Jarvis Chapter 18 Lungs & Thorax Flashcards
(213 cards)
1
Q
Smooth muscle, warms and humidifies, connects larynx to the brochi.
A
Trachea
2
Q
goblet cells secrete mucus which traps particles, cilia propels particles out to be swallowed or expelled.
A
Bronchi/Terminole Bronchioles
3
Q
What parts of the lower airway transport air but do not exchange gas.
A
Trachea and Bronchi/Terminole Bronchioles
4
Q
May indicate pulmonary edema or pneumonia; fine rattling sounds like a carbonated beverage on inhalation and sometimes on exhalation; liquid is in the alveoli & bronchioles; gets louder with coughing; does not clear with coughing
A
crackles
5
Q
Functional respiratory unit
A
Acinus
6
Q
Rattles, coarse, rattling sounds on EXHALATION, indicates mucus in bronchii, may clear with coughing;
A
ronchii
7
Q
Barrel chest, flattening of sternal angle
A
Signs of COPD
8
Q
What position is helpful to a client in respiratory distress?
A
semi-fowlers position helps them breathe; Lean - lean back, feet out, amrs dangling slows the O2 consumption; tripod position allows upper body to work at moving the air
9
Q
This portion of the airway is not sterile.
A
Upper Airway
10
Q
Name the three lung sounds
A
vesicular, bronchial, bronchovesicular
11
Q
This portion of the upper airway warms, humidifies, and filters air.
A
Nose
12
Q
Major breath sound over most of the lung; soft, low pitch; inspiration is longer than expiration;
A
Vesicular lung sounds
13
Q
Maintains inner air pressure, controls infection (traps particles)
A
Pharynx
14
Q
Intermediate intensity and pitch; inspiration and expiration are equal in length; best herad at 1st and 2nd ICS (anterior) or between the scapula (posterior) when heard at other locations; consolidation is likely;
A
bronchovesicular lung sounds
15
Q
Incomplete rings, vocal cords (sound and voice), initiates cough reflex.
A
Larynx
16
Q
Heard over trachea; expiratory sound predominates; is higher pitched and louder; if heard in other locations it indicates consolidation – a space that usually contains air now has fluid
A
bronchial lung sounds
17
Q
Opening between the vocal cords.
A
Glottis
18
Q
What are the respiratory centers in the brain?
A
The brain stem: pons and medulla
19
Q
High CO2
A
hypercapnia
20
Q
The only complete rigid ring of cartilage.
A
Cricoid Cartilage
21
Q
Low O2
A
hypoxemia
22
Q
Slow, shallow breathing causes carbon dioxide to build up in the blood.
A
Hypoventilation
23
Q
Which muscles are used in inspiration
A
The diaphragm is assisted by the intercostal muscles to lift the sternum and elevate the ribs
24
Q
Rapid, deep breathing causes CO2 to be blown off.
A
Hyperventilation
25
Are inhalation and exhalation active or passive?
inhalation - active; exhalation - passive
26
High surface area for gas exchange.
Acinus
27
This lung is responsible for 55% of activity and contains three lobes.
Right
28
postnatal exposure to ETS results in what?
increased incidence of otitis media, resp tract infections, & childhood asthma; possibly related are SIDS, negative behavioral and cognitive issues and increased rates of teen smoking
29
This lung is responsible for 45% of activity and contains two lobes.
Left
30
This portion of the pleura lines the outside of the lungs.
Visceral
31
What changes occur in the thorax and lungs for the aging adult?
costal cartilages calcify; elasticity of lungs decreases; vital capacity decreases; increased residual volume; increased risk for dyspnea;
32
This portion of the pleura lines the chest wall.
Parietal
33
Why are elderly at an increased risk of atelactasis and infection, esp post surgical?
reduced ability to cough, loss of protective airway reflexes and increased secretions;
34
Contains a thin layer of fluid, allows lungs to expand without friction, pressure is -4cm H2O.
Pleural Space
35
Where ribs join cartilages; not palpable
costochondral junctions
36
The diaphragm, external intercostals and accessory neck muscles are all considered what kind of muscles.
Inspiratory
37
The abdominals and internal intercostals are considered what kind of muscles.
