Week 5: Thorax And Lungs

Question 1

Anterior thoracic landmarks

Answer 1

•Suprasternal notch
•Sternum
•Sternal angle
•Costal angle

Question 2

Posterior thoracic landmarks

Answer 2

•Vertebra prominens
•Spinous processes
•Inferior border of scapula
•Twelfth rib

Question 3

The mediastinum of the thoracic cavity contains?

Answer 3

Esophagus, trachea, heart, great vessels

Question 4

Lobes of the lungs

Answer 4

Anterior, posterior and lateral

Question 5

Four functions of respiratory system

Answer 5

•Control of respiration
•Changing chest size during respiration
•Inspiration
•Expiration

Question 6

Developmental considerations for infants and children

Answer 6

•Surfactant
•Changes to circulatory system at birth
•Vulnerability related to small size and imma

Question 7

Developmental considerations for pregnant individuals

Answer 7

•Enlarging uterus elevates diaphragm; decreases vertical diameter of thoracic cage, compensated by increase in horizontal diameter

Question 8

Developmental considerations for older adults

Answer 8

•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

Question 9

Subjective data

Answer 9

•Cough
•Shortness of breath
•Chest pain with breathing
•History of respiratory infections
•Smoking history
•Environmental expos

Question 10

Normal breath sounds in the posterior chest for adults and older child

Answer 10

•Bronchial, sometimes called tracheal or tubular
•Bronchovesicular
•Vesicular

Question 11

Bronchial breath sounds description

Answer 11

•BRONCHIAL (TRACHEAL)
•High pitch
•Loud
•Inspiration < expiration
•Harsh, hollow, tubular
•Location – Over the trachea and larynx

Question 12

Bronchovesicular breath sound description

Answer 12

•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

Question 13

Vesicular breath sound description

Answer 13

•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

Question 14

Adventitious sounds

Answer 14

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.

Question 15

Atelectatic crackles

Answer 15

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

Question 16

Decreased or absent breath sounds may indicate?

Answer 16

•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

Question 17

Abnormal findings

Answer 17

Kyphosis, scoliosis, barrel chest, pectus excavatum, pectus carinatum

Question 18

How many breaths per minute is considered normal?

Answer 18

10-20 breaths per minute

Question 19

Tachypnea

Answer 19

Rapid, shallow breathing. Increased rate is more than 24 breaths per minute

Question 20

Hyperventilation

Answer 20

Increase in both rate and depth. Normally occurs with extreme exertion, fear or anxiety

Question 21

Bradypnea

Answer 21

Slow breathing, a decreased but regular rate (<10 breaths per minute)

Question 22

Hypoventilation

Answer 22

An irregular, shallow pattern caused by an overdose of narcotics or anaesthetic.

Question 23

Cheyne-Stokes respiration

Answer 23

•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

Question 24

Biot’s respiration

Answer 24

•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

Question 25

Adventitious lung sounds

Answer 25

Discontinuous
•Crackles – fine
•Crackles – coarse
•Atelectatic crackles
•Pleural friction rub

Continuous
•Wheeze – high pitched (sibilant)
•Wheeze – low pitched (sonorous rhonchi)
•Stridor

Question 26

Atelectasis

Answer 26

Collapsed lungs as a result of airway obstruction

Question 27

Lobar pneumonia

Answer 27

Infection in lung parenchyma leaves alveolar membrane edematous and porous, and so red blood cells (RBCs) and white blood cell (WBCs) pass from blood to alveoli. Alveoli progressively fill up with bacteria, solid cellular debris, fluid and blood cells, all of which replace alveoli air

Question 28

Bronchitis

Answer 28

nchitisCondition: Proliferation of mucous glands in the passageways, resulting in excessive mucus secretion. Inflammation of bronchi with partial obstruction of bronchi by secretions or constrictions. Sections of lung distal to obstruction may be deflated. Bronchitis may be acute or chronic with recurrent productive cough. Chronic bronchitis is usually caused by cigarette smoking