The Lung and Thorax Abnorms

Question 1

• Ribs are horizontal instead of normal downward slope
• Associated with normal aging, chronic emphysema, asthma and hyperinflation of the lungs
• No indents
• Round and equal AP to transverse diameter

Answer 1

Barrel chest

Question 2

• Sunken sternum and cartilages
• Depression begins at second intercostal space
• Noticeable during inspiration
• Usually congenital and non symptomatic

Answer 2

Pectus Excavatum

Question 3

• Forward protrusion of the sternum
• Ribs sloping back at either side
• No treatment, serverity may be surgery

Answer 3

Pectus Carinatum

Question 4

• Lateral S-shaped curvature of thoracic and lumbar spine
• Unequal shoulder and scapular height
• Unequal hip levels
• Rib interspaces flared on convex side
• May reduce lung volume
• At risk for cardiopulmondary function

Answer 4

Scoliosis

Question 5

• Exaggerated posterior curavature of the thoracic spine
• Causes significant back pain
• Limited mobility
• Compensation may be shown in the neck
• Associated with aging

Answer 5

Kyphosis

Question 6

Purposeful to expand alveoli

Answer 6

Sigh

Question 7

• Rapid, shallow breathing
• more than 24/min
• Normal responses to fever, fear, exercise
• Response to pneumonia, alkalosis, pleurisy, lesions in pons

Answer 7

Tachypnea

Question 8

• Increase in breath rate and depth
• Extreme exertion, fear, anxiety
• Diabetic ketoacidosis
• Blows off CO2 causing a decreased level in blood (alkolosis)

Answer 8

Hyperventilation

Question 9

• Slow breathing
• decreased but regular rate
• less than 10/min
• drug induced depression, increased intracranial pressure and diabetic coma

Answer 9

Bradypnea

Question 10

• irregular shallow pattern
• caused by overdose of narcotics or anesthetics
• prolonged bed rest
• conscious splinting of the chest to avoid resp. pain

Answer 10

hypoventilation

Question 11

• cycle where respirations gradually wax and wane in reg pattern
• increases in rate and depth and then decreasing
• breathing periods of 30 to 45 seconds then 20 seconds of apnea
• most commonly from heart failures

Answer 11

Cheyne-Stokes Respiration

Question 12

• normal inspiration and prolonged expiration to overcome increased airway resistance
• may lead to dyspenic episode because the person does not have enough time for full expiration

Answer 12

chronic obstructive breathing

Question 13

Why does increased tactile fremitus happen?

Answer 13

it is due to conditions that increase the density of lung tissue

Question 14

why does decreased tactile fremitus happen?

Answer 14

it is due to anything obstructing the transmission of vibrations

Question 15

what is rhonchal fremitus?

Answer 15

felt when inhaled air passes through thick srcretions in larger bronchi

Question 16

what is pleural friction fremitus?

Answer 16

inflammation of the parietal or visceral pleura causes a decrease in normal lubricating fluid

Question 17

what is a discontinuous sound in the lungs?

Answer 17

crackles and pleural friction rub

Question 18

what is continuous sounds in the lungs?

Answer 18

wheeze and stridor

Question 19

where did the crackles in sim lab occur?

Answer 19

alveoli - fluid

Question 20

where did stridor occur in sim lab?

Answer 20

trachea, beginning of path

Question 21

where did wheeze occur?

Answer 21

end of inspiration , beginning of expiration, obstructions

Question 22

Bronchophony

Answer 22

Voice transmission is soft and muffled and indistinct

Question 23

Egophony

Answer 23

“eeeee”

Question 24

Atelectasis

Answer 24

collapse

Question 25

caused by hypoventilation of alveoli and is often due to the high level of CO2 in the blood

Answer 25

hypercapnia

Question 26

low level of O2 in the arterial blood

Answer 26

hypoxemia

Question 27

draw of breath with other material in it that may cause obstruction

Answer 27

aspiration

Question 28

partial or complete lung collapse

Answer 28

atelectasis

Question 29

excess fluid in the lungs

Answer 29

pulmonary edema

Question 30

includes emphysema, chronic bronchitis and occassionally asthma

Answer 30

COPD

Question 31

over inflation of the alveoli is most likely linked to what disease?

Answer 31

emphysema

Question 32

a sound caused by a foreign body obstruction and airway tumor. the sound is heard early during inspiration

Answer 32

stridor

Question 33

sound occurs in the bronchi or bronchioles, can be cleared by coughing and is often during expiration

Answer 33

wheeze

Question 34

sound occurs in the alveoli and caused by fluid in the lungs typically

Answer 34

crackles (rales)

Question 35

what is caused by the collection of fluid in the interpleural space with compression of overlying lung tissue?

Answer 35

pleural effusion

Question 36

bacterial infection of the lung

Answer 36

TB

Question 37

where does the base of the lungs lie?

Answer 37

6th Rib, midclavicular line, on top of diaprahgm

Question 38

where does the apex of the lungs lie?

Answer 38

above inner 1/3 of clavicle

Question 39

what is the exchange of gases between the inhaled air and the blood in the pulmonary arteries

Answer 39

external resp

Question 40

what is the exchange of gases at the cellular level between the tissue cells and blood in the systematic capillaries

Answer 40

internal resp

Question 41

- calcified costal cartialages - less mobile thorax - decrease in respiratory muscle strength - lung elasticity decrease - decrease in vital cap - increase in res volume - decrease in number of alveoli - increase of post op infection and complications

Answer 41

the aging adult factors

Question 42

why do elders have an increase risk of complications and post op infection?

Answer 42

they arent able to cough as much, they have more secretions and have a lame protective airway reflexes