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
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