Expiratory
38
In what groups is TB more common?
A disproportionate amount in blacks; and highest in immigrants from Mexico, Phillipines, Vietnam, India, China
39
Innervated by C3-C5 and phrenic nerve. It increases superior/inferior diameter of chest and elevates lower ribs.
Diaphragm
40
coarse, crackling sensation palpable over the skin surface; subcutaneous emphysema due to open thoracic injury or surgery
crepitus
41
Innervated by T1-T11. Increase anteroposterior diameter by elevating ribs.
External Intercostals
42
predominates in normal healthy tissue
resonance
43
After heavy exercise or occurring with respiratory distress, commands the use of the scalene, sternocleidomastoid and trapezii to heave up the sternum and rib cage for forced inspiration.
Accessory neck muscles
44
too much air is present, i.e. emphysema or pneumothorax
hyperresonance
45
Normally this type of breathing is passive and muscles not needed.
Expiration
46
pneumonia, pleural effusion, atelactasis, tumor
dull note
47
These muscles force abdominal contents up to elevated the diaphragm. Used in forced expiration.
Abdominal
48
What are the four major functions of the respiratory system?
1-supplying O2 to the body for energy production 2-remove CO2, the waste product from energy reactions 3-maintain homeostasis (acid-base balance) of arterial blood 4-maintain heat exchange
49
These costal muscles draw ribs and sternum downward to decrease anteroposture diameter.
Internal
50
How long is the trachea (in cm)?
10-11 cm
51
This color of sputum usually indicates colds, bronchitis, viral infection.
White or clear
52
The postoperative older adult is at greater risk for these 4 pulmonary complications:
atelectasis, decreased ability to cough, loss of protective airway reflexes, and increased secretions.
53
This color of sputum usually indicates a bacterial infection.
Yellow or green
54
Anatomical landmark that marks the site of tracheal bifurcation.
Angle of Louis
55
This color of sputum usually indicates TB or pneumococcal pneumonia.
Rust
56
Term for blood in sputum
hemoptysis
57
This color sputum usually indicates pulmonary edema.
Pink and frothy
58
The normal stimulus to breathe is (hypercapnia or hypoxemia)?
hypercapnia
59
Rapid, shallow breathing >24/min.
Tachypnea
60
The posterior chest contains almost all (upper or lower) lobe.
lower
61
Increased rate and depth of of breathing. Usually causes dizziness. CO2 loss.
Hyperventilation
62
To meet increased O2 demands, pregnant women respond normally by increased RR or increased tidal volume (deeper breathing)?
tidal volume
63
Slow breathing <10/min and regular rate.
Bradypnea
64
The anterior chest contains mostly (upper, middle, or lower) lobe.
upper and middle
65
Difficult, labored breathing. SOB.
Dyspnea
66
Awakens with SOB and must be in upright position to achieve comfort.
Paroxysmal nocturnal dyspnea
67
Difficulty breathing when supine.
Orthopnea
68
Contain the respiratory bronchioles,alveolar ducts and alveoli.
Acinus
69
SOB relieved when lying down, worsens with sitting or standing increases.
Platypnea
70
Functional respiratory unit
Acinus
71
SOB sensed while lying on one side but not the other.
Trepopnea
72
High surface area for gas exchange.
Acinus
73
High pitched, musical, squeaking adventitious lung sound. Occurs with airway obstruction and on expiration.
Wheezing
74
The _____ chest contains mostly upper and middle lobe with very little lower lobe.
Anterior
75
High pitched wheezing result from turbulent air flow in upper airway. Primarily inspiratory.
Stridor
76
The trachea lies _____ to the esophagus and is 10 to 11 cm long in an adult.
Anterior
77
Normal Breathing
Eupnea
78
In the anterior chest, the ______, or highest point of the lung tissue is 3-4 cm above the inner third of the clavicles.
Apex
79
Coarse and low pitched sound heard on inspiration and expiration and accompanied by pain with breathing.
Pleural friction rub
80
The _____, or lower border, rests on the diaphragm at about the 6th rib in the midclavicular line.
Base
81
Cough with characteristic timing of being productive for at least 3 months of the year for 2 years.
