Assessment Test 3 lungs
Terms
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- what is the thoracic cage?
- bony structure with conical shape, narrower at the top
- What defines the thoracic cage?
- sternum 12 ribs and thoracic vertebrae
- What does the diaphragm do?
- seperates thoracic cavity form abdomen
- What are the costochondral junctions
- places where ribs join cartilages
- Where is the suprasternal notch?
- just above sturnum, between clavicles
- Another name for sternum?
- breastbone
- Three parts of sternum
- manubrium, body, xiphoid process
- Another name for manubriosternal angle
- Angle of louis
- What is the angle of louis
- where body of sternum and manubrium meet
- What does the angle of louis mark?
- where trachea splits into lungs
- What is the costal angle?
- angle rib cage forms
- Reference lines on the anterior chest?
- midsternal and midclavicular
- Reference lines on posterior chest
- vertebral and scapular
- mediastinum
- middle section of thoracic cavity
- what is in the mediastinum?
- esophagus, trachea, heart, great vessels
- highest point of lung tissue
- apex
- losest point of lung tissue
- base
- How many lobes does the right lung have?
- 3
- How many lobes does the left lung have?
- 2
- What seperates the lung lobes
- fissures
- what does the pleurae form?
- envelope between the lungs and chest wall
- What does the visceral pleura line?
- outside of lungs
- What does the parietal pleura line?
- inside chest wall and diaphragm
- What is the inside of the envelope formed by the pleurae form?
- pleural cavity
- What type of pressure does the pleural cavity have?
- negative, vaccuum
- What does the negative pressure of the pleural cavity do?
- holds the lungs tightly against the wall
- What do the trachea do?
- transport gases between the environment and lungs
- What do the bronchi do?
- transport gases between the environment and lungs
- What is the dead space in the lungs?
- trachea and bronchi
- What are the bronchi lined with?
- cilia
- What do cilia do?
- sweep particles upward to be swallowed or expelled
- What is an acinus?
- functional respiratory unit
- What does the acinus consist of?
- bronchioles, alveolar ducts, alveolar sacs, and alveoli
- What are the 4 major functions of the respiratory system?
- suppy 02 to body for energy prod, remove CO2 as a waste prod., maintain homeostasis, and maintain heat exchange
- hypercapnia
- increase of CO2 in blood
- What stimulates breathing
- hypercapnia
- What is hypoxemia
- decrease in O2 in blood
- Which is more effective hypercapnia or hypoxemia
- hypercapnia
- what is surfactant?
- lipid substance needed for sustained inflation of air sacs
- When is surfactant present?
- 32 weeks
- Vital capacity
- maximum amt of air that a person can expel from the lungs after first filling the lungs to maximum
- Residual Volume
- amount of air remaining in lungs even after most forceful expiration
- What group of people has the highest incidence of TB?
- asians
- What is the lecithin/sphingomyelin ratio?
- lab measuremnt of amniotic fluid indicatng fetal pulmonary maturaty
- What condition is char. by a cough all throughout the day
- respiratory infection
- What is char disease associated with cough in the afternoon and evening?
- exposure to irritants at work
- Char disease of cough at night?
- postnasal drip, sinusitis
- Char disease of early morning cough?
- chronic bronchial inflammation of smokers
- Char of chronic bronchitis?
- hx of productive cough for 3 months of the year, X 2 years
- What does white or clear sputum signify?
- colds, brnchitis, viral infections
- What does yellow or green sputum suggest
- bacterial infection
- What does rust colored sputum suggest?
- TB, pneumococcal pneumonia
- What does pink frothy colored sputum suggest?
- pulomary edema, or side effect from med
- What does a dry cough suggest?
- eary heart failure
- What does a barking cough suggest?
- croup
- What does a congested cough suggest?
- colds, bronchitis, pneumonia
- What is paroxysmal noctural dyspnea?
- awakening from sleep with SOB, and need to be upright to achieve comfort
- What should the thoracic cage be like?
- symmetric, elliptical
- What is the dx when the anteroposterior diameter = the transverse diameter?
- barrel chest
- When does barrel chest occur?
