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SRNAHealthAssessment > Thorax and Lungs > Flashcards

Thorax and Lungs Flashcards

(64 cards)

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1
Q

*****Suprastrenal Notch

A

Marks MIDPOINT OF TRACHEA

Optimal placement end of ET tube

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2
Q 
Sternal angle 
Starts with
Useful for counting to down
Localized findings \_\_\_\_\_
****What does the sternal angle Mark?
where dos it lie? 
Corresponds to \_\_\_\_\_\_\_\_\_\_\_
A 
Angle of Louis
Starts with 2nd rib
• Useful for counting to down 10th
• Localize findings horizontally
***** Marks TRACHEA BIFURCATION 
• Lies@levelofT4–T5
• Corresponds to upper border atria
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3
Q

*****What is the normal costal angle?

Disease state with increase costal angle?

A

Costal Angle normally <90° • >90° in emphysema

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4
Q

*****Spinous Processes

A

T1 – T4 align w/ same numbered ribs • T5 on - processes angle downward aligning w/ rib below

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5
Q

**Scapula Inferior Border •

lower tip at ________

A

Lower tips @ rib 7 or 8

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6
Q

*****Lines of reference

A

Midsternal Line
• Midclavicular Line
• Anterior Axillary Line

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7
Q

**Right lung____lobes and left lung ____lobes

A

3 lobes; 2 lobes

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8
Q

*****Reference lines cont’d

A

Vertebral Line
• Aka “mid-spinal line”
Scapular Line
• Extends thru inferior angle of scapula when arms are at the sides

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9
Q

*****Anterior Axillary Line

A

Extends down from anterior axillary fold

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10
Q

*****Midaxillary Line

A

• Extends down from axillary apex

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11
Q

**Posterior Axillary Line

A

• Extends down from post. Axillary fold

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12
Q
  • ***Lung Borders : Base

* ***Lung Borders :Apex

A

Rests on Diaphragm @ 6th rib midclavicular line

Extends 3-4 cm above inner 3rd clavicle

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13
Q

**Lobes Oblique fissures

A
  • cross 5th rib midaxillary

* Terminate @ 6th rib midclavicular

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14
Q

**Horizontal fissurea

A

Extends from 5th rib midaxillary up to 4th rib

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15
Q

***Thoracic Cavity - Posterior C7 marks ___

A

marks apex of lungs

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16
Q

**Thoracic Cavity - Posterior T10 marks ____

A

marks Bases of lungs

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17
Q

** Deep inspiration expands down to

A

T12

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18
Q

*****Upper lobes

• The rest is all Lower lobes

A

T1 – T3/T4

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19
Q

**2 Skeletal deformities limit thoracicc age excursion

A

• Scoliosis, Kyphosis

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20
Q

**AP:Transverse=__ indicates

A

1:1 • Barrel chest/horizontal ribs=chronic

Emphysema

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21
Q

**Hypertrophic Neck muscles

A

=COPD

** Cyanosis/Pallor/SkinLesions

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22
Q

**Tripod Position

A

COPD

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23
Q 
Posterior chest
****Check for \_\_\_\_\_\_
*****Place hands with \_\_\_\_\_\_@ what level ?
******Then do what?
****Unequal expansion indicates what?
FMPP
A

