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Flashcards in H&P Thorax/Lungs Deck (39)
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1

Trachea Bifurcation

-Sternal Angle
-T4 posteriorly

2

Visceral Pleura

Covers outer surface of lungs

3

Parietal Pleura

Lines inner rib cage and upper surface of diaphragm

4

Pleura Space

Space between visceral and parietal pleura

5

Primary Muscles of Respiration

Diaphragm and intercostal muscles

6

Accessory Muscles of Respiration

Sternocleidomastoid and Trapezius

7

Stridor

-High pitched wheeze
-Largely Inspiratory
-Results from turbulent airflow in upper airway
-Indicates laryngeal/upper airway obstruction
-->epiglottitis, foreign body aspiration

8

Clubbing of fingers

-Linked to heart or lung condition (COPD)

9

Pursed lip breathing

-Possible sign of COPD
-Reduces respiratory rate from 20-->12/15
-Increases Tidal Volume
-Decrease PaCO2, Increases Pa02

10

Crackles (rales)

-Caused by "popping open" of small airways and alveoli that have collapsed
-->fluid in the lung (e.g pneumonia, CHF)
-High pitched, discontinuous sounds

11

Rhonchi

-Snoring, coarse quality
-Caused by airway secretions and narrowing/partial obstruction (e.g. bronchitis, COPD)
-Low-pitched, continuous

12

Wheeze

-High pitched, continuous
-Whistle
-Caused by airways obstruction (e.g. asthma)
-Bronchus

13

Apnea

-Absence of breathing
-Cause: Cardiac arrest

14

Biot's

-irregular breathing with long periods of apnea
-Causes: increased ICP, drug induced respiratory depression, brain damage

15

Cheyne-Stokes

-Irregular breathing with intermittent periods of increased and decreased rates and depths of breaths alternating with periods of apnea
-Causes: Drug induced respiratory depression, CHF, brain damage

16

Kussmaul's

-Fast and deep breathing
-Causes: metabolic acidosis

17

Pectus carinatum

Protrusion of sternum and ribs

18

Pectus excavatum

Caved-in or sunken chest

19

Atelectasis

-Loss of air from lung or collapse of lung tissue with reduced lung volume
-Can result from blockage of air passage with mucus or from pleural effusion

20

Tension Pneumothorax

Large amount of air entering the chest when a one-way valve (air in) is formed by an area of damaged tissue

21

Pneumonia

-Refers to pneumonitis (inflammation of the lung)
-Lower respiratory infection
-Usually due to infection, but sometimes has noninfectious cause
-Has additional feature of pulmonary infiltrates/consolidation

22

Consolidation

-Condition in which lung tissue becomes firm and solid rather elastic and air-filled
-Due to accumulated fluids and tissue debris

23

Lung/pulmonary infiltrates

-Filling of the air spaces with fluid
-Infiltrates can cause consolidation

24

Pleural effusion

Collection of fluid in the pleural space (space between visceral and parietal pleura)

25

Hemothorax

-Blood in the pleural space

26

Empyema

-Pus in the pleural space
-Usually results from infection that spreads from the lungs (e.g. pneumonia, abscess)

27

Pleurisy/Pleuritis

Inflammation of the pleura

28

Bronchitis

-Inflammation of the bronchi (does not involve the lungs)
-URI
-Acute or chronic

29

Asthma (obstructive lung dz)

-Bronchial tubes (airways) are hyper-responsive
-Airways become inflamed and produce excess mucus
-Muscles around the airways tighten making the airways narrow=obstruct breathing
-Reversible w/ steroids
-Wheezing

30

COPD (emphysema)

-Airway resistance and residual volume of air even after expiration
-Can result in hyper inflated lungs and barrel chest
-Irreversible

31

Pleural Friction Rub

-Squeaking/grating sound of the pleural linings rubbing together
-Associated with pleurisy

32

Crepitus

-Palpable grating/crunching
-Can occur with rib movement due to fracture (bone crepitus)

33

Tactile Fremitus

-Vibrations transmitted through bronchopulmonary tree
-Use ulnar surface of the hand, ask pt to say "ninety-nine"
-Increased Fremitus: consolidation increases transmission (e.g. pneumonia)
-->solid transmits sound better than air
-Decreased fremitus: Air and effusions decrease transmission (e.g. pleural effusion, pneumothorax, COPD, fibrosis)

34

Normal breath sounds

Tracheal-heard over trachea in the neck
Bronchial-heard over manubrium
Bronchiovesicular- heard in 1st and 2nd interspaces anteriorly and between scapula posteriorly

35

Stridor

-High pitched wheeze
-Largely inspiratory
-Results from turbulent airflow in upper airway
-Indicates laryngeal/upper airway obstruction
-->epiglottitis, FB aspiration

36

Mediastinal crunch (Hamman sign)

-Loud crackles, clicks and gurgling sounds
-Due to pneumo-mediastinum (mediastinal emphysema)
-Synchronous with heart beat

37

Bronchophony

-"99" heard louder and clearer than normal even at a distance from larynx
-Indicates presence of fluid or solid tissue in alveoli
-E.g. consolidation (pneumonia), atelectasis, tumors

38

Egophony

-"E to A sounds"
-When voice sounds are louder, have a nasal quality
-Indicates consolidation (pneumonia), atelectasis, tumors

39

Whispered pectoriloquy

-whisper heard more loudly through consolidated lung tissue
=consolidation (pneumonia), atelectasis, tumors