Quiz 3 Chapter 18 no pic lungs and thorax Flashcards Preview

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Flashcards in Quiz 3 Chapter 18 no pic lungs and thorax Deck (26):
1

Suprasternal notch; Sternum; Manubriosternal angle ("sternal angle" or "angle of Louis"); Costal angle (should be 90 degrees or less; ribs join at angle at xiphoid process.)

Anterior thoracic landmarks

2

Angle of Louis -

important for listening for heart and lung sounds, also for 2nd rib, ICS's. Point where trachea bifurcates (at T4 posteriorly)

3

Vertebra prominens C7 (Feel the bony spur on neck -most prominent one is C7, next one down is T1); Spinous processes (T1-T3); Inferior border of scapula; Twelfth rib

Posterior Thoracic Landmarks

4

Useful when documenting findings: Midsternal line, Midclavicular line, Scapular line (back), Vertebral line (spine), *Anterior-, posterior-, and midaxillary lines

Location of reference lines

5

Mediastinum (behind sternum and b/w lungs), Lobes of lungs (3 on right, 2 on left), pleurae (protective layer), tracheal and bronchial tree (check location)

Thoracic cavity

6

Down to T10 on exhalation; T12 during inhalation

How far down lungs extend

7

Irregular respiratory pattern; obligatory nose breathers to 3 months; asthma, bronchitis, pneumonia frequent; Cheyne-Stokes respiration in sleep. Don't base everything on APGAR

Infants resp

8

Thin chest wall - hyperresonance is normal

Children resp

9

Increased transverse diam. of chest; diaphragm elevated b/o growing fetus. Deeper breathing, same RR, may feel like they have "dyspnea"

Pregnant resp

10

Barrel-shaped in COPD. Dec vital capacity, muscle strength & elastic properties. Dyspnea w/ exertion due to less ventilation in lung bases. Cheyne-Stokes pattern in sleep may be normal

Older adult resp

11

Coughing (dry, productive, sputum, quantity, color), SOB, fever, chest pain with breathing, hx of resp infection, smoking, hoarseness, environmental, self-care

Health History Questionnaire

12

Sputum and condition
Colds, virus, bronchitis =

clear/white

13

Sputum and condition
Bacterial infection =

yellow / green

14

Sputum and condition
TB / pneumococcal pneumonia =

rust-colored/bloody

15

Sputum and condition
Pulmonary edema =

frothy

16

Cough*, Hemoptysis, Dyspnea, Wheezing, Cyanosis, Chest pain, Sleep apnea, Sputum production, Clubbing
Chronic bronchitis = x3 months of yr for 3 yrs in a row

Pulmonary disease symtoms

17

Observe shape of chest wall. Transverse > anteroposterior (not barrel). Symetrical, ribs slope down about 45 degrees from spine

Posterior thoracic cage inspection

18

__ __: Assess for symmetric expansion of the chest with inspiration. Normal = 4-5 cm. change

Chest expansion:

19

Place ulnar side of hands on chest wall while pt. says "99" or "blue moon"; Should feel (equal) vibration not incor diminish; air trapping and consolidation affect normal intensity

Tactile (or vocal) fremitus

20

Abnormal tactile fremitus
increased=

consolidation

21

Abnormal tactile fremitus
decreased=

emphysema, pneumothorax, pleural effusion

22

Abnormal tactile fremitus
rhonchial fremitus

thick secretions in bronchi

23

pleural friction fremitus

creaky; pleuritis

24

Palpate the entire chest wall for

crepitus, tenderness

25

Side to side and compare. Avoid bones. Go down to about T10

Pattern for percussion

26

Best if they sit up, Slightly forward, crossing arms; Lie to side if lying down; Have them breathe and little deeper and through the mouth. Left to right, drop down, back to left, etc. Avoid bone

Auscultation