Mini Exam 3 pt 2 (09/09) Flashcards
(27 cards)
Identify the reference lines of the thorax (front view)
Anterior Axillary Line
Midclavicular Line
Midsternal Line
Identify the reference lines of the thorax (side view)
Anterior Axillary Line
Midaxillary Line
Posterior Axillary Line`
List the system-appropriate history questions for the lungs`
Cough? Shortness of Breath? Chest Pain? History of Respiratory Infections Smoking History Environmental Exposure Self Care
Inspection: Shape and Configuration of chest wall`
- spinus processes in a straight line ~no scoliosis or kyphosis(hunchback)
- Symmetric: Scapulae, thorax
- A:T (anterior to thoracic)
- Barrel Chest is 1:1 costal angle >90
- Ribs @ 45 degree slope
- accessory muscles
Inspection: Anterior Chest-Shape and Configuration
- costal angle <90 degrees
- abdominal muscles
- Facial Expression-relaxed
- Level of Consciousness- alert, cooperative
- Quality of respiration- effortless, regular
- No retraction or bulging of ICS
- Breathing Position- normal, not leaning/hunched over
- Skin color and condition- warm and dry
Palpation
touch
Inspection
view
Percussion
Tapping, vibrations
Ausculation
Sound
Percussion: Posterior Chest
Lung Fields -Side to side comparison -Avoid Scapulae and ribs -Apex @ C7 or 2-4cm above clavicles -Base lies on diaphragm Resonance -Hyperresonance -Hyporesonance
Auscultation: Posterior Chest
Breath sounds
Voice sounds
Auscultation: Anterior Chest
Side to side- one full breath Breath sounds: avoid breast tissue -Vesicular, Bronchovesicular, Bronchial Pulmonary function status -Pulse oximetry >90%
Expected Lung Sounds
Bronchial- high pitch, loud, harsh hollow tubular sound
Bronchovesicular- moderate pitch, moderate volume, mixed quality
Vesicular- low pitch, soft volume, rustling sounds
Adventitious sounds
crackles, wheezes, stir, atelectatic crackles
crackles
discrete, popping sounds
wheezes
connected, musical sounds
stidor
high pitched monophonic inspiratory crowing sounds. Louder in the neck, originates in larynx or trachea (swollen tissues or foreign body)
atelectatic crackles
crackles that disappear after cough, breath
Discuss developmental changes in the lungs of the aging adult
Thorax less mobile Chest expansion decreased Increased A:T diameter Kyphosis-outward curvature of the thoracic spine Decreased lung capacity Easily Fatigued
Bronchial
trachea, larynx -short inhale, long exhale
Bronchovesicular
bronchi- equal inhale and exhale
Vesicular
peripheral lung fields – long inhale, short exhale
typical A:T range
between 1:2 to 5:7
Hyperresonance
too much air; low pitch
