Chest and Lungs Flashcards
(98 cards)
1
Q
Parts of the thorax:
A
- Sternum
- Ribs
- Costal cartilages
2
Q
Flat bone
A
Sternum
3
Q
Sternum is divided into three parts:
A
- Manubrium
- Body
- Xiphoid process
4
Q
Forms upper part of sternum.
A
Manubrium
5
Q
Where does the manubrium articulate?
A
With the body of the sternum at the manubriosternal joint
6
Q
Where does the body of the sternum articulate?
A
- With the manubrium (above) and xiphoid process (below)
- With 2nd (lower half) to 7th ribs
7
Q
Thin plate of cartilage; no ribs or costal cartilages are attached.
A
Xiphoid process
8
Q
Xiphoid process during its adult life:
A
becomes ossified at its proximal end
9
Q
Formed by articulation of manubrium with body of sternum; important clinical landmark.
A
Sternal angle (Angle of Louis)
10
Q
Sternum - important clinical landmark:
A
- 2nd costal cartilage
- Intervertebral disc between T4 and T5.
- Junction between the aortic arch and the ascending and descending aorta.
- Bifurcation of the trachea
- Junction of superior and inferior mediastinum.
11
Q
How to locate the sternum:
A
- Insert your finger into the suprasternal notch (superior end of sternum).
- Slide fingers down the manubrium (~5cm) until it encounters a transverse ridge (sternal angle).
12
Q
How many pairs of ribs are there?
A
12 pairs
13
Q
Attached posteriorly to the thoracic vertebrae.
A
Ribs
14
Q
The ribs are divided into three categories:
A
- True ribs
- False ribs
- Floating ribs
15
Q
1st to 7th pairs; attached to the sternum by their costal cartilages.
A
True ribs
16
Q
Ribs 8th to 10th, attached anteriorly to each other.
A
False ribs
17
Q
They are also attached to the
7th rib by their costal cartilages and small synovial joints.
A
False ribs
18
Q
Ribs 11th and 12th; no anterior attachment.
A
Floating ribs
19
Q
Bars of cartilage
A
Costal cartilages
20
Q
Costal cartilages connects:
A
- Upper 7 ribs to lateral edge of sternum.
- 8th-10th ribs to cartilage above them.
21
Q
11th-12th ribs end in:
A
abdominal musculature
22
Q
Lower border of the lung crosses the:
A
6th rib at the midclavicular line and 8th rib at midaxillary line
23
Q
Inspiration and expiration are accomplished by:
A
- Increase and decrease of thoracic cavity capacity.
- Physiologic rate (16-20 cpm)
24
Q
Mechanics of respiration:
A
- Quiet inspiration
- Forced inspiration
- Quiet expiration
- Forced expiration
25
Increased vertical diameter of thoracic cavity (contraction and descent of diaphragm).
Quiet inspiration
26
Increased transverse and anteroposterior diameters (rising of ribs and thrusting of sternum
forward).
Quiet inspiration
27
It raises the 1st rib during forced inspiration.
Scalenus (anterior and medius)
28
It raises the sternum during forced inspiration.
Sternocleidomastoid
29
It raises the ribs during forced inspiration.
Serratus anterior and pectoralis minor
30
Passive process
Quiet expiration
31
Quiet expiration is accomplished by:
1. Elastic recoil of lungs
2. Relaxation of intercostal muscles
and diaphragm
32
Active process
Forced expiration
33
Forced expiration is accomplished by:
1. Contraction of muscles of abdominal wall.
2. Contraction of quadratus lumborum.
3. Contraction of latissimus dorsi.
34
The contraction of muscles of the abdominal wall forces the relaxed diaphragm upward by:
raising intraabdominal pressure
35
It pulls the 12th rib downward.
Contraction of quadratus lumborum
36
It pulls down the lower ribs.
Contraction of latissimus dorsi
37
Equipment for chest and lung assessment:
1. Stethoscope
2. Skin marker/pencil
3. Centimeter ruler
38
Normal adult thorax:
Oval, elliptical; wider than it is deep.
39
Increased anteroposterior diameter.
Barrel chest
40
Anteriorly displaced sternum.
Pigeon chest
41
Depressed lower sternum.
Funnel chest
42
Raised shoulder and scapula, thoracic convexity, and flared interspaces.
Thoracic kyphoscoliosis
43
Have client bend forward at the waist and observe from behind.