Chronic bronchitis
82
Slow breathing <10/min and regular rate.
Bradypnea
83
A bony structure with a conical shape, which is narrower at the top.
Thoracic cage
84
goblet cells secrete mucus which traps particles, cilia propels particles out to be swallowed or expelled.
Bronchi/Terminole Bronchioles
85
This is defined by the sternum, 12 pairs of ribs and 12 thoracic vertebrae.
Thoracic cage
86
Cough with characteristic timing of being productive for at least 3 months of the year for 2 years.
Chronic bronchitis
87
The floor of the thoracic cage is the.
Diaphragm
88
Ribs 8, 9, and 10 attach to the ______ above.
Costal cartilage
89
A musculotendinous septum that separates the thoracic cavity from the abdomen.
Diaphragm
90
The only complete rigid ring of cartilage.
Cricoid Cartilage
91
The first 7 ribs attach directly to the ______ via their costal cartilages.
Sternum
92
Area that is filled with air but is not available for gaseous exchange.
Dead space
93
Ribs 8, 9, and 10 attach to the ______ above.
Costal cartilage
94
_________ expands the lungs and the posterior lower border drops to the level of _____.
Deep Inspiration, T12
95
Ribs 11 & 12 are called _______.
Floating
96
What is the breathing mechanism?
Diaphragm, external and internal intercostals
97
Angle of Louis, this is the articulation of the manubrium and the body of the sternum, and is continuous with the second rib.
Manubriosternal Angle
98
A musculotendinous septum that separates the thoracic cavity from the abdomen.
Diaphragm
99
What is the breathing mechanism?
Diaphragm, external and internal intercostals
100
Innervated by C3-C5 and phrenic nerve. It increases superior/inferior diameter of chest and elevates lower ribs.
Diaphragm
101
The ______ is the middle section of the thoracic cavity containing the esophagus, trachea, heart, and great vessels.
Mediastinum
102
The floor of the thoracic cage is the.
Diaphragm
103
The right and left ______, on either side of the mediastinum contain the lungs.
Pleural cavities
104
Difficult, labored breathing. SOB.
Dyspnea
105
In the anterior chest, the ______, or highest point of the lung tissue is 3-4 cm above the inner third of the clavicles.
Apex
106
The valve attached to the entrance of the larynx.
Epiglottis
107
The _____, or lower border, rests on the diaphragm at about the 6th rib in the midclavicular line.
Base
108
Normal Breathing
Eupnea
109
______, lung tissue extends from the apex of the axilla down to the 7th or 8th rib.
Laterally
110
Normally this type of breathing is passive and muscles not needed.
Expiration
111
______, the location of ____ marks the apex of lung tissue and ____ usually corresponds to the base.
Posteriorly, C7, T10
112
The abdominals and internal intercostals are considered what kind of muscles.
Expiratory
113
_________ expands the lungs and the posterior lower border drops to the level of _____.
Deep Inspiration, T12
114
Innervated by T1-T11. Increase anteroposterior diameter by elevating ribs.
External Intercostals
115
The _____ lung is shorter because of the _____.
Right, liver
116
The lobes of the lungs are separated by ______.
Fissures
117
The ____ lung is narrower because of the _____.
Left, heart
118
Ribs 11 & 12 are called _______.
Floating
119
The _____ lung has three lobes.
Right
120
Opening between the vocal cords.
Glottis
121
The _____ lung has two lobes.
Left
122
Coughing up blood.
Hemoptysis
123
The lobes of the lungs are separated by ______.
Fissures
124
Increased rate and depth of of breathing. Usually causes dizziness. CO2 loss.
Hyperventilation
125
If you swallow an object it will go into the _____ lung because the bronchi is wider.
Right
126
Rapid, deep breathing causes CO2 to be blown off.
Hyperventilation
127
The trachea lies _____ to the esophagus and is 10 to 11 cm long in an adult.
Anterior
128
Slow, shallow breathing causes carbon dioxide to build up in the blood.
Hypoventilation
129
The _____ main bronchus is shorter, wider, and more vertical.
