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Health Assessment NUR 202 > CH: 19 Thorax and Lungs > Flashcards

CH: 19 Thorax and Lungs Flashcards

1
Q

suprasternal notch location?

A

top of sternum between clavicles
*hollow U shaped depression

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2
Q

what is the manubriosternal angle known as?

A

angle of Louis

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3
Q

manubriosternal angle lines up with?

A

2nd rib

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4
Q

location of 1st rib?

A

below clavicle

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5
Q

are intercostal spaces above or below ribs?

A

below
ex. 7th intercostal space below 7th rib

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6
Q

what is the costal angle?

A

right and left costal margins form angle where they meet at the Xiphoid process
*usually 90 degrees or less

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7
Q

how many ribs on the front?

A

11

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8
Q

how many ribs on the back?

A

12

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9
Q

which ribs attach directly to the sternum via costal cartilage?

A

1-7

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10
Q

which ribs attach to the costal cartilage above?

A

8, 9, 10
*7’s cartilage attaches to sternum, 8’s cartilage attaches to 7’s cartilage

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11
Q

which ribs are floating?

A

11 and 12

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12
Q

what is the bony prominence at the top of the neck?

A

spinous process of C7

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13
Q

where is the midsternal line?

A

down middle of sternum anteriorly

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14
Q

where is the midclavicular line?

A

the middle of the clavicle anteriorly

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15
Q

where is the midspinal/vertebral line?

A

down middle of back/spine posteriorly

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16
Q

where is the scapular line?

A

middle of scapula posteriorly

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17
Q

where is the anterior axillary line?

A

between anterior arm and chest

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18
Q

where is the midaxillary line?

A

middle of axillary laterally

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19
Q

posterior axillary line?

A

between posterior deltoid and back

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20
Q

what is contained in the mediastinum?

A

esophagus
trachea
heart
great vessels

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21
Q

what is contained in the right and left pleural cavities?

A

the lungs

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22
Q

apex of lung location?

A

above the clavical

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23
Q

base of lung location?

A

rests on diaphragm at about the 6th rib at midclavicular

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24
Q

how many lobes does the right lung have?

A

three (middle lobe)

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25
Q

how many lobes does the left lung have?

A

two

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26
Q

which lobe dominates the posterior region?

A

LOWER lobe

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27
Q

which lobe is SHORTER?

A

right
*because of underlying liver

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28
Q

which lobe is NARROWER?

A

left
*because heart bulges to the left

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29
Q

use of accessory muscles usually indicates?

A

trouble breathing, possible respiratory distress

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30
Q

why is surface area important?

A

so alveoli have space for gas exchange

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31
Q

what is atelectasis?

A

alveolar collapse

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32
Q

what is decubitus positioning?

A

lay flat and lift head
*to see fluid movement

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33
Q

what do loop diuretics help with?

A

ventilation and gas exchange
*they get rid of fluid

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34
Q

respiratory system mechanic functions?

A

chest size change during respiration
inspiration
expiration
control of respiration (breathing rate controlled by baroreceptors controlled by brain stem)

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35
Q

coughing up blood is called?

A

hemoptysis
*could indicate lung cancer

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36
Q

pulmonary edema cough produces?

A

thick, pink, frothy sputum
*could lead to respiratory arrest, emergent

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37
Q

what color sputum with TB?

A

rust

38
Q

bacterial/viral production?

A

green/yellow color
*ex. bronchitis

39
Q

SOB is a concern _____?

A

at rest

40
Q

takes deep breath and chest pain stays the same, possible cause?

A

heart/MI

41
Q

takes deep breath and chest pain worsens, possible cause?

A

lungs

42
Q

orthopnea?

A

difficulty breathing in supine position

43
Q

what is anteroposterior diameter?

A

distance from front to back when looking from the side

44
Q

what is transverse diameter?

A

true width of patient when looking straight at anterior

45
Q

normal AP diameter?

A

1:2 ratio

46
Q

barrel chest AP diameter?

A

1:1 ratio - hyperinflation
*usually in COPD

47
Q

assessment order for thorax and lungs?

A

inspect
palpate
percuss
auscultate

48
Q

organs sound ___?

A

dull

49
Q

bones sound ___?

A

flat

50
Q

in percussion, normal healthy lung sounds?

