THORAX & LUNGS

Question 1

-extends from the base of
the neck to the diaphragm.
-a.k.a Lower respiratory
tract
Composed of the lungs,
distal trachea, bronchi,
thoracic cage, and thoracic
cavity.

Answer 1

Thorax

Question 2

= shorter & more
vertical → more prone to aspiration

Answer 2

Right Bronchus

Question 3

recognizes ↑CO2 in the blood (primary stimulus) or ↓ O2 in the blood (secondary stimulus)

Answer 3

MEDULLA & Pons

Question 4

increases CO2 in the blood (primary stimulus)

Answer 4

hypercapnia/ hypercarbia

Question 5

decreases O2 in the blood (secondary stimulus)

Answer 5

hypoxemia

Question 6

signals diaphragm (to speed up or slow down)

Answer 6

Medulla

Question 7

**respiration/perfusion occurs (exchange of gases thru DIFFUSION)

Answer 7

Alveoli & Capillaries

Question 8

*Relaxes = goes up, passive process; leads to POSITIVE PRESSURE forcing air out

Answer 8

Exhalation

Question 8

*Contracts = goes down causing vertical expansion; creates NEGATIVE PRESSURE

Answer 8

Inhalation

Question 9

Trachea, bronchi, esophagus,
heart, great vessels

Answer 9

MEDIASTINUM

Question 10

-Provides support and protection Composed of:
-sternum
-12 pairs of ribs
-12 thoracic vertebrae
-muscles
-cartilage

Answer 10

Thoracic Cage

Question 10

Cone-shaped, elastic organs in the
thoracic cavity where gas exchange occurs

Answer 10

LUNGS

Question 11

U-shaped indentation.

Answer 11

Suprasternal notch

Question 12

• Marks 2nd pair of ribs.
• Reference point for counting ribs and ICS.

Answer 12

Sternal angle (angle of Louis)

Question 13

= vertebral prominence

Answer 13

C7

Question 14

= floating ribs

Answer 14

11th & 12th rib

Question 14

*coastal angle:
(anterior)

Answer 14

<90°

Question 15

Vertical Reference Lines (Anterior)

Answer 15

• RIGHT midclavicular line
• Midsternal line
• LEFT midclavicular line

Question 15

*costochondral angle
(posterior)

Answer 15

idk

Question 16

lung right lobes

Answer 16

upper right lobes
middle right lobes
lower right lobes

Question 16

Vertical Reference Lines (Lateral)

Answer 16

-Anterior axillary line
- Midaxillary line
- Posterior axillary line

Question 16

Vertical Reference Lines (Posterior)

Answer 16

• LEFT scapular line
• Vertebral line
• RIGHT scapular line

Question 17

lung left lobes

Answer 17

upper left lobes
lower left lobes

Question 18

Seen in labored breathing (especially in children); indicates hypoxia.

Answer 18

Nasal Flaring

Question 19

Early Clubbing

Answer 19

(180° angle) → Hypoxia.

Question 19

Observed in asthma, emphysema, CHF; helps slow expiration & keep alveoli open.

Answer 19

Pursed Lip Breathing

Question 19

-a drawing in of the muscles between the ribs when a person inhales. -may be sternal, suprasternal, clavicular, intercostal.

Answer 19

Retractions

Question 20

inspiratory contraction of the sternocleidomastoid, trapezius, and scalene muscles (commonly associated with severe obstructive

Answer 20

Accessory muscle use

Question 21

implies decreased ventilation to one side

Answer 21

Asymmetrical chest movement

Question 21

(swayback) common posture of pregnancy “Pride of Pregnancy”

Answer 21

Lordosis

Question 21

: (Leaning forward, hands on knees) → Seen in COPD to increase breathing capacity.

Answer 21

Tripod Position

Question 22

(>180° angle) → Chronic oxygen deprivation.

Answer 22

Late Clubbing

Question 22

the diamond-shaped gap formed when two opposing fingers are placed back to back

Answer 22

Schamroth window

Question 23

thoracic kyphosis, lumbar lordosis & internally rotated shoulders

Answer 23

Swimmer’s slouch

Question 24

: excessive forward rounding of the upper back. Can be common in the elderly.

