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Phar 741 > Lung Section > Flashcards

Lung Section Flashcards

1
Q

List Pleura, their location, and function:

A

Visceral Pleura - outer surface of lung.
Parietal Pleura - inside of rib cage, top of diaphragm.
Pleural Fluid - b/w the two Pleural tissues; reduces friction.

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2
Q

Common or Concerning Symptoms regarding the Chest and Lungs:

A 
Chest Pain - MI
Dyspnea - Cardiac/Pulmonary disease
Wheezing - Partial airway obstruction; secretions and/or inflammation due to asthma/foreign body.
Coughing - Many.
Hemoptysis
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3
Q

Gesture warranting concern with regards to Chest Pain:

A

Clenched fist over sternum - Angina pectoris.
Finger pointing - Musculoskeletal pain.
Up and down motion - Heart burn.

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4
Q

Physicals indicators with regards to hemoptysis:

A

Vomiting - blood probably from GI tract.
Coughing blood - Due to aspiration; think nasopharyngeal or GI.
Dark blood - Think GI.
Lighter blood - Think respiratory.

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5
Q

Three classes of Cough and definitions:

A

Acute - Less than 3 weeks.
- Think viral URI
Subacute - 3-8 weeks.
- Think acute bronchitis, HF, pneumonia, or asthma.
Chronic - More than 8 weeks.
- Think Chronic Bronchitis, postnasal drip, or asthma.

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6
Q

Two main areas of health promotion with regards to the lungs:

A

Smoking Cessation.

Immunizations.

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7
Q

Stages of Change

A 
Precontemplation
Contemplation
Preparation
Action
Maintenance
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8
Q

4 Points of observation with regards to Respirations:

A

Rate
Rhythm
Depth
Effort of Breathing

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9
Q

Normal Respiratory rates

A

14-20 BPM in Adults

44 BPM in Infants

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10
Q

Causes of Slow Breathing (Bradypnea):

A 
Secondary to:
Diabetic coma
Drug induced
Depression
Increased Intracranial-Pressure
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11
Q

Causes of Rapid Shallow Breathing (Tachypnea):

A

Restrictive lung disease
Pleuritic chest pain
Elevated diaphragm

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12
Q

Cheyne-Stokes Breathing defined, and causes:

A 
Alternating deep breathing and dyspnea.
Causes:
HF
Uremia
Drug induced respiratory-depression
Brain damage
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13
Q

Obstructive breathing defined, and causes:

A

Prolonged expiratory phases; harder to expel air.
Causes:
COPD
Asthma

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14
Q

Rapid Deep Breathing (Hyperpnea, Hyperventilation) causes:

A

Exercise
Anxiety
Metabolic acidosis
Coma patients: Infarction, hypoxia, or hypoglycemia, and midbrain/pons are affected.

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15
Q

Ataxic Breathing (Biot’s Breathing) definition and causes:

A

Unpredictable irregularity, shallow or deep, with short pauses.
Cause:
Respiratory depression
Brain damage (medullary level)

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16
Q

Test Chest Expansion

A

Palm lower ribs with both hands, squeezing some skin between thumb tips, and watch them breathe.

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17
Q

Feeling for Tactile Fremitus

A

Ball or palm of hand against various sections of the anterior/posterior chest.
Decreased - COPD, Obstruction, Pleural changes.
Increased - Pneumonia; fluid in lungs.

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18
Q

Various percussion notes with examples:

A 
Flat = thigh
Dull = Liver
Resonant = Healthy lung
Hyperresonant = Usually none
Tympanic = Puffed-out cheek.
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19
Q

Causes of Hyperresonance:

A

Unilateral - Large pneumo-thorax, Large air-filled bulla.

Generalized - COPD, Asthma.

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20
Q

Causes of Dullness:

A 
Lobular pneumonia
Pleural accumulation of fluids:
Pleural effusion - Serous
Hemothorax - Blood
Empyema - Pus
Pleural accumulation of tissues:
Fibrous tissues - Scarring
Tumor - Cancer
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21
Q

Auscultation involves:

A

Listening to sounds generated by breathing.
Listening to any adventitious sounds.
If abnormalities present, listening to spoken or whispered voice through chest wall.

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22
Q

Decreased breath sounds can be due to either:

A

Decreased air flow.
or
Poor Transmission of Sound.