Adam’s forward bend test
44
Normal spine:
1. 2 forward curves (cervical and lumbar spine)
2. 2 backward curves (thoracic and sacral area)
3. Vertically aligned
45
For clients with respiratory complaints, palpate all _________ for bulges, tenderness, or abnormal movements.
chest areas
46
Normal chest:
Chest wall intact, no masses, no tenderness
47
Abnormal chest:
1. Lumps
2. Bulges
3. Depressions
4. Crepitus
5. Chest tenderness
6. Fractures
48
Associated with subcutaneous emphysema.
Crepitus
49
A condition in which air is trapped under the skin.
Subcutaneous emphysema
50
The popping, crackling, grating, or crunching sensation that can occur when air is pushed through the soft tissue in the chest.
Crepitus
51
Normal posterior chest (respiratory excursion):
1. Full and symmetric chest expansion
2. Thumbs separate 3-5 cm (1.5-2 in)
52
Normal vocal fremitus findings:
1. Bilateral symmetry
2. Low pitched voices of males are
more readily palpated than higher
pitched voices of female.
53
Abnormal vocal fremitus findings:
1. Decreased/Absent fremitus (as in Pneumothorax)
2. Increased - associated with pneumonia
54
Vibration of chest wall; sound transmitting through lung tissue.
Tactile fremitus
55
Causes of decreased fremitus:
1. Excess air in lungs
2. Increased thickness of chest wall
56
Causes of increased fremitus:
1. Lung consolidation
2. Air in lung is replaced by inflammatory exudate, blood, pus, and cells.
57
Normal findings when percussing the chest:
1. Resonance except over the scapula
2. Lowest point of resonance at the
level of 8th-10th posterior rib
58
Abnormal findings when percussing the chest:
1. Asymmetry in percussion
2. Areas of dullness or flatness over
lung tissue
59
Resonance (long, loud, low pitched)
Normal lung
60
Flat (short, soft, high pitched)
Atelactasis
61
Dull (medium intensity)
Lobar pneumonia
62
Hyperresonant (very loud)
Pneomothorax
63
Tympanic (Musical)
Large pneumothorax (air collection)
64
The distance between the resonance over the lungs and the dull over the diaphragm.
Diaphragmatic excursion
65
Normal bilateral excursion in males:
5 to 6cm
66
Normal bilateral excursion in females:
3 to 5cm
67
Normal diaphragm:
Slightly elevated on the right side (3 to 5 cm).
68
Abnormal diaphragm:
Abnormally high level of dullness
69
Auscultate the chest using the:
flat disc diaphragm of the stethoscope
70
Used for lower frequency sounds.
Bell
71
Used for higher frequency sounds.
Diaphragm
72
Common use of the diaphragm:
Breath sounds, wheezing or crackles, S1 and S2, Korotfkoff sounds, bowel sounds.
73
Common use of the bell:
Heart gallops (S3, S4) and vascular bruits
74
Pressure needed for the diaphragm:
Firm pressure
75
Pressure needed for the bell:
Light pressure
76
Using the diaphragm is ideal for:
General checkups and high pitched sounds.
77
Using the bell is ideal for:
Detecting subtle or abnormal low-pitched vibrations.
78
Normal breath sounds:
Vesicular and bronchovesicular breath sounds
79
Abnormal breath sound:
1. Adventitious breath sounds
2. Absence of breath sounds (collapsed and removed lung lobes)
80
Normal breathing rate and pattern.
Eupnea
81
Increased respiratory rate
Tachypnea
82
Decreased respiratory rate
Bradypnea
83
Absence of breathing
Apnea
84
Normal rate, deep respirations.
Hyperpnea
85
Gradual increases and decreases in respirations with periods of apnea.
Cheyne-Stokes
86
Rapid, deep respirations, with short pauses between sets.
Biot's
87
Tachypnea and hyperpnea
Kussmaul's
88
Prolonged inspiration, shortened expiration
Apneustic
89
Normal costal angle and angle at which the ribs enter the spine:
angle is less than 90 degrees
90
Abnormal costal angle and angle at which the ribs enter the spine:
costal angle is widened
91
Palpate anterior chest for:
respiratory excursion
92
If the breasts are large and cannot be retracted for palpation, this part of the examination is usually:
omitted
93
Normal anterior chest findings (percussion):
Resonant until 6th rib at the level of diaphragm but are flat in other areas.
94
Abnormal anterior chest findings (percussion):
Asymmetry in percussion; dullness
or flatness over lung tissue.
95
Normal tracheal auscultation findings:
Bronchial and tubular breath sounds
96
Abnormal tracheal auscultation findings:
Adventitious breath sounds
97
Normal findings when auscultating the anterior chest:
Bronchovesicular and vesicular
98
Abnormal findings when auscultating the anterior chest:
Adventitious breath sounds
