Chapter 19 Flashcards
1
Q
Alveoli
A
Functional unit of the lung
Thing-walled chambers surrounded by networks of capillaries that are the site of respiratory exchange of CO2 and 02
2
Q
Angle of Louis
A
Manubriosternal angle, the articulation of the manubrium and body of the sternum, continuous with the second rib
3
Q
Apnea
A
Cessation of breathing
4
Q
Asthma
A
An abnormal respiratory condition associated with allergic hypersensitivity to certain inhaled allergens
Characterized by: Inflammation, bronchospasm, wheezing, and dyspnea
5
Q
Atelectasis
A
An abnormal respiratory condition characterized by collapsed, shrunken, deflated sections of alveoli
6
Q
Bradypnea
A
Slow breathing, fewer than 10 breaths per minutes
7
Q
Bronchiole
A
On of the smaller respiratory passageways into which the segmental bronchi divide
8
Q
Bronchitis
A
Inflammation of the bronchi with partial obstruction of bronchi due to excessive mucus secretion
9
Q
Bronchophony
A
The spoken voice sound heard through the stethoscope, which sounds soft, muffled, and indistinct over normal lung tissue
10
Q
Bronchovesicular
A
The normal breath sound heard over major bronchi
Characterized by: Moderate pitch, an equal duration of inspiration and expiration
11
Q
Chronic obstructive pulmonary disease (COPD)
A
A functional category of abnormal respiratory conditions
Characterized by: Airflow obstruction
12
Q
Cilia
A
Millions of hairlike cells lining the tracheobronchial tree
13
Q
Consolidation
A
The solidification of portions of lung tissue as it fills up with infectious exudate
Ex. pneumonia
14
Q
Crackles (Rales)
A
Abnormal, discontinuous, adventitious lung sounds heard on inspiration
15
Q
Dead space
A
Passageways that transport air but are not available for gaseous exchange
Ex. Trachea, bronchi
16
Q
Dyspnea
A
Difficult, labored breathing
17
Q
Emphysema
A
Chronic obstructive pulmonary disease
Characterized by: Enlargement of alveoli distal to terminal bronchioles
18
Q
Fissure
A
The narrow crack dividing the lobes of the lungs
19
Q
Fremitus
A
A palpable vibration from the spoken voice felt over the chest wall
20
Q
Friction rub
A
A coarse, grating, adventitious lung sound heard when the pleurae are inflamed
21
Q
Hypercapnia
A
Increased levels of CO2 in the blood
22
Q
Hyperventilation
A
Increased rate and depth of breathing
23
Q
Hypoxemia
A
Decreased level of oxygen in the blood
24
Q
Intercostal Space
A
Space between the ribs
25
Kussmaul Respiration
type of hyperventilation that occurs with diabetic ketoacidosis
26
Orthopnea
Ability to breathe easily only in an upright position
27
Paroxysmal Nocturnal Dyspnea
Sudden awakening from sleeping, with shortness of breath
28
Percussion
Striking over the chest wall with short, sharp blows of the fingers to determine the size and density of the underlying organ
29
Pleural Effusion
Abnormal fluid between the layers of the pleura
30
Rhonchi
Low-pitch, musical, snoring, adventitious lung sounds caused by obstruction from secretions
31
Tachypnea
Rapid, shallow breathing
| More than 24 breaths per minute
32
Vesicular
Refers to soft, low-pitched, normal breath sounds heard over peripheral lung feilds
33
Wheeze
High-pitched, musical, squeaking adventitious lung sounds
34
Xiphoid process
Sword-shaped lower top of the sternum
35
What subjective thing would you ask about when assessing?
```
Cough
Chest pain
Respiratory infections
Smoking
Shortness of breath
Environmental exposure
```
36
Pleura
Thing slippery serous membrane between chest wall and lungs
37
What structures are composed of dead space?
Trachea
| Bronchi
38
What elements would you include in inspection of respiratory system?
Shape and configuration
Color
Respiration rate
Use of accessory muscles
39
What characteristics define barrel chest?
