Respiratory Gen Flashcards
(86 cards)
1
Q
A
2
Q
A
3
Q
What are ‘true ribs’?
A
Ribs 1-7 that attach directly to the sternum by costal cartilage
4
Q
How do ribs 8, 9, and 10 attach?
A
Attach to the costal cartilage above
5
Q
What are ribs 11 and 12 classified as?
A
‘Free floating’ ribs
6
Q
What is the costotransverse joint?
A
Joint between the tubercle of the rib and the transverse costal facet of the corresponding vertebra
7
Q
What is the costovertebral joint?
A
Joint between the head of the rib and the superior and inferior costal facets of the corresponding vertebra
8
Q
What is unique about rib 1?
A
Shorter and wider, has one facet on its head for articulation
9
Q
What characterizes rib 2?
A
Thinner and longer than rib 1, has two articular facets on the head
10
Q
What is the significance of the suprasternal notch?
A
U-shaped depression just above the sternum between clavicles
11
Q
What is the manubriosternal angle also known as?
A
‘Angle of Louis’ or ‘Sternal Angle’
12
Q
Where is the manubriosternal angle located?
A
At the articulation of the manubrium and sternum, continuous with the second rib
13
Q
What anatomical landmark marks the site of tracheal bifurcation?
A
Manubriosternal angle
14
Q
What is the costal angle?
A
Angle formed by the right and left costal margins at the xiphoid process, usually less than 90 degrees
15
Q
What is the vertebra prominens?
A
Seventh cervical vertebra, most prominent bony spur at the base of the neck
16
Q
Where is the inferior border of the scapula typically found?
A
At the 7th or 8th rib
17
Q
What are the reference lines for the anterior chest?
A
Midsternal line, midclavicular line
18
Q
What encloses the thoracic cavity?
A
Ribs, sternum, vertebral column, top of diaphragm
19
Q
What structures are found in the mediastinum?
A
- Esophagus
- Trachea
- Heart
- Great vessels
20
Q
How many lobes does the right lung have?
A
3 lobes
21
Q
How many lobes does the left lung have?
A
2 lobes
22
Q
What is the apex of the lung?
A
Highest point of lung tissue, 3 to 4 cm above inner 1/3 of clavicle
23
Q
Where does the base of the lung rest?
A
On the diaphragm, around the 6th rib at midclavicular line
24
Q
What is the function of the pleurae?
A
Form an envelope between lungs and chest wall, with visceral pleura lining outside of lungs
25
What is the trachea's length in adults?
10 to 11 cm long
26
What is the difference between the right and left main bronchus?
Right main bronchus is shorter, wider, and more vertical than the left
27
What is the acinus?
Functional unit consisting of bronchioles, alveolar ducts, alveolar sacs, and alveoli
28
What are common respiratory issues in infants and children?
Increased vulnerability to respiratory issues due to environmental tobacco smoke exposure
29
What is the most common chronic disease in childhood?
Asthma
30
What factors contribute to lung cancer?
Smoking leading to mutational burden
31
What is the significance of subjective data in respiratory assessment?
Includes cough, shortness of breath, chest pain with breathing
32
What should be assessed regarding smoking history?
Onset, duration, and pattern of smoking
33
What are the five A's of smoking cessation counseling?
* Ask
* Advise
* Assess
* Assist
* Arrange
34
What should be noted during inspection of the thoracic cage?
Shape and configuration of chest wall, skin color, and condition
35
What does tactile fremitus assess?
Palpable vibrations using hands
36
What sound predominates in healthy lung tissue during percussion?
Resonance, a low-pitched, clear, hollow sound
37
What is the primary characteristic of lung auscultation?
Passage of air through tracheobronchial tree creates audible noises
38
What is the low-pitched, clear, hollow sound that predominates in healthy lung tissue in adults?
Normal breath sounds
## Footnote
This sound is relative and varies among different body types.
39
What technique for measuring diaphragmatic excursion is no longer recommended?
Technique of measuring diaphragmatic excursion
## Footnote
This is mentioned as not being recommended in clinical practice.
40
What are the three types of breath sounds heard normally in adults and older children?
* Bronchial
* Bronchovesicular
* Vesicular
41
What should be noted when listening to breath sounds?
Description of characteristics and location of breath sounds
## Footnote
Do not confuse background noise with lung sounds.
42
What are the added sounds that are not normally heard in lungs?
* Crackles (or rales)
* Wheeze (or rhonchi)
* Atelectatic crackles
* Stridor
43
What are crackles and how are they classified?
* Fine crackles
* Course crackles (rales)
* Atelectatic crackles
* Pleural friction rub
44
What is the normal quality of voice sounds or vocal resonance?
Soft, muffled, and indistinct
## Footnote
You can hear sound through the stethoscope but cannot distinguish exactly what is being said.
45
What should be assessed during the inspection of the anterior chest?
* Shape and configuration of chest wall
* Patient’s facial expression
* Level of consciousness
* Skin color and condition
* Quality of respirations
* Respiratory effort
* Symmetry
46
What is tactile fremitus and how is it assessed?
Assessment of vibrations from one side to another while the person repeats 'ninety-nine'
## Footnote
Increased or decreased tactile fremitus can indicate abnormalities.
47
What is the significance of percussion during the anterior chest exam?
