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Flashcards in Lungs and Thorax Lecture Deck (42):
1

What are the ROS for thorax/ lungs?

Chest pain SOB/ dyspnea Wheezing Cough Hemoptysis

2

2 conditions to be concerned with for health maintenance

Smoking 

Influenza 

3

Where does the trachea bifurcate into main bronchi?

Sternal angle/ T4

4

What is the order to the pulmonary exam?

Inspection Palpation Percussion Auscultation

5

What four things are we looking for on inspection?

Color

Breathing/ wheezing

Neck

Shape of chest

6

What is an acceptable AP to lateral ratio of the chest?

2:1

7

What is a barrel chest associated with?

COPD can be with normal aging

8

What is this a picture of? 

Q image thumb

Barrel Chest

9

What is a traumatic flail chest?

2 or more ribs broken in 3 or more places

Paradoxical movement

Moves in on inspiration, out on expiration 

10

What is this?

Q image thumb

Pectus Excavatum (funnel chest) 

11

What is this?

Q image thumb

Pectus Carinatum (pigeon chest) 

12

What are the spots for tactile fremitus?

3 B/L anterior 

4 B/L posterior 

13

What causes a absent or decrease in tactile fremitus?

Bronchial dilation

COPD

Pneumothorax

Atelectasis

Tumor

Pleural effusion 

14

What can cause an increase in tractile fremitus?

Consolidation (lobar pneumonia) 

15

What four things can cause abnormal chest excursions?

Splinting

Bronchial obstruction

Pleural effusion

Lobar pneumonia 

16

How many sites do you perform percussion?

Posteriorly- 7 sites

Anteriorly 6 sites 

17

What type fashion should you move in when doing percussion?

Ladder fashion 

18

What is the normal sound with percussion of the lung?

Resonant 

19

What is hyper-resonance associated with?

Emphysema, pneumothorax 

20

What is tympany associated with?

Large pneumonia 

21

What are three specials for lung auscultation? 

Bronchophony

Whispered petrolioquy

Egophony 

22

What are vesicular breath sounds?

Normal sound heard over healthy tissue 

23

What are bronchovesicular lung sounds?

Sounds heard over a large bronchi 

24

What does a pleural rub sounds like?

Stepping on snow 

25

What is mediastinal crunch (Hamman's Sign)?

Series of precordial crackles syncronous with the heart beat, not with respiration

26

What is atelectasis?

Main bronchus is plugged with fluid or blood 

27

What is consolidation? 

Alveoli filled with fluid or blood cells, as in pneumonia, pulmonary edema or pulmonary hemorrhage 

28

What is a pleural effusion?

Fluid in pleural spaces separates air-filled lung from pluera 

29

What is a pneumothorax?

When air leaks into pleural space causing lung to recoil from chest wall, pleural air blocks transmission of sound

30

What age is pnemococcal vaccine given to?

Adults >65 

31

What other populations in pneumococcal vaccine given to?

Routine vaccine for all children and infants

adults with chronic illness

smokers age 19-64

anyone about to get a cochelar implant

adults and children older than 2 who are immunocomprimised 

32

What are the 5 A's 

Ask

Advise

Assess 

Assist

Arrange

33

What are the steps of the stages of  change model?

Precontemplation

Contemplation

Preparation

Action 

Maintenance 

34

What causes a unilateral decreases in chest expansion?

Chronic fibrosis of the underlying lung or pleura

Pleural effusion

Lobal pneumonia

Pleural pain w/ splinting

Unilateral bronchial obstruction 

35

What does unilateral hyperresonance suggest?

Large pneumothorax or a large air filled bulla in the lung 

36

What's a sound that is soft and low pitched, heard through inspiration, continue without pause through expiration then fade away about 1/3 through expiration 

Vesicular 

37

What are louder, harsher, sounds higher in pitch. 

Short silence between inspiratory and expiratory sounds 

Expiratory sound lasts longer 

Bronchial 

38

What is a Discontinuous, intermittent, nonmusical, brief sound that is like a dot in time?

Crackle (rales) 

39

Where might bronchial breath sounds replace normal vesicular breath sounds?

Over airless areas of the lung 

40

What is it called when a spoken "ee" is heard as an "ay"?

Egophony 

41

What is it called when spoken words are heard louder on auscultation?

Bronchophony 

42

Will tactile fremitus be increased or decreased in the airless state of the lung?

Increased