Answer 24

Kyphosis

Question 24

is a lateral (sideways) curve of the spine.

Answer 24

Scoliosis

Question 25

Sternum protrudes forward. Congenital. Increased AP diameter.

Answer 25

Pectus Carinatum (Pigeon Chest)

Question 26

depression in lower sternum and is seen with congenital conditions that can cause murmurs or compress the heart and vessels..

Answer 26

Pectus Excavatum (Funnel Chest)

Question 27

Ribs appear horizontal (>45° angle) common in COPD. AP to transverse diameter = 1:1

Answer 27

Barrel chest

Question 28

Lung consolidation (pneumonia, tumor).

Answer 28

↑fremitus

Question 29

Air trapping (emphysema, pneumothorax, pleural effusion, obstruction, asthma).

Answer 29

↓fremitus

Question 30

Thumbs move 5–10 cm apart symmetrically with deep breath.

Answer 30

Chest Expansion

Question 30

Resonance over healthy lung tissue; flat over the scapula

Answer 30

percussion tones

Question 30

Indicates trapped air (emphysema, pneumothorax).

Answer 30

Hyperresonance:

Question 31

Suggests fluid or solid tissue replacing air (pneumonia, pleural effusion, tumor)

Answer 31

Dullness

Question 32

is commonly used as an indication of pyelonephritis; may also indicate fractures in elderly.

Answer 32

Costovertebral angle tenderness: a.k.a “costochondral junction tenderness”

Question 33

3–5 cm; up to 7–8 cm in well conditioned individuals. Percuss from resonance to dullness at: exhalation inhalation

Answer 33

Normal DIAPHRAGMATIC excursion

Question 34

- Very loud, high pitch - Over trachea

Answer 34

Tracheal

Question 34

Normal BREATH sounds

Answer 34

Tracheal Bronchial Bronchovesicular Vesicular

Question 34

- Loud, high pitch - Over manubrium

Answer 34

Bronchial

Question 35

-Medium loudness, intermediate pitch - 1st & 2nd ICS, and between scapula

Answer 35

Bronchovesicular

Question 36

- Soft, low pitch - Most of the lung field

Answer 36

Vesicular

Question 37

Trachea shifts ipsilaterally (toward affected side), ↓ breath sounds.

Answer 37

Obstructive atelectasis

Question 38

Trachea shifts contralaterally (away from affected side), absent breath sounds.

Answer 38

Pneumothorax/ Pleural effusion/ Hemothorax

Question 39

: Prolonged breath sounds, hyperresonance.

Answer 39

Emphysema

Question 40

high-pitched; musical sounds during exhalation, then eventually also during inhalation ex. Asthma or chronic emphysema

Answer 40

Sibilant

Question 41

low-pitched; snoring/moaning sounds mainly during exhalation; may clear with coughing; A.k.a RHONCHI. ex. Bronchitis

Answer 41

Sonorous

Question 42

harsh, honking wheeze with severe broncholaryngospasm or obstruction in larynx/trachea ex. Croup, epiglottitis, foreign body in airway

Answer 42

STRIDOR

Question 43

high-pitched; popping; rolling strands of hair between fingers near your ear; due to air suddenly opening deflated alveoli coated with secretions ex. Pneumonia, CHF, bronchitis, asthma, emphysema

Answer 43

FINE

Question 44

low-pitched; bubbling, moist sounds; a.k.a “Velcro rales”; due to air coming into contact with secretion-lined narrowed trachea & bronchi ex. *same as fine crackles, and pulmonary fibrosis

Answer 44

COARSE

Question 45

Low-pitched, sandy, HARSH GRATING, LEATHERY SOUND -friction of inflamed and roughened pleura -heard on inspiration and expiration -often mistaken for coarse crackles Ex. pleuritis

Answer 45

PLEURAL FRICTION RUB

Question 46

*due to increased distance between lung and chest wall Common in: ▪ Asthma, emphysema ▪ Tumor, atelectasis, total obstruction ▪ Effusions, fibrosis

Answer 46

ABSENT or DIMINISHED