Costal angle >90
Appears as if in continuous inspiration
Hyperinflation of the lungs
40
What condition is barrel chest most common in?
COPD
41
Bronchial lung sound
High-pitch
Inspiration < expiration
Harsh, hollow, tubular
Trachea and larynx
42
Bronchovesicular lung sound
Moderate pitch
Inspiration = expiration
Over major bronchioles
43
Vesicular lung sounds
Low pitch
Inspiration > expiration
Rustling sound
Peripheral lung fields
44
The manubriosternal angle is also called ___
Angle of Louis
45
What is a normal costal angle?
90 degrees
46
Anteroposterior/ Tranverse diameter ratio
2:1
47
Condition if AP diameter is equal to transverse diameter
Barrel chest
48
A tripod position is common with which condition?
COPD
49
What type of sound is heard when percussing over lungs?
Resonance
50
What is the manubriosternal angle?
The articulation of the manubrium and the body of the sternum
51
The left lung is ___ compared to the right
Narrower
| has only 2 lobes
52
The characteristic timing of the cough of chronic bronchitis is described as:
Productive cough for at least 3 months of the year for 2 consecutive years
53
How do you note symmetric chest expansion in an assessment?
Placing hands on the postriolateral chest wall with thumbs up pinching a small fold of skin
54
How do you correctly assess lung sounds?
Hold the diaphragm of the stethoscope against the chest wall
| Listen for one full respiration in each location, being sure to do side-to-side compaeisons
55
Patient presenting: Fever, increased respiratory rate, decreases left side chest expansion, Dull percussion over left lower lobe, Fine crackles over left lobe
What is it?
Lobular Pneumonia
56
Clubbing and spongy nail bases are indicators of ____
COPD
57
You hear a coarse low pitched sound during inspiration and expiration and the patient report pain while breathing. What is this an indicator of?
Pleural friction rub
58
While using the technique egophony what would you ask the patient to do?
Say "eeee" each time the stethoscope is moved
59
When examining tactile fremitus what is important to do?
Palpate the chest symetrically
60
Pulse oxygen measure ___
Arterial oxygen saturation in hemoglobin
61
A pleural rub is best detected by what technique?
Auscultation
62
What changes occur to the respiratory system in a pregnant woman?
Increased estrogen level relaxes chest cage ligaments
Circumference of chest increases
Tidal volume increase by 40%
Physiologic dyspnea
63
Physiologic dyspnea
An increased awareness of the need to breathe
64
What changes occur to the respiratory system as we age?
Costal cartilages become calcified > thorax less mobile
Barrel chest
Kyphosis
65
Hemoptysis
Blood in coughed up sputum
66
Decreased fremitus occurs with:
Any barrier that comes between the sound and your palpation
| Obstructed bronchus, pleural effusion or thickening, pneumothorax, or emphysema
67
Increases fremitus occurs with:
Compression or consolidation of lung tissue
| Ex. Lobar pnuemonia
68
Rhonchal Fremitus
Palpable with thick bronchial secretion
69
Pleural friction fremitus
Palpable with inflammation of the pleura
70
Crepitus
A coarse crackling sensation palpable over skin surfaces
71
When is crepitus most likely to happen?
After open thoracic injury or surgery
72
When would you hear hyperresonance in the lungs when percussing?
When there is too much air present
| Ex. Emphysema or Pneumonothorax
73
When would you hear a dull sound in the lungs when percussing?
When there is an abnormal density present
| Ex. pneumonia, mass, or pleural effusion
74
Decreased/Absent breath sounds occur when:
Bronchial tree obstruction
Emphysema - loss of elasticity of lungs
Anything obstructing transmission of sound to stethoscope
75
Increased breath sounds occur with:
With consolidation or compression of lung tissue
76
Symptoms of a strained, tired face and pursed-lipped breathing accompany ____
COPD
77
What does bulging of the intercostal spaces mean?
