Thorax & Lungs I

Question 1

@ what level is the horizontal fisure locatated laterally

Answer 1

Located from mid axillary line to the 4th/5th rib ant

Question 2

@ what level does the oblique line from on the left side

Answer 2

T3 level too 6th rib ant

Question 3

At the lateral aspect how low do the ribs go

Answer 3

8th rib

Question 4

full inspiration post goes down to what rib level

Answer 4

down to 10th rib

Question 5

What is the normal breathing rate

Answer 5

14-20 breaths/min

Question 6

What is tachypnea and causes

Answer 6

Rapid shallow breathing

• COPD (mc)
• Pleuric chest pain
• elevateed diaphram

Question 7

What is hyperpenea and causes

Answer 7

Rapid deep breathing

• Exercise
• Anxiety
• Acidosis

Question 8

Bradypnea and causes

Answer 8

Slow breathing

• Diabetic coma
• drug induced

Question 9

What is cheyne stokes breathing, causes and what pop can have this normally

Answer 9

Periods of deep breathing alternate with periods of apnea (>10sec)

• heart failure
• Uremia
• Brain damage

Kids<4 can have this pattern normally

Question 10

What is ataxic (biots) breathing

Answer 10

Unpredicatable irregularity

• Brain damage at medullary level
• Drug induced respiratory depression

Question 11

What is indicitive of obstructive breathing and causes

Answer 11

Manifested by prolonged expiration

• astma
• COPD
• chronic bronchitis

Question 12

What is most chest pain related to

Answer 12

GI related (40% of time)

Question 13

What are some cardinal s/s of lung pathology

Answer 13

• chest pain
• dyspnea/laboured breathing
• wheezing
• cough
• hemoptysis (coughing up blood)

Question 14

What is orthopnea vs paroxysmal nocturnal dyspnea

Answer 14

orthopnea- shortness of breath when flat (due to heart isues, obesity; relieved by sitting)

Paroxysmal nocturnal dyspnea- Severe shortness of breath at night that still happens in sitting pos

Question 15

What are some risk factors to lung issues

Answer 15

• cardiac/lung disorders
• Smoking hx
• Birth control use
• travel
• recent fx, sig injury
• fam hx

Question 16

What are the main steps in respiratory exam

Answer 16

1. Inspection
2. Palpation (chest exp/ tactile fremitus)
3. Percussion (diaphragmatic excursion)
4. Auscultation
5. Special techniques

Question 17

what side will the trachea deviate to in a lung problem

Answer 17

deviation to side of less pressure

Question 18

Why does club finger occur

Answer 18

poor o2 to extremities (pts with COPD)

Question 19

what is friction rub

Answer 19

inflammed pleura rubbing against eachother

Question 20

Where to palpate for chest expansion ant and post

Answer 20

thumbs on midline
Post- 10th rib post
ant- along costal margins

Question 21

How to measure tactile fremitus (how many spots ant/post, what does pt say)

Answer 21

4 post (3 parspianal, 1 mid axil)
3 ant (2 parasten, 1 mid axil)

get pt to say 99 or 1-1-1

Question 22

What does increased + decreased tactile fremitus indicate

Answer 22

increased- consolidation of lung tissue (increased vib)

decreased- Obstruction, Pleural effusion, pneumothorax, COPD

Question 23

How to percuss + what does it help determine

Answer 23

Helps determine whether the underlying tissues are air filled, fluid filled or solid

Plexormeter finger- hyperextended middle finger
Plexor finger- Partially flexed middle finger

Question 24

What are the percussion locations is post and ant thorax

Answer 24

Post- 7 areas (5 parastenally, 2 mid axillary)

Ant- 6 areas (4 parasternally, 2 mid axillary)

Question 25

What are the normal and other sounds that can be heard with percussion

Answer 25

Resonant- hallow (normal)
Dull- Thud like (liver/heart)
Hyperresonant- drum like (abnormal)
Tympanic- booming (abnormal

Question 26

Where will you hear heart dullness

Answer 26

in 3rd to 5th left intercostal spaces medial to mid clavicular line

Question 27

@ what levels do you check for diaphragmic excursion and how do you perform the movement

Answer 27

Dull is the level (can determine where the diaphragm is)
Take breath in and see how low u go when it is dull again. , then full breath out and move back up to where its resonant

T8-T11