23
Q

Decreased breath sounds, due to decreased air flow, are due to:

A

COPD
or
Muscular Weakness

24
Q

Decreased breath sounds, due to poor transmission of sound, due to:

A 
Pleural effusion.
or
Pneumothorax.
or
COPD
25
Q

Crackles - Example of clear abnormality, and causes:

A

Example: Fine late crackles that persist.
Causes: Pneumonia, Fibrosis, early HF, Bronchitis.

26
Q

Wheezes - Example of clear abnormality, and causes:

A

Example: High pitched with hissing or shrilling.
Causes: Narrowed airways; Asthma, COPD, Bronchitis.

27
Q

Rhonchi - Example of clear abnormality, and causes:

A

Example: Low-pitched with snoring quality.
Causes: Secretions in the large airways; Bronchitis.

28
Q

Bronchophony:

A

Louder voice sounds
- “99”
Suggests Lung has become airless.

29
Q

Egophany:

A

“ee” sounds like A.

Present in pneumonia.

30
Q

Pectoriloquy:

A

Louder and clearer whispered sounds.

Suggests consolidation.

31
Q

Differentiating characteristic of Chronic Bronchitis:

A

Chronic productive cough FOLLOWED BY slow progressive dyspnea.

32
Q

Differentiating characteristic of Asthma:

A

Acute episodes separated by symptom free periods.
- and -
Nocturnal episodes occur.

33
Q

Differentiating characteristic of Pneumonia:

A

An acute illness.

34
Q

Differentiating characteristic of Pulmonary Embolism:

A

SUDDEN onset of dyspnea.

Think after surgeries, birth, major injury, etc.

35
Q

Differentiating characteristic of Anxiety:

A

Episodic.

36
Q

Acute forms of chest inflammation:

A

Laryngitis
Tracheobronchitis
Mycoplasma AND Viral Pneumonias
Bacterial Pneumonias

37
Q

Differentiating characteristic of Laryngitis:

A

Hoarseness.

It’s location in general.

38
Q

Differentiating characteristic of Tracheobronchitis:

A

Burning retrosternal discomfort - That deep chest burn with a pretty bad cough.

39
Q

Differentiating characteristic of Mycoplasma and Viral Pneumonias:

A

Dry hacking cough; becomes productive of mucoid sputum.

Febrile.

40
Q

Differentiating characteristic of Bacterial Pneumonias:

A

Pneumonococcal: Sputum is mucoid or purulent, may be blood-streaked, kinda pink/rusty.
Klebsiella: Similar, or more like sticky red jelly-like stuff.
Both - High fever, often preceded by acute URI.

41
Q

Chronic Forms of Chest Inflammation:

A 
Postnasal drip
Chronic Bronchitis
Bronchiectasis
Pulmonary TB
Lung Abscess
Asthma
Gastroesophageal reflux
42
Q

Differentiating characteristic of Postnasal drip:

A

Repeated attempts to clear throat.

Postnasal discharge may be seen in posterior pharynx.

43
Q

Differentiating characteristic of Chronic Bronchitis:

A

Long history of smoking.
- and -
Recurrent superimposed infections.

44
Q

Definition, and differentiating characteristic, of Bronchiectasis:

A

Definition: Permanent enlargement of parts of the airways.

Often copious amounts of mucoid of purulent sputum that may be blood-streaked or bloody.

45
Q

Differentiating characteristic of Pulmonary TB:

A

Anorexia
Fatigue
Fever
Night sweats

46
Q

Differentiating characteristics of Lung Abscesses:

A

Often an episode of impaired consciousness; leads to aspiration.

47
Q

Differentiating characteristics of Asthma:

A

Episodic wheezing and dyspnea.
Cough may occur alone.
Often - Allergy Hx.

48
Q

Differentiating characteristics of Gastroesophageal Reflux:

A

Early morning hoarseness
Heartburn
Regurgitation

49
Q

Breath sounds of normal lung:

A

Predominantly vesicular in nature.

50
Q

Breath sounds of airless lung:

A

Bronchial or Broncho-vesicular over involved area.

51
Q

Transmitted voice sounds of normal lung:

A

Spoken = muffled/indistinct.
“ee” sounds like “ee.”
Whispered = faint.

52
Q

Transmitted voice sounds of airless lung:

A 
Bronchophony
- Louder "99"
Egophony
- "ee" is now A.
Whispered Pectoriloquy
- Louder and clearer.
53
Q

Tactile Fremitus in normal lung:

A

Normal levels of vibrations.

54
Q

Tactile Fremitus in airless lung:

A

Increased levels of vibrations.

Phar 741 (2 decks)

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