Right
130
The diaphragm, external intercostals and accessory neck muscles are all considered what kind of muscles.
Inspiratory
131
The _____ and ______ transport gasses between the environment and the lung parenchyma.
Trachea, bronchi
132
These costal muscles draw ribs and sternum downward to decrease anteroposture diameter.
Internal
133
The _____ and _____ constitute the dead space, or space that is filled with air but is not available for gaseous exchange.
Trachea, bronchi
134
Incomplete rings, vocal cords (sound and voice), initiates cough reflex.
Larynx
135
Area that is filled with air but is not available for gaseous exchange.
Dead space
136
______, lung tissue extends from the apex of the axilla down to the 7th or 8th rib.
Laterally
137
The _____ lung has no middle lobe.
Left
138
The ____ lung is narrower because of the _____.
Left, heart
139
The _____ chest contains mostly upper and middle lobe with very little lower lobe.
Anterior
140
The _____ lung has no middle lobe.
Left
141
The ____ chest contains almost all lower lobe.
Posterior
142
The _____ lung has two lobes.
Left
143
What are the important landmarks for the thorax and lungs?
substernal notch, sternal angle, 2nd rib, 2nd intercostal space, intercostal spaces, costal angle (<90), 7th cervical vertebral prominence; angle of Louis
144
This lung is responsible for 45% of activity and contains two lobes.
Left
145
What is the angle of Louis
The angle at the manubrial-stternal border
146
This portion of the airway is sterile.
Lower Airway
147
How many lobes on each lung? Which can be heard from the back?
Left side: 2 lobes, Right side, 3 lobes; Cannot hear the right middle lobe from the back; nearly all of the back consists of lower lobes; upper lobe is only to T3 or T4.
148
Trachea, Bronchi/Terminole Brochioles and Acinus make up the
Lower Airway
149
Where are the lungs located?
The apex is above 3-4 cm above the inner clavicle; the lower border is about the 7th rib resting on the diaphragm; On posterior side C7 is apex and T10 is base;
150
Angle of Louis, this is the articulation of the manubrium and the body of the sternum, and is continuous with the second rib.
Manubriosternal Angle
151
What is dyspnea?
shortness of breath
152
The ______ is the middle section of the thoracic cavity containing the esophagus, trachea, heart, and great vessels.
Mediastinum
153
What is the rating scale for dyspnea?
0 - never; 1 - ealking 20' or climbing stairs; 2 - w/moderate exertion such as dressing, bedside commode or distance < 20'; 3-w/minimal exertion such as eating, talking or performing ADL's or w/agitation; 4-at rest, day or night
154
This portion of the upper airway warms, humidifies, and filters air.
Nose
155
What are important sujective data for the thorax and lungs health history?
Cough - productive?, sputum?, SOB, breathing difficulties, chest pain w/ breathing, history of respiratory diseases, smoking, 2nd hand smoke, allergies, past chest trauma, environmetnal exposure; recent TBC skin test, chest x-ray, flu or pnuemococcal vac
156
Difficulty breathing when supine.
Orthopnea
157
What does chest pain with breathing usually indicate?
pleuritis
158
This portion of the pleura lines the chest wall.
Parietal
159
What is the first step in the interview?
Obtain all the data you can from observing the patient; for example, agitated patients or low conscious patients may have a breathing issue; mouth vs nose breathing; patent or flaring nares? pursing of lips; color; facial expression; neck trachial
160
Awakens with SOB and must be in upright position to achieve comfort.
Paroxysmal nocturnal dyspnea
161
Why do people purse their lips?
prolongs expiration and increases positive pressure
162
Maintains inner air pressure, controls infection (traps particles)
Pharynx
163
What is RSV?
Respiratory synctial virus; a common virus among children and adults; may cause more serious problems in older adults and adults with heart/lung disease, preemies and babies with other medical conditions
164
This color sputum usually indicates pulmonary edema.
Pink and frothy
165
What are causes of clubbing?
chronic hypoxia; lung cancer
166
SOB relieved when lying down, worsens with sitting or standing increases.
Platypnea
167
What is a normal Respiration rate?
12-20 RPM
168
The right and left ______, on either side of the mediastinum contain the lungs.
