Ch 18 Throax & Lungs Flashcards Preview

Nursing Health Assessment exam 2 > Ch 18 Throax & Lungs > Flashcards

Flashcards in Ch 18 Throax & Lungs Deck (57)
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0
Q

Pleural cavities

A

On either side of the mediastinum contain the lungs

1
Q

Mediastinum

A

Middle section of the thoracic cavity containing the esophagus trachea heart and great vessels

2
Q

Lobes of the lungs of

A

Right lung has 3 lobes and left lung has 2

lobes

3
Q

Pleurae

A

Thin slippery, forms an envelope between the lungs and the chest wall

4
Q

Visceral pleura

A

Lines the outside of the lungs dipping down into the tissues it is continuous with the parietal pleura lining the inside of the chest wall and diaphragm

5
Q

Costodiaphragmatic recess

A

The pleural extend about 3cm below the level of the lungs forming . This is the potential space; when it abnormally fills with air or fluid it compromises lung expansion

6
Q

Acinus

A

Functional respiratory unit consist of bronchioles, alveolar ducts, alveolar sacs, and the alveoli. Gas exchange occurs across the respiratory membrane in alveoli ducts.

7
Q

Mechanics of Respirations

A

(1) supply oxygen to the body for energy production (2) removing carbon dioxide as a waste product for energy reaction (3) maintain homeostasis (acid-base balance) of Arterial blood (4) maintain heat exchange

8
Q

Hypercapnia

A

Increase of carbon dioxide in the blood

The normal stimulus for us to breathe

9
Q

Hypoxemia

A

A decrease of oxygen in the blood

Also increases Respirations but is less effective

10
Q

Surfactant

A

The complex lipid substance needed for sustained inflation of the air sacs

11
Q

Characteristics timing of a cough

A

Continuous throughout the day– acute illness (ex respiratory infection)

Afternoon/evening– may reflect exposure to irritants at work

Night– postnatal drip, sinusitis

Early morning – chronic bronchial inflammation of smokers

12
Q

Hemoptysis

A

The act of coughing up blood

13
Q

Chronic bronchitis characterized

A

History of productive cough for 3 months out of a year for 2years in a row

14
Q

Characteristic sputum production :

White or clear mucoid

A

Colds , bronchitis, viral infections,

15
Q

Characteristic sputum production :

Yellow or green mucoid

A

Bacterial infection

16
Q

Characteristic sputum production :

Rust colored mucoid

A

Tuberculosis pneumococcal pneumonia

17
Q

Characteristic sputum production :

Pink frothy mucoid

A

Pulmonary edema some sympathomimetic medication have side effect pink tinged mucus

18
Q

Conditions of Characteristics cough sound

A

Mycoplasma pneumonia = hacking

Early heart failure= dry

Croup= Barking

colds, bronchitis, pneumonia = congested

19
Q

Orthopnea

A

Difficulty breathing when supine need pillows to fine a comfort zone to breath

20
Q

Paroxysmal nocturnal dyspnea

A

Awakening from sleep with a shortness of breath (SOB) and needing to be upright to achieve comfort

21
Q

Emphysema

A

A type of COPD damaging the air sac alveoli in the lungs

22
Q

Histoplasmosis

A

A fungus that can effect the lungs once inhaled typical seen with farmers the fungus is found in soil

23
Q

Coccidioidomycosis

A

A fungus Found in the soil of south western United States and Mexico

24
Q

Pneumoconiosis

A

Lung disease cause by inhaling dust and coal mines

25
Q

Atelectasis

A

collapse or closure of the lung resulting in reduced or absent gas exchange. It may affect part or all of one lung.

26
Q

Symmetric chest expansion

A

You place your hand on the back of pt. as they inhale your thumbs slide apart evenly

Unequal chest expansion occur with atelectasis or pneumonia

27
Q

Tactile (vocal) Fremitus

A

Fremitus is a palpable vibration sound is generated from larynx are transmitted through patent bronchi and lung parenchyma to the chest wall where you feel the vibration

Have pt. repeat 99 or blue moon they generate strong vibrations

28
Q

Tactile Fremitus can be heard:

A

More prominent between the scapulae and around the sternum,

Affects the normal intensity: Thick chest wall , obese or muscular chest , pitch and intensity: a loud, low-pitch voice generates more than soft, high-pitched sound.