To assess borders of cardiac dullness and detect lung pathology
## Footnote
Do not percuss directly over female breast tissue to avoid dull notes.
48
What is the forced expiratory time?
Number of seconds it takes to exhale from total lung capacity to residual volume
49
What is the normal SpO2 range for a healthy person?
97% to 98%
## Footnote
Must be evaluated in context of a person’s Hb level, acid-base balance, and ventilatory status.
50
What is the 6-minute walk test (6 MWT)?
A clinical measure of functional status in aging adults
51
What are the normal respiratory rates for newborns?
30 to 40 breaths per minute, may spike up to 60 breaths per minute
52
What is the Apgar scoring system?
Newborn’s first respiratory assessment to measure successful transition to extrauterine life
53
What respiratory pattern is common in infants?
Obligate nose breather until 3 months
54
What are common abnormal findings in respiration patterns?
* Sigh
* Tachypnea
* Hyperventilation
* Bradypnea
* Hypoventilation
* Cheyne-Stokes respiration
* Biot’s respiration
* Chronic obstructive breathing
55
What are potential causes of chronic dyspnea?
* Atelectasis
* Lobar pneumonia
* Emphysema
* Asthma
* Pleural effusion
* Tuberculosis
* Lung cancer
56
What defines chronic bronchitis?
Productive cough for greater than 3 months for 2 successive years not attributed to another cause
57
What is the GOLD Classification of COPD?
A system to assess the severity of Chronic Obstructive Pulmonary Disease
58
What is the typical presentation of asthma?
* Bronchoconstriction
* Intermittent cough
* Wheezing
* Chest tightness
* Shortness of breath
59
What are signs that asthma is not controlled?
* Symptoms >2 days/week
* Weekly nighttime awakening
* Limitation in normal activity
* Use of short-acting bronchodilators for symptom control >2 days/week
60
What is cystic fibrosis?
An autosomal disorder caused by a mutation in the CFTR gene leading to abnormal thickened secretions and obstructive lung disorder
61
What are the pulmonary function test findings in cystic fibrosis?
* Decreased FEV1
* Decreased FEV1 to FVC ratio
* Increased residual volume
62
What are common findings in interstitial lung diseases?
* Fine crackles
* Clubbing of fingers
* Progressive dyspnea on exertion
* Non-productive cough
63
What is the role of a multi-disciplinary approach in cystic fibrosis management?
To optimize medical management and plan for sputum clearance techniques
64
What are Interstitial Lung Diseases?
A group of lung diseases characterized by inflammation and fibrosis of the lung parenchyma.
65
What is a key symptom of Restrictive Lung Disease?
Progressive dyspnea on exertion.
66
What type of cough is associated with Interstitial Lung Diseases?
Non-productive cough.
67
What are the physical findings in Interstitial Lung Diseases?
* Fine crackles in lung sounds
* Clubbing of fingers.
68
What are the diagnostic methods for Interstitial Lung Diseases?
* Clinical assessment
* Radiographs
* CT scans
* Surgical lung biopsy.
69
What is the role of pulmonology consultation in Interstitial Lung Diseases?
To optimize medical management and look for exacerbations.
70
What is Pulmonary Hypertension?
A condition that can be associated with some Interstitial Lung Diseases and may involve other body systems.
71
Which systemic diseases can be associated with Interstitial Lung Diseases?
* Sarcoidosis
* Systemic lupus
* Rheumatoid arthritis.
72
What is Obstructive Sleep Apnea?
A sleep disorder characterized by repetitive upper airway collapse and apnea lasting 10 seconds or longer.
73
What percentage of the general population is affected by Obstructive Sleep Apnea?
9-25%.
74
What is the standard screening method for Obstructive Sleep Apnea pre-operatively?
Screening questionnaires such as STOP-Bang.
75
What does the Apnea-hypopnea index (AHI) measure?
The number of abnormal respiratory events in an hour.
76
What are the classifications of Obstructive Sleep Apnea based on AHI?
* Mild OSA: 5-14
* Moderate OSA: 15-30
* Severe OSA: > 30.
77
What is a recommended practice for patients with known OSA undergoing surgery?
Optimized management of comorbid conditions and use of PAP after surgery.
78
What is the leading cause of preventable morbidity and mortality?
Smoking.
79
What are some effects of long-term smoking on health?
* Reduced tissue perfusion
* Impaired immune function
* Impaired collagen production
* Reduced lung capacity.
80
What are the potential consequences of tobacco use on surgery?
* Increased risk of surgical infections
* Delayed wound healing
* Increased ICU admissions.
81
How long before surgery should smoking cessation occur to reduce complications?
3-4 weeks.
82
What is a 'Teachable Moment' in the context of smoking cessation?
An opportunity to motivate patients to quit smoking due to increased surgical risks.
83
What is the updated approach to smoking cessation referral?
From 'Ask, Advise, Refer' to 'Ask, Advise, Connect.'
84
What is the ARISCAT score used for?
To predict the overall risk of postoperative respiratory complications.
85
What are some post-operative respiratory complications?
* Atelectasis
* Respiratory infections
* Hypoxemia.
86
What are some risk factors associated with postoperative respiratory complications?
Perioperative events, micro aspirations, excessive administration of fluids.
