Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Health Assessment Exam #2 > Oxingination- Thorax and the Lungs > Flashcards

Oxingination- Thorax and the Lungs Flashcards

1
Q

Anterior Thorax

A

12 pairs of ribs

Sternum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Posterior Thorax

A

12 thoracic vertebrae

Spinal column

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Ribs

A

1-7 articulate with sternum
8-10 articulate with costal cartilage
11-12 do not articulate= free floating
All articulate with vertebrae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Right Lung

A

Three lobes: Upper, Middle, Lower

Shorter than left lung

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Left lung

A

two lobes- upper and lower

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Lung apex

A

Top of lung
Anterior - 2.5-4 cm above clavicles
Posterior at level of T1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Lung base

A

Bottom of lung
Anterior- 6th rib at MCL
Posterior- T10 on expiration and T12 on inspiration
Lateral 8th rib at MAL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Mediastinum

A

Extends from sternum to spine

Trachea and pulmonary vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Bronchi

A

Trachea bifurcates at sternal angle and level of 4th and 5th vertebrae
Right= shorter, more vertical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

External intercostal muscles

A

elevates ribs and increase size of thoracic cavity on inspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

internal intercostal muscles

A

draw ribs together during expiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Accessory Muscles

A

Used when there is increased demand for oxygen

Scalene, sternocleidomastoid, trapezius, abdominal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Inferior angle of scapula

A

Level of 7th rib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Anterior landmark lines

A

Anterior axillary line
Midclavicular line
Midsternal (vertebral) line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Axillary landmark lines

A

Anterior axillary line
Midaxillary line
Posterior axillary line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Posterior Landmark lines

A

Posterior axillary line
Scapular line
Midspinal or vertebral line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Inspiration

A

active, Muscle contraction, Negative intra-pulmonic pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Expiration

A

Passive, Muscles relax, Positive intra-pulmonic pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Common chief complainst

A

Dyspnea, Cough, Sputum, chest pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Generalized thorax approach

A

Compare right vs. left
systematic approach
Ask patient to displace breast tissue to palpate, auscultate, and percuss anterior thorax
Proceed from lung apices to the bases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Shape of thorax

A

Transverse diameter

Anteroposterior (AP) diameter- AP to transverse ratio 1:2 twice as wide as thick

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Barrel chest

A

1:1 ratio–round chest

COPD–air trapped in alveoli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Pectus carinatum

A

Protrusion of sternum

Congenital, Rickets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Pectus excavatum

A

Depression of sternum= Can compress heart and lungs

Congenital

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Posterior shape of thorax variations

A

Kyphosis-hunch back or scoliosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Symmetry of Anterior chest wall

A

Note any differences between the two sides, shoulder height should be the same, Masses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Symmetry of posterior chest wall

A

Note any differences between the two sides, position of scapula and shoulder height- should be the same, Masses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Presence of superficial veins

A

Dilated veins should not be seen

Note pattern and symmetry, if present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Costal angle

A

Angle formed by ribs and bottom of sternum= Normal is 90

Angle is less during expiration and rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Angle of ribs

A

Articulate with sternum at 45 degree angle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Intercostal spaces inspection

A

Observe through respiratory cycle
There should be no bulging or retraction
Abnormal: bulging during expiration/ retraction during inspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

7 Inspections of Respirations

A

Rate, Pattern, Depth, Symmetry, Audibility, Patient position, Mode

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Respiration Rate

A

full minute, do it slyly, in/out=1 cycle. Normal btw 12-20 breaths per min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Eupnea

A

12-20 breaths per minute (normal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Tachypnea

A

> 20 breaths per minute (stress, respiratory illness)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Bradypnea

A

< 12 breaths per minute (increased intracranial pressure, drug overdose)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Apnea

A

No respiration for 10 or more seconds (brain injury, sleep apnea)

38
Q

Respiration rhythm

A

Note rhythm or pattern of breathing- regularity or irregularity
Normal respirations should be regular and even

39
Q

Cheyne-Stokes

A

Pattern of Regularly irregular with gradual increase in depth then gradual decrease and a period of apnea (brain injury, coma)

40
Q

Agonal

A

Irregularly irregular with varying depths and patterns (impending death)

41
Q

Respiratory Depth

A

Observe at inspiration

Inspiration should be nonexaggerated and effortless

42
Q

Shallow depth

A

Minimal movement of chest (pain, lung problems)

43
Q

Hyperpnea

A

Greater volume but rate and pattern is even (warm-up for exercise, emotions, high altitude)

44
Q

Kussmaul’s

A

Increased rate and depth (diabetic acidosis)

45
Q

Respiratory Symmetry

A

How chest rises and falls during respiratory cycle

R/L thorax should move in unison

46
Q

Abnormal respiratory symmetry

A 
Unilateral expansion (absent or collapsed lung)
Paradoxical movement (fractured ribs)
47
Q

Respiratory Audibility

A

Listen for audibility of respiration

Normally audible a few cms from nose or mouth

48
Q

Abnormal Respiratory Audibility

A

Audible breaths when a few feet away (upper airway sounds)

49
Q

Orthopnea

A

difficulty breathing when lying down (COPD, congestive heart failure)

50
Q

Tripod position

A

easier to use accessory muscles (COPD)

