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Health Assessment > Week 9 - Respiratory Assessment > Flashcards

Week 9 - Respiratory Assessment Flashcards

1
Q

Anatomy of Upper Airway (4)

A
  1. Mouth & oropharynx
  2. Nose & nasopharynx (better filtration)
  3. Pharynx
  4. Larynx
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2
Q

Anatomy of Lower Airway (4)

A
  1. Trachea
  2. Carina
  3. Bronchi
  4. Terminal Bronchioles (slows down air flow, smaller diameter)
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3
Q

Anatomy of Acinus (4)

A
  1. Respiratory Bronchioles
  2. Alveolar ducts
  3. Alveolar sacs
  4. Alveoli
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4
Q

Type I Alveolar cells

A

responsible for structure

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5
Q

Type II Alveolar cells

A

responsible for surfactant

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6
Q

Alveolar Macrophages

A

keepin’ clean

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7
Q

3 Types of Pleura

A
  • Visceral Pleura
  • Parietal Pleura
  • Pleural Space
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8
Q

Four Major Functions of the Respiratory System

A
  1. Supply oxygen to the body
  2. Remove carbon dioxide
  3. Maintain homeostasis (acid-base balance)
  4. Maintain heat exchange
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9
Q

Hypoventilation

A

increases CO2 in the blood

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10
Q

Hyperventilation

A

decreases CO2 in the blood

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11
Q

Properties of respiration control (3)

A
  1. Normally involuntary
  2. Mediated by the respiratory center in the brain stem
  3. Breathing patterns change in response to varying levels of CO2 AND O2 in the blood
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12
Q

Stimulus to Breathe

A
  1. Normal stimulus to breathe in most people is an increase in CO2 or hypercapnia
  2. A decrease in O2 (hypoxemia) also increases respirations, but less effective than hypercapnia
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13
Q

Hypercapnia

A

increase in CO2 in bloodstream

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14
Q

Hypoxemia

A

decrease in O2 in bloodstream

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15
Q

Landmarks of the Thoracic Cage (4)

A
  • Sternum
  • 12 pairs of ribs
  • 12 thoracic vertebrae
  • Diaphragm
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16
Q

Landmarks of Anterior chest (7)

A
  1. Ribs 2, 4, 5, 6
  2. Suprasternal notch
  3. Manubrium of sternum
  4. Angle of Louis
  5. Body of sternum
  6. Xiphoid process
  7. Costal angle
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17
Q

Landmarks of Posterior chest (6)

A
  1. T1
  2. C7 (vertebra prominens)
  3. T3
  4. Inferior angle of scapula
  5. T10 and T12
  6. 12th rib
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18
Q

Anterior Reference Lines (3)

A
  1. Anterior axillary line
  2. Midclavicular line
  3. Midsternal line
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19
Q

Posterior Reference Lines (2)

A
  1. Scapular line

2. Vertebral line

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20
Q

Axillary Reference Lines (3)

A
  1. Anterior axillary line
  2. Midaxillary line
  3. Posterior axillary line
21
Q

Areas of lung assessment

A
  1. Mediastinum (middle of thoracic cage) location of hear
  2. Right pleural cavity
  3. Left pleural cavity
  4. Right lung has 3 lobes, left lung only has 2
  • Posterior chest is all lower lobes
  • Anterior chest is mostly upper lobes
  • Lateral sides we can see all 3 lobes, only place we hear the mid lobe (right side)
22
Q

Considerations for Infants and Children (3)

A
  • Surfactant not present until 32w gestation
  • Smaller size of the respiratory system
    ○ Nasal passages
    ○ Diameter of airway
    ○ Distance between structures
  • Immune system immaturity
23
Q

Considerations for Pregnancy (3)

A
  • Decreased space for lung expansion
  • Increased circumference of thoracic cage
  • Increased O2 demand
24
Q

Considerations for Aging Adults (4)

A
  • Costal cartilage calcification (stiff)
  • Decreased respiratory muscle strength
  • Decreased elasticity within the lungs (more rigid, harder to inflate)
  • Increase in small airway closure
25
Q

Components of Subjective Respiratory Assessment (7)