Symmetrical Expansion
THUMBS @T9
PINCH SMALL FOLD OF SKIN between thumbs

Marked atelectasis
Pneumonia
Fx ribs
Pneumothorax

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24
Q

*****Pain w/ deep breathing indicative

A

Pleuritis

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25
***Check for palpable vibrations known as ask the patient to do WHAT PART OF THE HAND DO YOU USE?
• Check for Tactile Fremitus (palpable vibrations) USE BALL OF HAND or ULNAR EDGE Ask pt. to repeat “ninety-nine” Resonant phrase generates strong vibrations
26
****Decreased Fremitus = (POPE) (4)
Pleural effusion Obstructed bronchus Pneumothorax, Emphysema
27
****Increased Fremitus =
consolidation – lobar pneumonia
28
****Rhonchal fremitus =
thick bronchial secretions
29
******Crepitus = Indicats 2
palpable crackling w/ air in Sub-Q space (SubQ Emphysema) or S/P open thoracic surgery
30
*****Hyperresonance = means ______ ex: - -
too much air Emphysema Pneumothorax
31
``` *****Dull note means 4 conditions (TAPP) ```
abnormally dense • Pneumonia • Pleural effusion - Atelectasis • Tumor
32
If theres no excursion means
pleural effusion or atelectasis of lower lobes
33
*****Normally 3 types of sounds: (breath)
* Bronchial (“Tracheal”) B (short ins than exP) * Bronchovesicular BV (same) * Vesicular V (Periphery) insp longer than ex
34
****Decreased breath sounds due to | FOMSE
``` DECREASED: Obstructed Bronchial tree • Fb • Mucous plug • Secretions Emphysema • Lungs already hyperinflated =decreases noise ```
35
****For DECREASED breath sounds OTHER obstruction to sound can be because of
Pleurisy/pleural thickening • Air (pneumothorax) • Fluid (pleural effusion)
36
****Adult avg chst excursion
3-5 cm
37
****INCREASED breath sounds include | CCP :
INCREASED: Consolidation Pneumonia Compression (fluid in intrapleural space)
38
****Adventitious Sounds Crackles “rales”
Fine–high pitched popping–not cleared by coughing. • Stiimulate sound by rolling strand of hair b/t fingers near ear • Or moisten thumb & index finger & separate them near your ear • Course crackles – (opening a Velcro fastener)
39
****Pleural Friction Rub –
coarse & low pitched, 2 pieces of leather | • Rubbed together close to ear
40
****Wheeze (Rhonchi)
* High pitched, musical squeaking – air squeezes thru constricted airway • Asthma if ONE EXPIRATION , OBSTRUCTION if on INSPIRATION * Low pitched – musical snoring, moaning • Obstruction
41
****Stridor –CEO
High pitched, inspiratory, crowing • CROUP EPIGLOTITS OBSTRUCTION
42
Normal voice transmission through chest wall is
soft, muffled, indistinct
43
****Pathology causes normal voice transmission to be
• Makes words/sounds Louder, Clear and Distinct
44
***Hypertrophic abd. Muscles can indicate
chronic emphysema
45
*** Strained/Tired face
COPD
46
*****Drowsiness
Cerebral hypoxia
47
**** Clubbing distal fingers can indicate
Chronic Resp. Ds.
48
***Cutaneous ANGIOMAS on chest can indicate
liver ds / portal HTN
49
****Unequal expansion can indicate
obstructed or collapsed lung
50
***Accessory being muscles used can indicate
acute airway obstruction / massive atelectasis
51
***During anterior exam ______lag indicates
Expansion lag indicates | • atelectasis, pneumonia
52
***marks apex of lungs
Posterior C7
53
***Marks bases of lungs
Posterior T10
54
***Lungs extend from_____down to ______
Axilla Apex down to 7th rib
55
****Avoid percussing
over bone
56
****Pleural friction fremitus indicates
pleural inflammation
57
****What should be the DEPTH OF PERCUSSION
5-7 cm
58
******LESION _________wide are ________
<2-3cm are NOT DETECTABLE BY PERCUSSION
59
****What do you do to DETERMINE diaphragm excursion
PERCUSSION
60
****You percuss to do What
Determine diaphragm excursion
61
****Anterior Chest ______Chest for _______ Use _______along _______
Palpate CHEST FOR symmetric expansion | THUMBS; Costal margins
62
***what is a normal Ex time?
4 seconds
63
***Force exp > ______= ___Disease, what do you do ?
6 seconds -Obstructive Refer for PFTs
64
****C7 is the
VERTEBRA PROMINENS

SRNAHealthAssessment (20 decks)

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