Lung And Respiration Assesement

Question 1

Define Ventilation

Answer 1

The mechanical movement of air

Question 2

Where are the two types of gas exchange and where do they occur?

Answer 2

1. Pulmonary/external - alveoli
2. Cellular/internal - cells

Question 3

What is the sternal angle (angle of Louis)?

Answer 3

The angle where the manubrium meets the sternum at the 2nd rib

Question 4

What is the costal margin?

Answer 4

The border of the lower ribs and the abdomen

Question 5

How do you count intercostal spaces?

Answer 5

The rib above it (top palpable intercostal space = first intercostal space)

Question 6

Which lung has a middle lobe?

Answer 6

Right lung

Question 7

Where is the pleural space?

Answer 7

Between the parietal and visceral pleura

Question 8

What aligns with the split of the trachea?

Answer 8

The sternal angle and T4 vertebrae

Question 9

Which bronchus is more prone to foreign body aspiration?

Answer 9

Right

Question 10

How much air comes in on an inspiration?

Answer 10

500-800mL

Question 11

Which is longer and by how long: inspiration or expiration?

Answer 11

Expiration, 2x

Question 12

What muscles are used in expected inspiration?

Answer 12

Intercostal muscles and diaphragm

Question 13

What muscles are used in expected expiration?

Answer 13

None (passive recoil of inspiration muscles)

Question 14

What are the accessory muscles/muscle groups in active breathing?

Answer 14

• Abdominals
• Sternocleidomastoid
• Scalene
• Pectoralis minor

Question 15

What are the three anterior columns for landmarking the chest?

Answer 15

1. Anterior axillary line
2. Midclavicular line
3. Midsternal line

Question 16

What are the two posterior columns used for landmarking the upper back?

Answer 16

1. Scapular line
2. Vertebral line

Question 17

Where are the lung fields?

Answer 17

2-4 cm above the clavicles to the 6th rib (clavicular)/8th rib (axilary)

Question 18

Where can the right middle lobe be auscultated?

Answer 18

Between the 4th and 6th right ribs anteriorly

Question 19

Where should the lower lobes be auscultated?

Answer 19

Between T3 and T10 posteriorly

Question 20

How should the base of the lungs move in inspiration?

Answer 20

Descend by ~2 rib spaces

Question 21

What is barrel chesting?

Answer 21

A change of thorax shape linked to COPD; the chest is equally as wide transverse as longitudinal

Question 22

What is crepitus?

Answer 22

The feel of air trapped within the pleural cavity; “bubble wrap” feel

Question 23

What is the preferred search pattern of the lungs?

Answer 23

Ladder pattern

Question 24

Can you auscultate over clothing?

Answer 24

No

Question 25

What is spirometry?

Answer 25

A measure of the patients lung volume/expiration volume

Question 26

What is dyspnea?

Answer 26

Difficulty breathing

Question 27

What is orthopnea?

Answer 27

Difficulty breathing while lying flat

Question 28

What is paroxysmal nocturnal dyspnea?

Answer 28

In which patients wake, breathless, during the night

Question 29

What is sputum?

Answer 29

Fluid that may be coughed up; mucus, phlegm

Question 30

What does clear/white/grey mucoid sputum indicate?

Answer 30

Bronchitis

Question 31

What does purulent yellow/green sputum indicate?

Answer 31

Bacterial infection

Question 32

What does overly thick sputum indicate?

Answer 32

Dehydration or cystic fibrosis

Question 33

What does rusty/bloody sputum indicate?

Answer 33

Tuberculosis, *Pneumococcal penumonia* or lung cancer

Question 34

What does thin, frothy sputum indicidate?

Answer 34

Heart failure

Question 35

What is hemoptysis?

Answer 35

Sputum bloodied through contact with upper respiratory lesions

Question 36

What is the tripod position?

Answer 36

A position where a patient in respiratory distress leans forwards, stabilizing themselves on their knees or objects in front of them

Question 37

What is stridor?

Answer 37

High pitched crowing sound from laryngal/tracheal spasm

Question 38

What is scoliosis?

Answer 38

Unusual horizontal spinal curvature

Question 39

What is kyphosis?

Answer 39

Hypercurvature of the upper spine

Question 40

What is subcutaneous emphysema?

Answer 40

Air collecting and displacing below the skin

Question 41

What are retractions?

Answer 41

Indentations between bones caused by pressure while struggling to breathe

Question 42

What is tactile fremitus?

Answer 42

Assesement in which the vibration from speaking is evaluated

Question 43

What might ronchal fremistus (coarse vibration) indicate?

Answer 43

Pneumonia or other airway exudates

Question 44

What is pleural friction fremitus?

Answer 44

Grating sensations caused by pleural friction

Question 45

What might hyperressonance of the lungs indicate?

Answer 45

Hyperinflation of the lungs

Question 46

What is diaphragmatic excursion?

Answer 46

An evaluation in which the displacement if the diaphragm is measured using percussion

Question 47

What is the expected displacement of the diaphragm?

Answer 47

3-5 cm (7-8cm in well conditioned adults)

Question 48

What are the three key breathsounds?

Answer 48

1. Vesicular - soft, low pitched near sites of gas exchange 2. Bronchivesicular - mid volume and pitched 3. Bronchial - loud, high-pitched near the trachea/larynx

Question 49

What is egophony?

Answer 49

A muffled distortion of sound that makes "ee" sound like "a"

Question 50

What are the 6 adventitious breath aounds?

Answer 50

1. Fine rales/crackles 2. Coarse rales/crackles 3. Wheeze 4. Ronchi 5. Pleural friction rub 6. Stridor

Question 51

What is the APGAR scoring system?

Answer 51

An evaluation of newborns and vital signs (HR, Resp. effort, muscle tone, reflexes, colour)

Question 52

What is acrocyanosis?

Answer 52

Blueish of extremities such as hands and feet