A
  1. Cough
    - Productive? - coughing anything up
    - Hemoptysis - blood
  2. SOB (Dyspnea)
  3. Chest pain with breathing
  4. Past history of respiratory infections
  5. Smoking history
  6. Environmental exposure
  7. Self care behaviours
26
Q

Hemoptysis

A

Blood in cough

27
Q

Components of Inspection (8)

A
  1. Skin colour and condition
  2. Nail beds (cap refill less than 2s), clubbing
  3. Thoracic cage: shape and configuration, costal angle is 90, less deep than wide
  4. Respirations: rate, rhythm, depth, pattern
  5. Work Of Breathing, persons position and facial expression, extra muscles
  6. LOC
  7. Signs of distress
  8. Sputum
28
Q

Signs of respiratory distress (10)

A
  1. Increased WOB
  2. Sudden onset of SOB
  3. Gasping
  4. Colour changes around lips and nail beds
  5. Increasing RR
  6. Decreasing oxygen saturation
  7. Changes in LOC
  8. Tracheal tugging
  9. Retractions/indrawing
  10. Nasal flaring
29
Q

Barrel chest

A

(Unexpected Configurations of thoracic cage)

Depth of chest is wider or equal to width of chest

30
Q

Scoliosis

A

(Unexpected Configurations of thoracic cage)

S-shape in spine

31
Q

Kyphosis

A

(Unexpected Configurations of thoracic cage)

Curvature in spine (old person hunch)

32
Q

Pectus excavatum

A

(Unexpected Configurations of thoracic cage)

Sunken sternum

33
Q

Pectus carinatum

A

(Unexpected Configurations of thoracic cage)

Protruded sternum

34
Q

Components of Palpation

A

Check anterior, posterior & lateral chest for symmetry

Tactile Fremitus (vibrations in the chest wall) - say “99” or “blue moon” for resonance

35
Q

Pleural Effusion

A

Fluid in the lungs

Decreased fremitus on palpation

36
Q

Pneumothorax

A

Collapsed lung

Decreased fremitus on palpation

37
Q

Pneumonia

A

Consolidation of lung tissue (alveoli fill with pus)

Increased fremitus on palpation
Dullness in percussion

38
Q

Crepitus

A

Sounds like bubble-wrap, air enters subcut. tissue

39
Q

Percussion notes

A
  1. Resonance (should predominate)
  2. Hyperresonance (too much air)
  3. Dullness (abnormal density in lungs, pneumonia)
  4. Tympany (abdominal area)
40
Q

Expected breath sounds (Auscultation)

A
  • Bronchial (tracheal) = insipration < expiration
  • Bronchovesicular: insipration = expiration
  • Vesicular: insipration > expiration, hear it everywhere
41
Q

Adventitious Breath Sounds (Auscultation)

A
  1. Crackles
  2. Wheezes
  3. Rubs
  4. Stridor
42
Q

Crackles

A

Adventitious Breath Sounds (Auscultation)

Fine = sounds like hair rubbing together
Coarse = sounds like velcro
43
Q

Wheezes

A

Adventitious Breath Sounds (Auscultation)

Inspiratory and Expiratory

44
Q

Rubs

A

Pleural friction rub (inflamed, unlubricated pleura)

Sounds like leather

45
Q

Stridor

A

Narrowing of upper airway, sounds like a whale or dolphin

46
Q

Abnormal/unexpected breath sounds

A
  • Diminished, decreased or absent sounds

- Increased sounds

47
Q

Bronchophony

A

Tests for consolidation (pneumonia)

Say “99”

Expected: hear sound but can’t tell what’s been said
Unexpected: you can hear “99” on auscultation

48
Q

Egophony

A

Tests for consolidation (pneumonia)

Say “eeeee”

Expected: hear “eeeee”
Unexpected: you “aaaaaa” on auscultation

49
Q

Whispered Pectoriloquy

A

Tests for consolidation (pneumonia)

Whisper “1, 2, 3”

Expected: hear faintly, muddled, inaudible
Unexpected: hear it clearly and distinctly

Health Assessment (8 decks)

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