of adventitious sound, is not pathologic; short, popping, crackling sounds that sound like fine crackles but do not last beyond a few breaths, heard only in the periphery
Decreased or absent breath sounds may indicate?
•Obstruction of the bronchial tree
•Emphysema – loss of elasticity of lung fibres and hyper inflated lungs
•Obstruction – due to pleural effusion or pneumothorax where there is an obstruction of the transmission of the sound
Abnormal findings
Kyphosis, scoliosis, barrel chest, pectus excavatum, pectus carinatum
How many breaths per minute is considered normal?
10-20 breaths per minute
Tachypnea
Rapid, shallow breathing. Increased rate is more than 24 breaths per minute
Hyperventilation
Increase in both rate and depth. Normally occurs with extreme exertion, fear or anxiety
Bradypnea
Slow breathing, a decreased but regular rate (<10 breaths per minute)
Hypoventilation
An irregular, shallow pattern caused by an overdose of narcotics or anaesthetic.
Cheyne-Stokes respiration
•A cycle in which respirations gradually wax and wane in a regular pattern, increasing in rate and depth and then decreasing. The breathing periods last 30 to 45 seconds, with periods of apnea (20 seconds) alternating the cycle. The most common cause is severe heart failure; other causes are renal failure, meningitis, drug overdose, and increased intracranial pressure. Occurs normally in infants and older adults during sleep
Biot’s respiration
•Similar to Cheyne-Stokes respiration, except that the pattern is irregular. A series of normal respirations (three to four) is followed by a period of apnea. The cycle length is variable, lasting anywhere from 10 seconds to 1 minute. Occurs with head trauma, brain abscess, heat stroke, spinal meningitis, and encephalitis