A

resonance
-low pitched, clear, hollow

51
Q

in what diseases might you see accessory muscle use?

A

COPD
ARDS
asthma
respiratory infection
chronic bronchitis
pneumonia
emphysema
pulmonary edema
pulmonary embolism

52
Q

positioning for respiratory distress?

A

tripod

53
Q

thumb placement during symmetric expansion?

A

9th rib
*normal should be bilaterally symmetric

54
Q

who might not have bilaterally symmetric expansion?

A

atelectasis (collapsed lung/alveoli)
pneumonia
pneumothorax
lobotomy

55
Q

what does tactile fremitus assess?

A

vibration of larynx through bronchi

56
Q

who might not have equally bilateral tactile fremitus?

A

lung disease
pneumonia

57
Q

who might have decreased tactile fremitus?

A

asthma
pleural effusion
atelectasis
*with hyperinflation

58
Q

what are the three breath sounds?

A

bronchial
bronchovesicular
vesicular

59
Q

which breath sound is the loudest with high pitch, hollow quality, expiration>inspiration?

A

bronchial

60
Q

which breath sound is moderate pitch and amplitude, mixed quality, expiration=inspiration?

A

bronchovesicular

61
Q

which breath sound is quieter with low pitch, rustling quality, inspiration>expiration?

A

vesicular

62
Q

main airway sounds?

A

vesicular

63
Q

peripheral field sounds?

A

vesicular

64
Q

is the diaphragm better for high or low pitched?

A

high pitched
*bell for low pitched

65
Q

crackles sound and cause?

A

discontinuous popping, like rice crispies
high pitched
*caused by inhaled air colliding with deflated airway
*inspiration, expiration, or both

66
Q

wheezes sound and cause?

A

continuous high pitched whistling
*caused by airway constriction
*inspiration, expiration, or both

67
Q

rhonchi sound and cause?

A

continuous low pitched snoring quality
*caused by secretions in large airway
*inspiration, expiration, or both

68
Q

stridor sound and cause?

A

continuous high pitched wheeze in upper airway
*caused by obstruction or narrowing, associated with anaphylaxis late response
*usually heard on inspiration, listen over trachea

69
Q

bronchophony sound?

A

have patient say 99
*muffled is normal
*clear indicates fluid or mucus in lungs

70
Q

egophony sound?

A

whisper 99
*clear sound is abnormal

71
Q

whispered pectoriloquy?

A

have patient say “e”- if sounds like “a” indicates fluid accumulation

72
Q

are breath/lung sounds louder through vesicular or bronchial tubes?

A

bronchial
*vesicular is quieter

73
Q

cyanosis occurs with?

A

tissue hypoxia

74
Q

what is rhonchal fremitus?

A

palpable with thick bronchial secretions

75
Q

what is pleural friction fremitus?

A

palpable with pleura inflammation

76
Q

what is crepitus?

A

coarse, crackling palpable over skin surface
(rice crispies)
*happens when SUBQ air escapes lung and enters SUBQ tissue

77
Q

what is hyperresonance?

A

low pitched booming sound when too much air is present

78
Q

6 min walk?

A

measures pulmonary rehab
stop if breathlessness or if O2 below 85

79
Q

what happens during sleep apnea?

A

tongue falls back and obstructs airway

80
Q

kyphosis usually from___?

A

degenerative disease

81
Q

sighs are purposeful to___?

A

expand alveoli

82
Q

tachypnea?

A

rapid, shallow breathing

83
Q

bradypnea?

A

slow rate

84
Q

hyperventilation?

A

increased rate AND depth

85
Q

hypoventilation?

A

decreased rate AND depth

86
Q

Cheyne-Stokes breathing?

A

wax and wane (increase and decrease) until apnea in regular pattern
*seen most commonly with heart failure

87
Q

Biot’s respiration?

A

same as CSB but irregular pattern
*seen with head trauma

88
Q

chronic obstructive breathing?

A

normal inspiration and prolonged expiration
*leads to air trapping

89
Q

kidneys make___?

A

BICARB
lungs drive Co2
Co2 is acidic
pH down when acidic and up when basic

90
Q

COPD is similar to____?

A

asthma
*asthma reversible, COPD is not (chronic)

Health Assessment NUR 202 (17 decks)

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