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Assessment Test 3 lungs

Terms

undefined, object
copy deck
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

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