Flashcards in Lung Flash Cards 3 Deck (25)
In a health history of the lungs, what should you ask about?
Acute/chronic sym, hx of chest pain, shortness of breath, difficulty breathing on expiration and/or inspiration, orthopnea, coughing, fever, chills, weight loss, hx of asthma, tobacco use, occupation exposure, hx of resp. infections, and cardiac probs
What are the planes of the anterior chest wall?
Midsternal line, midclavicular line, and anterior axillary line
What are the planes of lateral chest wall?
RUL, RLL, RML, LUL, and LLL
During the lung inspection, what do you assess for?
chest wall diameter later > anterior- posterior diameter, movement of chest w/ inspiration/expirations, use of accessory muscles, skin & m. membranes color, and pt. desired breathing position
What is a normal chest wall shape?
lateral diameter > anterior-posterior diameter
What is a barrel chest?
AP = Lateral Diameter
What is pectus carinatum?
Anteriorly displaced sternum and depressed costal cartilages
What is Pectus Excavatum?
Funnel chest ( chest caved in), may have murmurs
What are the scoliotic changes of chest wall?
Spinal convexity to the right when pt. bending forwards. Left ribs are close together and right ribs are widely separated
What is Flail Chest?
Expiration ribs out and inspiration goes in
What is palpation used for?
Asses chest expansion, detect fremitus or vibration during speaking, and low-use assessment skill
What is percussion used for?
if tissues are fluid/air/solid filled, assess lesions, tones, and sounds, which should be symmetrical
What kinds of notes may be emitted from percussion?
Flat, dull (abnormal lung tissue), Resonant (healthy), Hyper-Resonant ( hyper inflated lung tissues, due to COPD/asthma), and tympany
What are the special consideration (populations) for lung sounds?
women, pregnant women, children, infants, and frail elderly or immobilized patients
What are normal breath sounds?
smooth and rhythmic, sound breezy. May be difficult to hear in neonate and very old/frail/infants. Should be audible in all lung fields.
What kind of sound is hear over Vesicular Respiratory Sounds?
Where is the Broncho-vesicular and what kind of sound?
below the scapulae (1st & 2nd ICS Anteriorly) and has an intermediate sound
Where is the Bronchial located and what kind of sound?
Loud sound and over the manubrium
Where is the tracheal and what kind of sound do you hear?
high pitched sounds heard over trachea in neck
Where are the 5 abnormal sounds to listen for?
crackles, wheezes, rhonchi, stridor,and pleural rub
What is a crackle?
air bubbles flowing through secretions or snapping open of airways closed by secretions, asthma, acute URI, or chronic bronchitis
What are wheezes?
Air flow through narrowed airways in asthma, COPD, or acute URI EX: hissing or shrill quality
What is a Rhonchi?
lower pitch than wheezes, secretions in large airways EX: snoring quality
What is a stridor?
wheeze on inspiration only, emergency situation