Lung and Thoracic Exam I

Question 1

fissure

Answer 1

line that divides the lobes

Question 2

sternal angle

Answer 2

separates manubrium and body of sternum

Question 3

interspace of each rib

Answer 3

located below that rib

Question 4

costal angle

Answer 4

angle below xyphoid process

Question 5

which ribs articulate directly with the sternum?

Answer 5

true ribs 1-7

Question 6

which ribs articulate indirectly with the sternum?

Answer 6

8-10 (thinner and longer than others-come all the way around the body-easily fractured)

Question 7

which ribs are called “floating ribs”?

Answer 7

11-12

Question 8

costochondritis

Answer 8

pain and inflammation of the cartilage around the ribs

-clinically, palpate, range of motion, deep breathing will cause more pain

Question 9

where is the lower lung border anteriorly?

Answer 9

crosses 6th rib midclavicular line and 8th rib midaxillary line

Question 10

where is the lower lung border posteriorly?

Answer 10

T10 spinous process

Question 11

when would the diaphragm lose its elasticity?

Answer 11

emphysema-loses its ability to move back and forth

Question 12

base of the lung is where?

Answer 12

at the base (bottom)

Question 13

apex of the lung is where?

Answer 13

uppermost portion of the lung

Question 14

what are the major (oblique) fissures?

Answer 14

Right and Left lung are divided in half by them

Question 15

where is the minor (horizontal) fissure located?

Answer 15

in the right lung

Question 16

which lung is inferior?

Answer 16

left lobe, because it holds the heart

Question 17

lingula

Answer 17

area where Left middle lobe should be, but is occupied by the heart

Question 18

which lobe is matched with the heart space medially?

Answer 18

right middle lobe

Question 19

where does the trachea bifurcate anteriorly?

Answer 19

at the sternal angle

Question 20

where does the trachea bifurcate posteriorly?

Answer 20

T4 spinous process

Question 21

what is the name of the tracheal bifurcation?

Answer 21

carina

Question 22

why is the tracheal bifurcation important?

Answer 22

ET tube (endotracheal tube)-needs to sit above bifurcation

Question 23

how many 2nd bronchi does the R bronchi have?

Answer 23

3 secondary

Question 24

how many 2nd bronchi does the L bronchi have?

Answer 24

2 secondary

Question 25

visceral pleura

Answer 25

serous membrane which covers outer surface of each lung including inside the fissures

Question 26

parietal pleura

Answer 26

serous membrane which lines the thoracic cavity (inner ribcage and upper surface of the diaphragm)

Question 27

pleural space

Answer 27

lubricated space between pleura (pleural fluid) | allows lungs to move freely

Question 28

lung parankima

Answer 28

actually lung tissue | has not nerve endings

Question 29

what are the muscles of respiration?

Answer 29

1. diaphragm 2. muscles in ribcage and neck 3. parasternals 4. scalenes

Question 30

when diaphragm contracts, what happens?

Answer 30

descends in the chest, which opens thoracic cavity and air rushes into the lungs

Question 31

what is happening at the alveoli?

Answer 31

CO2 is going out of the blood | O2 is going into the blood

Question 32

what is the concentration of oxygen in the air?

Answer 32

18-20%

Question 33

what muscles would be used if the pt needs to work harder to breathe?

Answer 33

sternomastoids scalenes abdominal muscles intercostals

Question 34

when does clubbing happen?

Answer 34

``` chronic and fairly severe hypoxemia true clubbing warrants more investigation -cystic fibrosis -COPD -emphysema ```

Question 35

what are some causes of impaired movement

Answer 35

hemothorax flail chest fractures rib pneumonectomy

Question 36

pectus excavatum

Answer 36

chest that looks like it's scooped out - many times needs to be repaired - partially sternum/articulations of ribs with sternum

Question 37

pectus carinatum

Answer 37

chest that looks like to pokes out like a bird's beak | -does allow more room

Question 38

barrel chest

Answer 38

fairly symmetric expansion of chest area transverse view will look like a barrel (o-shaped) chronic -COPD -emphysema -air trapping from malfunctioning alveoliq

Question 39

kyphosis

Answer 39

major curvature of the spine causes abnormal use of the lungs can often cause pneumonia because of atelectasis

Question 40

atelectasis

Answer 40

any time the lung can't open like it's supposed to.

Question 41

scoliosis

Answer 41

abnormal s-type curvature in the spine

Question 42

tactile fermitus

Answer 42

not sure yet

Question 43

how far does percussion penetrate into the chest?

Answer 43

5-7 cm, but will not help to detect deep lesions | -not effective with obese patients

Question 44

what does percussion accomplish?

Answer 44

establish whether underlying tissue is air filled, fluid filled, or solid

Question 45

flatness

Answer 45

soft, high pitched, short sound | thigh

Question 46

dullness

Answer 46

medium, medium pitched, medium length sound | liver

Question 47

resonance

Answer 47

loud, low pitched, long length sound | healthy lung

Question 48

hyperresonance

Answer 48

very loud, low pitched, longer length sound | abnormal in most cases

Question 49

tympany

Answer 49

loud, high pitched sound | gastric bubbles

Question 50

what is the pattern of auscultation

Answer 50

step-ladder approach to be able to compare bilateral sounds

Question 51

what are the different types of breath sounds?

Answer 51

vesicular (most of lung sounds you are listening to) bronchovesicular (lateral of central airways, in between normal lung tissue and bronchi) bronchial (anteriorly, over the bronchi)

Question 52

what is the most frequent cause of chest pain in children?

Answer 52

anxiety | costochronditis

Question 53

what is stridor?

Answer 53

audible wheezing which indicates obstruction of the larynx and/or trachea

Question 54

what do sinus tracts indicate?

Answer 54

infection of the underlying pleura and lung (TB or actinomycosis