Lung and Thoracic Exam I Flashcards Preview

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Flashcards in Lung and Thoracic Exam I Deck (54):
1

fissure

line that divides the lobes

2

sternal angle

separates manubrium and body of sternum

3

interspace of each rib

located below that rib

4

costal angle

angle below xyphoid process

5

which ribs articulate directly with the sternum?

true ribs 1-7

6

which ribs articulate indirectly with the sternum?

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

7

which ribs are called "floating ribs"?

11-12

8

costochondritis

pain and inflammation of the cartilage around the ribs
-clinically, palpate, range of motion, deep breathing will cause more pain

9

where is the lower lung border anteriorly?

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

10

where is the lower lung border posteriorly?

T10 spinous process

11

when would the diaphragm lose its elasticity?

emphysema-loses its ability to move back and forth

12

base of the lung is where?

at the base (bottom)

13

apex of the lung is where?

uppermost portion of the lung

14

what are the major (oblique) fissures?

Right and Left lung are divided in half by them

15

where is the minor (horizontal) fissure located?

in the right lung

16

which lung is inferior?

left lobe, because it holds the heart

17

lingula

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

18

which lobe is matched with the heart space medially?

right middle lobe

19

where does the trachea bifurcate anteriorly?

at the sternal angle

20

where does the trachea bifurcate posteriorly?

T4 spinous process

21

what is the name of the tracheal bifurcation?

carina

22

why is the tracheal bifurcation important?

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

23

how many 2nd bronchi does the R bronchi have?

3 secondary

24

how many 2nd bronchi does the L bronchi have?

2 secondary

25

visceral pleura

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

26

parietal pleura

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

27

pleural space

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

28

lung parankima

actually lung tissue
has not nerve endings

29

what are the muscles of respiration?

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

30

when diaphragm contracts, what happens?

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

31

what is happening at the alveoli?

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

32

what is the concentration of oxygen in the air?

18-20%

33

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

sternomastoids
scalenes
abdominal muscles
intercostals

34

when does clubbing happen?

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

35

what are some causes of impaired movement

hemothorax
flail chest
fractures rib
pneumonectomy

36

pectus excavatum

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

37

pectus carinatum

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

38

barrel chest

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

39

kyphosis

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

40

atelectasis

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

41

scoliosis

abnormal s-type curvature in the spine

42

tactile fermitus

not sure yet

43

how far does percussion penetrate into the chest?

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

44

what does percussion accomplish?

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

45

flatness

soft, high pitched, short sound
thigh

46

dullness

medium, medium pitched, medium length sound
liver

47

resonance

loud, low pitched, long length sound
healthy lung

48

hyperresonance

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

49

tympany

loud, high pitched sound
gastric bubbles

50

what is the pattern of auscultation

step-ladder approach to be able to compare bilateral sounds

51

what are the different types of breath sounds?

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)

52

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

anxiety
costochronditis

53

what is stridor?

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

54

what do sinus tracts indicate?

infection of the underlying pleura and lung (TB or actinomycosis

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