Trapped air
78
A palpable grating sensation with breathing indicates:
Pleural friction fremitus
79
6-Minute Walk Test
Recreating the patient's everyday activities to measure respiratory rehabilitation
Measure of how far patient walks in 6 minutes without exerting themselves
80
A barrel shaped chest in an infant after 6 years may be an indicator of ___ or ___
Chronic asthma or Cystic fibrosis
81
What is the highest score on the APGAR scale?
10
| You can only have 2 in each category
82
An infant with an APGAR score of 6 is considered:
Moderately depressed
83
Newborns are predominantly _____ breather until 3 months
Nose breathers
84
Normal respiratory range for newborn is:
30-40 breaths/minute
85
What type of lung sounds will you hear in the peripheral lung fields in a child until 5-6 years old?
Bronchovesicular
86
Crackles in the immediate newborn. Abnormal/Normal
Normal
| The adaptation of extrauterine life: opening of the airways and clearing of fluid
87
Pectus excavatum
Sunken sternum
| Congenital defect
88
Pectus carinatum
Forward protrusion of the sternum
89
Scoliosis may increase what risks regarding the thorax/lungs?
Reduce lung volume
| Impair cardiopulmonary function
90
Tachypnea
Rapid shallow breathing
| More than 24 breaths per minute
91
Bradypnea
Slow breathing
| Less than 10 breaths per minute
92
Factors that would provoke bradypnea
Drug induce depression of the medulla
Increases intracranial pressure
Diabetic coma
93
Cheyne-Stokes Respiration
Cyclic pattern of increasing rate and depth then decreasing
94
Causes of Cheyne-Stokes Respiration
```
Heart failure***
Renal failure
Meningitis
Drug overdose
Increased intracranial pressure
```
95
Hyperventilation
Increase in both rate and depth
96
Kussmaul respirations
Hyperventilation that occurs with diabetic ketoacidosis
97
What does hyperventilation cause regarding blood?
Alkalosis
| Blowing off increase CO2 levels
98
Hypoventilation
Irregular shallow pattern
99
Hypoventilation is caused by:
Narcotics
Anesthetics
Prolonged bed rest
100
Chronic obstructive breathing
Normal inspiration and prolonged expiration to overcome increased airway resistance
101
Atelectatic crackles
Sound like fin crackles
| Disappears after first few breaths or coughs
102
Wheezes are usually heard inspiration/expiration?
Predominate in expiration but could be heard in both
103
Stridor
Monophonic, inspiratory, crowing sound
| Louder in the neck that over chest wall
104
Broncophony
Ask the person to repeat "99" while listening with a stethoscope
105
While using the techniques broncophony, you should hear a clear "99" like they are saying right into your ear. Normal/Abnormal
Abnormal
| The sound hear through the stethoscope should be soft, muffled, and indistinct
106
Egophony abnormality
Hearing an "aaaa" sound instead of "eee"
107
Whispered Pectoriloquy
Ask the person to whisper a phrase "one-two-three" as you auscultate
Should be muffled and indistinct
108
Atelectasis
Collapsed, shunken lung
| Breath sounds decreased, cough, lag on expansion of chest
109
Acute bronchitis is characterized by:
Cough lasting up to 3 weeks
110
Emphysema is characterized by:
```
Permanent enlargement of air sacs distal to terminal bronchioles and rupture of interalveolar walls
Increased expiration resistance
Barrel chest
Tripod position
SOB
Tachypnea
```
111
What is chronic bronchitis usually caused by?
Cigarette smoking
112
Chronic Brontitis
Excessive mucus secretion
| Inflamed bronchi with partial obstruction
113
Heart Failure causes __ ___
Pulmonary congestion
114
What adventitious sounds would you hear on a patient with heart failure
Crackles at lung bases
| S3 heart sound
115
What adventitious sounds accompany a pulmonary embolism?
Crackles
| Wheezes
116
Pleural effusion
Collection of excess fluid in intrapleural space with compression of overlying lung tissue
117
Symptoms of pleural effusion
```
Tactile fremitus
Crackles
Wheezing
Breath sounds decreased
Bronchophony
Egophony
Whispered pectoriliquy
```
