Ch. 19 (Thorax & Lungs)

Question 1

What vertebrae is known as the vertebrae prominens?

Answer 1

C7

Question 2

What is the middle section of the thoracic cavity where the esphogaus, trachea, heart and great vessels are?

Answer 2

mediastinum

Question 3

What is located on each side of the mediastinum?

Answer 3

pleural cavities

Question 4

What do pleural cavities hold?

Answer 4

the lungs

Question 5

What do we call the top region of the lung borders?

Answer 5

apex

highest point of lung tissue

Question 6

What do we call the bottom region of the lung borders?

Answer 6

base

Question 7

Where does the base of the lungs rest?

Answer 7

in the pleural cavities, above the diaphragm

Question 8

What is the separator between the lungs and the abdominen?

Answer 8

diaphragm

Question 9

The lungs are assymetrical.

Which lung is shorter and why?

Answer 9

right, to make room for the liver

Question 10

How many lobes does the right lung contain?

Answer 10

3

Question 11

How many lobes does the left lung contain?

Answer 11

2

Question 12

Why are the two lobes on the left lung, narrower?

Answer 12

to make room for the heart

Question 13

What lung has no middle lobe?

Answer 13

left (only two lobes)

Question 14

Describe the size of the lobes in the lungs when assessing the anterior chest.

Answer 14

• mostly upper and middle lobes
• very little lower lobe is shown

Question 15

Describe the size of the lobes in the lungs when assessing the posterior chest.

Answer 15

• almost all lower lobe

Question 16

What thin slippery envelope is located between the lungs and chest wall?

Answer 16

pleurae

Question 17

Where is the pleural cavity located?

Answer 17

on each side of the mediastinum, inside the pleurae

Question 18

Air pressure can either be neutral, positive or negative.

The pleural cavity’s air pressure would be described as what?

Answer 18

negative

Question 19

The pleural cavity’s air pressure is negative.

What does negative air pressure do to the lungs in the pleural cavity?

Answer 19

holds the lungs tightly against the chest wall (keeping them inflated)

Question 20

When the lungs inspirate, what happens?

Answer 20

air rushes in, diaphragm descends

Question 21

When the lungs expirate, what happens?

Answer 21

air is expelled, diaphragm relaxs upwards

Question 22

When assessing the thorax and lungs, what kind of subjective data do you gather?

Answer 22

• cough
• shortness of breath (SOB)
• chest pain w/breathing (burning, stabbing, constant, come & go)
• past Hx respiratory probs/infections
• smoking Hx
• environmental exposure
• self care behaviors

Question 23

When inspecting the thoractic cage of the posterior chest, what do we inspect?

Answer 23

• spine (nml=symmetrical)
• thorax (nml=symmetrical)
• anterior-posterior/transverse diameter
• skin color, lesions
• ease of breathing/respiratory rate
• position (nml=upright)

Question 24

When the anterior-posterior diameter of the thoractic cage is the same as the transverse diameter, what would we classify this finding as?

Answer 24

barrel chest

Question 25

When palpating the thoractic cage of the posterior chest, what do we assess?

Answer 25

* symmetrical chest expansion * tactile fremitis * lumps, tenderness

Question 26

When palpating the thoractic cage of the posterior chest, how do we go about assessing symmetrical chest expansion?

Answer 26

1. put hands in w postion on pt's mid back, 1-2in below scapula 2. pinch small fold of skin between thumbs 3. ask pt to take a deep breath in 4. thumbs should move apart symmetrically

Question 27

When palpating the thoractic cage of the posterior chest, how do we go about assessing tactile fremitis?

Answer 27

1. use ball of your hand and touch pt's back while he/she says ninety-nine - do not palpate over scapula - vibrations should be symmetrical

Question 28

When percussing the thoractic cage of the posterior chest, how do we go about percussing?

Answer 28

1. start at apex of lungs, above scapula 2. down to interspace, side to side, not percussing over the spine 3. eventually towards base of lungs, expand outwards when percussing

Question 29

When percussing the thoractic cage of the posterior chest, what would we hear when percussing over normal healthy, lung tissue?

Answer 29

resonance

Question 30

When percussing the thoractic cage of the posterior chest, what would we hear when percussing over a lung that holds a lot of air?

Answer 30

hyperresonance

Question 31

When percussing the thoractic cage of the posterior chest, what would we hear when percussing over a tumor, big area of fluid consolidation, or bone?

Answer 31

dull

Question 32

When percussing the thoractic cage of the posterior chest, what would we hear when percussing over bone?

Answer 32

flat

Question 33

How would we go about auscultating the thoractic cage of the posterior chest?

Answer 33

* auscultate over clothes * pt leans forward slightly * breaths in and out through **mouth** * auscultate starting superior and moving inferiorly

Question 34

What are the three different types of nml breath sounds?

Answer 34

* bronchial * branchovesicular * vesicular

Question 35

# There are three different types of nml breath sounds. What type of breath sound would you hear over the trachea and be described as loud?

Answer 35

bronchial

Question 36

# There are three different types of nml breath sounds. What type of breath sound would you hear over the major bronchi, upper sternum and would be described as moderate in volume?

Answer 36

bronchovesicular

Question 37

# There are three different types of nml breath sounds. What type of breath sound would you hear over lower portions of the lungs (base) and would be described as a soft, low pitched sound?

Answer 37

vesicular

Question 38

# There are three different types of nml breath sounds. The majority of breath sounds would sound like what type of nml breathing?

Answer 38

vesicular

Question 39

When auscultating the thoractic cage of the posterior chest, and you hear abnormal breathing, what kind of sound would this be classified as?

Answer 39

adventitious sound

Question 40

There are many different types of adventitious sounds emitted from the thoractic cage of the posterior chest. When auscultating the thoractic cage of the posterior chest, what abnormal sound would be emitted in separate incremenets instead of a complete sound?

Answer 40

discontinuous sounds

Question 41

There are many different types of adventitious sounds emitted from the thoractic cage of the posterior chest. When auscultating the thoractic cage of the posterior chest, what abnormal sound would be emitted when aveoli has collapsed or become filled with fluid?

Answer 41

rales/crackles | on inhalation

Question 42

There are many different types of adventitious sounds emitted from the thoractic cage of the posterior chest. When auscultating the thoractic cage of the posterior chest, what abnormal sound would be described as a low-pitched, rattling sound, similar to snoring?

Answer 42

rhonchi