29
Q

Decreased Fremitus (vibration)

A

Occurs when anything obstructs transmission of vibrations (ex. Obstructed bronchus, pleural effusion or thickening, pneumothorax, or emphysema

30
Q

Increased Fremitus

A

Occurs with compression or consolidation of lung tissue (ex. Lobar pneumonia)

31
Q

Rhonchal Fremitus

A

Is palpable with thick bronchial secretions. vibration felt when inhaled air passes through thick secretion in the larger bronchi

32
Q

Pleural friction Fremitus

A

Is palpable with inflammation of the pleura produced when inflammation of the parietal or visceral pleura causes a decrease in the normal lubricating fluid

33
Q

Crepitus

A

Is a coarse crackling sensation palpable over the skin surface. Occurs in subcutaneous emphysema when air escapes from the lung and enters the subcutaneous tissue.

34
Q

Resonance

A

Is the low-pitched , clear, hollow sound that predominates in healthy lung tissue in the adult. However it has not constant standard

35
Q

Hyperresonance

A

Is a low-pitched booming sound found when too much air is present as in emphysema or pneumothorax

36
Q

Dull

A

Soft muffled thud signals abnormals density in the lungs as with pneumonia , pleural effusion atelectasis or tumor

37
Q

Diaphragmatic excursion

A

“Exhale and hold it” briefly while you press down the scapular line until sound changes from resonant to dull (on ea. side) this estimates the level of diaphragm separating the lungs from the abdominal viscera mark that spot “take a deep breath and hold it” continue précis sing down from 1st mark and mark the level where the sound changes to dull. Measure the difference this is the diaphragmatic excursion Should be equal bilaterally and measure about 3 to 5 cm in adults

38
Q

Pleural effusion

A

is excess fluid that accumulates in the pleural cavity. This excess can impair breathing by limiting the expansion of the lungs.

39
Q

Types of Normal breath sounds

A

Bronchial (tracheal) , bronchovesicular , vesicular

40
Q

Bronchial (tracheal)

A

High pitched loud amplitude sound quality is harsh, hollow tubular in the trachea and larynx

41
Q

Bronchovesicular

A

Moderate pitch and amplitude sound quality is mixed heard over the bronchi where fewer alveoli are located around the sternum

42
Q

Vesicular

A

Low pitch soft amplitude sound rustling like the sound of wind in trees heard over the peripheral lungs fields where air flows through

43
Q

Adventitious sounds

A

The added sounds that are not normally heard in the lungs. Crackles/rales, wheeze/rhonchi, or stridor

44
Q

Crackles (fine)

A

Sounds like rolling hair between the fingers occurs with obstructive disease (emphysema, chronic bronchitis) or restrictive diseases (pneumonia, heart failure)

45
Q

Crackles (coarse)

A

Loud low pitch bubbling gurgling sound sounds like opening Velcro occurs with pulmonary edema , pneumonia, pulmonary fibrosis

46
Q

Wheeze (sibilant) high pitched

A

High pitched musical squeaking sounds that sound polyphonic occurs diffuse airway obstruction from acute asthma or chronic emphysema

47
Q

Wheeze low pitched (sonorous rhonchi)

A

Low pitched monophonic single note musical snoring moaning sounds they are heard throughout the cycle occurs Bronchitis, single bronchus obstruction , Tumor

48
Q

Voice sounds

A

Ask a person to repeat a phrase such as 99 while you listen normal voice transmission is soft muffled and indistinct. Usually not done in the routine examination. Performed if suspected lung pathology on the basis of earlier data

Testing for bronchophony, egophony, or whispered pectoriloquy

49
Q

Bronchophony

A

Person repeats 99 listen with stethoscope Normally: is soft muffled and indistinct Abnormal : you auscultate a clear 99 pathology that increases lung density will enhance transmission of voice sounds

50
Q

Egophony

A

Listen while person says long “ee-ee-eee-ee” Normally: you hear eeeeeee
Abnormal: you hear a bleating long aaaaa sound

51
Q

Whispered Pectoriloquy

A

Auscultate ask pt. whispers one-two-three
Normally: faint muffled almost inaudible
Abnormal: with only small consolidation the whisper is very clearly

52
Q

Apgar scoring system

A

Scores the baby on its ability to extrauterine life it scores heart rate respiratory effort, muscle tone, reflex irritability and color

53
Q

Barrel chest

A

Equal anteroposterior-to-transverse Ribs are horizontal instead of normal downward slope An increased anteroposterior chest diameter.

54
Q

Scoliosis

A

A lateral S-shaped curvature of the thoracic and lumbar spine usually involved vertebrae rotation unequal shoulder and scapular height and unequal hip levels

55
Q

Kyphosis

A

An exaggerated posterior curvature of thoracic spine (humpback) that causes significant back pain and limited mobility

56
Q

Phrenic Nerve

A

When breathing is initiated messages are sent from the medulla’s respiratory center by way of this nerve to the primary respiratory muscles.