- chronic emphysema
- How do you confirm symmetric chest expansion?
- place hands of back, put fold of skin between fingers, pt breaths, hands should move outward
- When does unequal chest expansion occur?
- atelectasis or pneumonaia,
- Another name for symmetric chest expansion
- resp. excursion
- What is fremitus?
- palpable vibration
- How do you assess for tactile fremitus?
- pt says "99", palpate over lungs with fists moving down back
- What should fremitus be?
- symmetric
- When does decreased fremitus occur?
- when you have obstructions
- When does increased fremitus occur?
- compression of consolidation of lung tissue
- What is rhonchal fremitus?
- palpable with thick bronchial secretion
- What is pleural friction fremitus
- palpable with inflammation of the pleura
- What should the predominant note over lung fields be?
- resonance
- Hyperresonance
- found when too much air is present
- conditions where you might find hyperresonance
- emphysema, pneumothorax
- What does a dull note signal?
- abnormal density in lungs
- conditions when you might see dull note?
- pneumonia, pleural effusion, atelectasis or tumor
- What is diaphragmatic excursion?
- detects difference in lung size between inhalation and exhalation
- What is normal diaphragmatic excursion?
- 3-5 cm
- Describe how to do diaphragmatic excursion?
- 3-5 cm
- Which side is normally higher in diaphragmatic excursion?
- right side
- 3 types of normal breath sounds
- bronchial, bronchovesicular, vesicular
- Pitch of bronchial sounds?
- high
- Pitch of bronchovesicular sounds?
- moderate
- Pitch of vesicular sounds?
- low
- Duration of bronchial sounds
- inspiration < expiration
- Duration of bronchovesicular sounds?
- inspiration = expiration
- Duration of vesicular sounds?
- inspiration > expiration
- Where should you find bronchial sounds?
- over the neck
- Where should you find bronchovesicular sounds?
- close to the sternum and back bone
- Where should you hear vesicular sounds?
- over lung fields
- what are adventitious sounds
- abnormal sounds
- rales
- crackles
- rhonchi
- wheezes
- atelectatic crackles
- short, poppleing, crackles
- What does normal voice transmission sound like?
- soft, muffled, indistinct
- What enhances sound heard over lungs?
- consolidation and compression
- how do you do bronchophony?
- have person repeat 99 while you listen over chest wall
- Normal findings of bronchophony?
- soft muffled, and indistinct
- Abnormal findings of bronchophony
- hear a clear 99
- How do you do egophony?
- auscultate while person says eee
- Normal findings of egophony
- hear eee sound
- Abnormal finding of egophony
- hear aaaa
- How do you do whispered pectoriloquy?
- auscultate while person whispers a phrase
- Normal findings of whispered pectoriloquy
- faint, muffled, and almost inaudible
- abnormal findings of whispered pectoriloquy
- heard clearly and distinctly
- When does clubbing occur?
- Chronic respiratory disease
- forced expiratory time
- number of seconds it takes for person to exhale from total lung capacity to residual volume
- What does forced expiratory time screen for?
- airflow obstruction
- what does a pulse oximeter assess?
- arterial O2 saturation
- When does a barrel chest develop in a child?
- asthma or cystic fibrosis
- What is Harrisons groove?
- groove in rib cage
- What disease does Harrisons groove occur with?
- rickets
- newborns first respiratory assessment
- apgar score
- When is the apgar scored?
- at 1 min and 5 min after birth
- A one min apgar score that indicates normal resp
- 7-10
- kyphosis
- outward curvature of the thoracic spine
- Pectus excavatum
- sunken sternum
- percus carinatum
- forward protusion of sternum
- scoliosis
- S - shaped curvature of the thoracis and lumbar spine
- Normal rate for adult breathing
- 10-20
- tachypnea
- rapid shallow breathing
- hyperventilation
- increase in rate and depth
- bradypnea
- slow breathing
- hypoventilation
- irregular shallow pattern caused by overdose
- Cheyne-Stokes
- cycle where respirations wax and wane in regular patten
- Biots respiration
- cycle where respiratiosn wax and wane in abnormal pattern