Pleural cavities
169
What do you report about respirations?
rate*rhythm*depth*effort
170
Coarse and low pitched sound heard on inspiration and expiration and accompanied by pain with breathing.
Pleural friction rub
171
regular irregularity often w/periods of apnea; seen in patients who are dying; heart failure
Cheyne Stokes breathing
172
Contains a thin layer of fluid, allows lungs to expand without friction, pressure is -4cm H2O.
Pleural Space
173
iregular with apnea; brain damage; respiratory depression; may be normal in babies
Biot's breathing
174
The ____ chest contains almost all lower lobe.
Posterior
175
What are childrens respiratory rates by age?
12 15-20
176
______, the location of ____ marks the apex of lung tissue and ____ usually corresponds to the base.
Posteriorly, C7, T10
177
What is PECTUS EXCAVATUM
Sunken chest; congenital defect
178
The _____ lung is shorter because of the _____.
Right, liver
179
What is rectus carniatum
prominent sternum; congenital
180
If you swallow an object it will go into the _____ lung because the bronchi is wider.
Right
181
You can see the ribs working hard to move the air; example croup
Retractions
182
The _____ lung has three lobes.
Right
183
Upper airway obstruction
stridor
184
The _____ main bronchus is shorter, wider, and more vertical.
Right
185
Lower airway obstruction; musical, may hear without a stethoscope; high pitch notes; asthma; emphysema
wheeze
186
This lung is responsible for 55% of activity and contains three lobes.
Right
187
Caused by air in tissues; feels like bubble wrap or rice krispies under the skin;
crepitus
188
This color of sputum usually indicates TB or pneumococcal pneumonia.
Rust
189
The first 7 ribs attach directly to the ______ via their costal cartilages.
Sternum
190
High pitched wheezing result from turbulent air flow in upper airway. Primarily inspiratory.
Stridor
191
Rapid, shallow breathing >24/min.
Tachypnea
192
A bony structure with a conical shape, which is narrower at the top.
Thoracic cage
193
This is defined by the sternum, 12 pairs of ribs and 12 thoracic vertebrae.
Thoracic cage
194
What parts of the lower airway transport air but do not exchange gas.
Trachea and Bronchi/Terminole Bronchioles
195
The _____ and _____ constitute the dead space, or space that is filled with air but is not available for gaseous exchange.
Trachea, bronchi
196
The _____ and ______ transport gasses between the environment and the lung parenchyma.
Trachea, bronchi
197
Smooth muscle, warms and humidifies, connects larynx to the brochi.
Trachea
198
SOB sensed while lying on one side but not the other.
Trepopnea
199
This portion of the airway is not sterile.
Upper Airway
200
This portion of the pleura lines the outside of the lungs.
Visceral
201
High pitched, musical, squeaking adventitious lung sound. Occurs with airway obstruction and on expiration.
Wheezing
202
This color of sputum usually indicates colds, bronchitis, viral infection.
White or clear
203
This color of sputum usually indicates a bacterial infection.
Yellow or green
204
is measured by the ration of lecitin and sphingolin
fetal pulmonary development
205
is facilitated by diaphragm and intercostals muscles
inspiration
206
there is an increase in tactile fremetus in individual with pneumonia
pneumonia
207
seen in COPD
purse lip breathing
208
is defined by sternum, ribs, diaphragm
the thoracic wall
209
An acute pulmonary insult (trauma, gastric acid aspiration, shock, sepsis) damages alveolar capillary membrane, leading to increased capillary permeability of pulmonary capillaries and alveolar epithleium, and to pulmonary edema.
ARDS
210
Acute onset of apprehension and dyspnea.
Restlessness, Disorientation,Rapid shallow breathing, productive cough,
211
An allergic hypersensitivity to certain inhaled allergens, irritants, microbes, stress, or exercise that produces bronchospasm, inflammation, edema in walls of bronchioles, and secretion of highly viscous mucus.
Athsma
212
Airway resistance.
Wheezing, dyspnea, and chest tightness.
213
Collapsed shrunken section of alveoli or an entire lung >>> airway obstruction, compression on the lung, lack of surfactant.
Atelectasis