51
Q

Mode of breathing

A

nose, mouth, or both to breathe
Note which part of respiratory cycle each is used
Should be able to inhale and exhale through nose

52
Q

Abnormal mode of breathing

A

Continuous mouth breathing (nasal or sinus blockage)

Pursed-lip breath–used to prolong expiration (COPD)

53
Q

Sputum inspection

A

color, consistency, amount, and odor

54
Q

Normal sputum findings

A

small amount clear or light yellow, odorless sputum, can be thick or thin depending on hydration

55
Q

Palpation of Anterior Thorax

A

apex to base. Above clavicles to bottom of ribs- ribs and intercostal spaces

56
Q

Palpation of Posterior Thorax

A

apex to base= Level of T1 to bottom of ribs

Palpate thoracic vertebrae, ribs, ICS

57
Q

Palpate lateral thorax

A

Have patient lift arms- apex to base= Axilla to bottom of ribs
Palpate ribs, ICS

58
Q

Pulsations

A

No pulsations should be present

Pulsation may indicate thoracic aortic aneurysm

59
Q

Masses

A

no masses should be present

60
Q

Palpation

A

Palpate Posterior, Anterior, and Lateral areas for all

61
Q

Thoracic Tenderness

A

No tenderness should be present- may be due to fractured ribs, chest trauma

62
Q

Crepitus

A

Beads of air are trapped in subcutaneous tissue= Crackling sensation when palpated (rice krispies

63
Q

Causes of Crepitus

A

pneumothorax, chest trauma or surgery

64
Q

Thoracic expansion

A

Assess extent and symmetry via thumbs at costal margins (A) and 10th vertebrae (P)

65
Q

Normal thoracic expansion

A

3-5 cm symmetrically

66
Q

Tactile fremitus definition

A

Palpable vibration of chest wall produced by spoken word, felt as buzzing

67
Q

Assessing tactile fremitus

A

Use ulnar aspect of closed fist, patient says “99,”

Down either side of sternum/vertebrae, out to sides- Note increase or decrease fremitus

68
Q

Lateral assessment of tactile fremitus

A

midaxillary, nipple level, xiphoid process level

69
Q

Normal tactile fremitus findings

A

More fremitus near major bronchi = 2nd ICS anteriorly, T1 and T2 posteriorly
Less fremitus in periphery of lungs

70
Q

Abnormal tactile fremitus findings

A

Increased= consolidation, decreased= increased air in lungs/thorax

71
Q

Tracheal position

A

Place finger pad on the trachea in the suprasternal notch

Move laterally to right and left of trachea

72
Q

Tracheal position Normal findings

A

midline in suprasternal notch

73
Q

Tracheal position abnormal findings

A

deviation may be due to pressure in thorax or enlarged thyroid

74
Q

General approach to percussion

A

indirect percussion, side-to-side/ top to bottom, compare sounds bilaterally, should be resonant

75
Q

Percussion of Anterior thorax

A

clavicles down to 6th ribs, in ICS, zig-zag motion

76
Q

Percussion of Posterior thorax

A

head bent forward, arms crossed

level of T1 to down to 10th rib btw scapula and vertebrae

77
Q

Percussion of Left Lateral thorax

A

axilla to 8th rib- mid axilla, nipple level, xiphooid process level, 8th rib= curved L

78
Q

Percussion of left lateral thorax

A

axilla to 8th rib- backwards z= axillary, posterior axillary line, anterior axillary line (nipply level), 8th rib

79
Q

General approach to auscultation

A

use diaphram of stethoscope to hear breath sounds. take deep breath through mouth.compare side to side w/ same pattern as percussion

80
Q

Bronchial breath sounds

A

I<E, Heard anteriorly near trachea

81
Q

Bronchovesicular breath sounds

A

I=E

Heard at 1st and 2nd ICS adjacent to sternum and between the scapulae

82
Q

Vesicular

A

I>E

Heard in peripheral lung tissue

83
Q

Fine Crackle

A

Mostly heard on late inspiration- High-pitched crackle or popping
Due to moisture in small airways as they reinflate

84
Q

coarse Crackle

A

Heard on inspiration- Low-pitched crackle or gurgling

Due to moisture in large airways as they reinflate

85
Q

Adventitious Breath sounds

A

crackle, wheeze, pleural friction rub, stridor

86
Q

Sonorous wheeze

A

Mostly heard on expiration- Low-pitched snoring sound

Due to narrowing of large airways or obstruction

87
Q

Sibilant Wheeze

A

Heard on expiration- High-pitched musical sound

Due to narrowing of large airways or obstruction

88
Q

Pleural Friction Rub

A

Heard on both inspiration and expiration- Creaking or grating sound
Due to inflammation of pleural membranes

89
Q

Stridor

A

Heard on inspiration- Crowing sound

Due to partial obstruction of larynx or trachea

90
Q

Bronchophony

A

“99”when stethoscope is moved side-to-side for comparison
Sound should be muffled
Abnormal if sound is clear and louder= consolidation

91
Q

Egophony

A

“e” when stethoscope is moved side-to-side for comparison
Sound should be muffled
Abnormal if sounds like “ay”= consolidation

92
Q

Whispered pectoriloquy

A

“99” when stethoscope is moved side-to-side for comparison
Sound should be muffled
Abnormal if sound is clear and louder= consolidation

Health Assessment Exam #2 (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions