Respiratory

Question 1

What is the Mediastinum

Answer 1

contains esophagus, trachea, heart, and great vessels

Question 2

xipoid process, manubrium, lingula

Question 3

epiglotitis is what ? Know RSV

Question 4

why does the right side have an extra lobe compared to the left ?

Answer 4

Because the heart is in the way

Question 5

Top of lung is called? bottom of lung

Answer 5

apex and base ( top is actually the bottom and bottom is the top )

Question 6

rihgt middle lobe you would listen to on which side of the body

Answer 6

The front

Question 7

what is rhe pleura?

Answer 7

a slipperly sac that has a thin amount of fluid- think seran wrap sprayed with cooking spray - anything that can cause and infection in the lung can cause infection in the pleura -

Question 8

primary muscles we need to breathe

Answer 8

Primary muscles are the diaphragm and external intercostal muscles

Question 9

recruitment of the accessory muscles (Accessory muscles” refers to muscles that assist, but do not play a primary role, in breathing)

Answer 9

the sternocleidomastoid, internal intercostals and trapezius muscles that are used only during exertion (exercise or COPD

Question 10

Expiration is mostly

Answer 10

passive in nature and occurs with relaxation of intercostal muscles & diaphragm.

Question 11

what are the bad signs

Answer 11

retractions, use of accessory muscles, grunting ( an emergency)

Question 12

Why do we have to be careful giving o2 to COPD patients

Answer 12

because the respiratory drive will change from a CO2 drive to an O2 drive and this means that giving too much o2 at once can be dangerous

Question 13

difference between tachypnea and hyerpventilation

Answer 13

hyperventilating is rapid , deep breathing , whereas tachypnea would be just taking more breaths per minute with normal depth of respirations

Question 14

can you have normal respiration but abnormal type of ventilation ( what does the depth look like )

Answer 14

yes you can

Question 15

what is hypoventilation

Answer 15

(slow, shallow breathing) causes carbon dioxide to build up in blood,

Question 16

what is hypoxemia ? vs hypoxia. Can you have one without the other?

Question 17

mid axillary

Answer 17

under the arm pit

Question 18

track scalpula , not on top of it but beside it

Question 19

questions to ask

Answer 19

trouble breahthing, do you have a cough, do you have chest pain

Question 20

different kinds of pain it could be

Answer 20

pulmonary pain, pleural pain, muscular pain, cardiac pain, gastric pain describe in detail

Question 21

pleural pain ?

Answer 21

happens with inspiration or cough

Question 22

muscular pain

Answer 22

can you reproduce the pain ? can the patient touch the pain ? if the pain is the same always can be pneumonia,

Question 23

signs of a heart attack

Answer 23

Nausea vomitting, pale , pain radiating down the left side , women will experience more jaw pain and neck pain

Question 24

percussing over air, it should sound

Answer 24

resonant or hollow

Question 25

never listen to breath sounds through clothing

Question 26

anterior to posterior ratio

Answer 26

1:2 , COPD patients will have a 1:1 ratio due to barrel chest

Question 27

Tactile fremitius

Answer 27

a tactile vibration Conditions that increase density of lung tissue make a better conducting medium for sound vibrations and increase tactile fremitus Fremitus varies among persons, but symmetry is most important; vibrations should feel same in corresponding area on each side

Question 28

thoracic excursison

Question 29

percussion should be done

Answer 29

in the intercostal spaces

Question 30

what is a wheeze ?

Answer 30

Musical or squeaking * High-pitched, continuous sounds * Auscultated during inspiration and expiration * Occurs in small air passages(unrelieved by coughing) - Often heard in diffuse airway obstruction like in acute asthma or chronic emphysema

Question 31

what is a rhonchi ?

Answer 31

Sonorous or course or mourning sounds * Low-pitched snoring or moaning, continuous sounds - Occurs in large air passages(bronchi and trachea) * Coughing may clear the sound - heard in bronchitis and pneumonia

Question 32

what is a stridor

Answer 32

narrowing of the upper airway , whooping cough it is common, choking , airway obtruction and croup. Heard on inspiration High pitched , whistling sound Harsh quality - continuous sounds

Question 33

what is crackling

Answer 33

* Bubbling, crackling, popping * Low- to high-pitched, discontinuous sounds * Auscultated during inspiration * Occurs in small air passages, alveoli, bronchioles, bronchi, and trachea (unrelieved by coughing - heard in pneumonia, , CCF , Bronchitis, asthma, emphysema, COPD, pulmonary edema

Question 34

what is friction rub ?

Answer 34

Continuous low pitched dry, Rubbing or grating sound and discontinuous * Loudest over lower lateral anterior surface * Auscultated during inspiration and expiration - Heard in pleuritis Occurs as a result of rubbing of two inflamed plural surfaces.

Question 35

what are the situations where pulse ox would not be accurate

Answer 35

cyanosis, nail polish, when there is carbon monoxide poisoning, people who go through trauma and lose blood

Question 36

people with carbon monoxide poisoning will look like what ?

Answer 36

Like they have a sun burn

Question 37

hemoglobin should be

Answer 37

around 13- 15

Question 38

what are kussmauls breaths ?

Answer 38

often happens in diabetics, fruit acetone breath

Question 39

what are cheyne stokes breaths ?

Answer 39

waxing & waning at regular intervals)

Question 40

biots breathing is what ?

Answer 40

few normal respirations followed by apnea)

Question 41

l purcussed lung sounds in emphysema and pneunothorax

Answer 41

percussion sounds will be exagerated ( normal air sounds will be hollow, low in pitch and long in duration

Question 42

purcussed lung sounds with plural effusion and pulmonary consolidation

Question 43

Hyperresonant sounds may also be heard when percussing lungs hyperinflated with air, such as may occur in patients with

Answer 43

COPD, or patients having an acute asthmatic attack. An area of hyperresonance on one side of the chest may indicate a pneumothorax.