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Health Assessment > Week 9 - Respiratory Assessment > Flashcards

Week 9 - Respiratory Assessment Flashcards

(49 cards)

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1
Q

Anatomy of Upper Airway (4)

A
  1. Mouth & oropharynx
  2. Nose & nasopharynx (better filtration)
  3. Pharynx
  4. Larynx
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2
Q

Anatomy of Lower Airway (4)

A
  1. Trachea
  2. Carina
  3. Bronchi
  4. Terminal Bronchioles (slows down air flow, smaller diameter)
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3
Q

Anatomy of Acinus (4)

A
  1. Respiratory Bronchioles
  2. Alveolar ducts
  3. Alveolar sacs
  4. Alveoli
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4
Q

Type I Alveolar cells

A

responsible for structure

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5
Q

Type II Alveolar cells

A

responsible for surfactant

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6
Q

Alveolar Macrophages

A

keepin’ clean

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7
Q

3 Types of Pleura

A
  • Visceral Pleura
  • Parietal Pleura
  • Pleural Space
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8
Q

Four Major Functions of the Respiratory System

A
  1. Supply oxygen to the body
  2. Remove carbon dioxide
  3. Maintain homeostasis (acid-base balance)
  4. Maintain heat exchange
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9
Q

Hypoventilation

A

increases CO2 in the blood

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10
Q

Hyperventilation

A

decreases CO2 in the blood

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11
Q

Properties of respiration control (3)

A
  1. Normally involuntary
  2. Mediated by the respiratory center in the brain stem
  3. Breathing patterns change in response to varying levels of CO2 AND O2 in the blood
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12
Q

Stimulus to Breathe

A
  1. Normal stimulus to breathe in most people is an increase in CO2 or hypercapnia
  2. A decrease in O2 (hypoxemia) also increases respirations, but less effective than hypercapnia
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13
Q

Hypercapnia

A

increase in CO2 in bloodstream

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14
Q

Hypoxemia

A

decrease in O2 in bloodstream

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15
Q

Landmarks of the Thoracic Cage (4)

A
  • Sternum
  • 12 pairs of ribs
  • 12 thoracic vertebrae
  • Diaphragm
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16
Q

Landmarks of Anterior chest (7)

A
  1. Ribs 2, 4, 5, 6
  2. Suprasternal notch
  3. Manubrium of sternum
  4. Angle of Louis
  5. Body of sternum
  6. Xiphoid process
  7. Costal angle
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17
Q

Landmarks of Posterior chest (6)

A
  1. T1
  2. C7 (vertebra prominens)
  3. T3
  4. Inferior angle of scapula
  5. T10 and T12
  6. 12th rib
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18
Q

Anterior Reference Lines (3)

A
  1. Anterior axillary line
  2. Midclavicular line
  3. Midsternal line
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19
Q

Posterior Reference Lines (2)

A
  1. Scapular line

2. Vertebral line

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20
Q

Axillary Reference Lines (3)

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A
  1. Anterior axillary line
  2. Midaxillary line
  3. Posterior axillary line
21
Q

Areas of lung assessment

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A
  1. Mediastinum (middle of thoracic cage) location of hear
  2. Right pleural cavity
  3. Left pleural cavity
  4. Right lung has 3 lobes, left lung only has 2
  • Posterior chest is all lower lobes
  • Anterior chest is mostly upper lobes
  • Lateral sides we can see all 3 lobes, only place we hear the mid lobe (right side)
22
Q

Considerations for Infants and Children (3)

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A
  • Surfactant not present until 32w gestation
  • Smaller size of the respiratory system
    ○ Nasal passages
    ○ Diameter of airway
    ○ Distance between structures
  • Immune system immaturity
23
Q

Considerations for Pregnancy (3)

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A
  • Decreased space for lung expansion
  • Increased circumference of thoracic cage
  • Increased O2 demand
24
Q

Considerations for Aging Adults (4)

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A
  • Costal cartilage calcification (stiff)
  • Decreased respiratory muscle strength
  • Decreased elasticity within the lungs (more rigid, harder to inflate)
  • Increase in small airway closure
25
Components of Subjective Respiratory Assessment (7)
1. Cough - Productive? - coughing anything up - Hemoptysis - blood 2. SOB (Dyspnea) 3. Chest pain with breathing 4. Past history of respiratory infections 5. Smoking history 6. Environmental exposure 7. Self care behaviours
26
Hemoptysis
Blood in cough
27
Components of Inspection (8)
1. Skin colour and condition 2. Nail beds (cap refill less than 2s), clubbing 3. Thoracic cage: shape and configuration, costal angle is 90, less deep than wide 4. Respirations: rate, rhythm, depth, pattern 5. Work Of Breathing, persons position and facial expression, extra muscles 6. LOC 7. Signs of distress 8. Sputum
28
Signs of respiratory distress (10)
1. Increased WOB 2. Sudden onset of SOB 3. Gasping 4. Colour changes around lips and nail beds 5. Increasing RR 6. Decreasing oxygen saturation 7. Changes in LOC 8. Tracheal tugging 9. Retractions/indrawing 10. Nasal flaring
29
Barrel chest
(Unexpected Configurations of thoracic cage) Depth of chest is wider or equal to width of chest
30
Scoliosis
(Unexpected Configurations of thoracic cage) S-shape in spine
31
Kyphosis
(Unexpected Configurations of thoracic cage) Curvature in spine (old person hunch)
32
Pectus excavatum
(Unexpected Configurations of thoracic cage) Sunken sternum
33
Pectus carinatum
(Unexpected Configurations of thoracic cage) Protruded sternum
34
Components of Palpation
Check anterior, posterior & lateral chest for symmetry Tactile Fremitus (vibrations in the chest wall) - say "99" or "blue moon" for resonance
35
Pleural Effusion
Fluid in the lungs Decreased fremitus on palpation
36
Pneumothorax
Collapsed lung Decreased fremitus on palpation
37
Pneumonia
Consolidation of lung tissue (alveoli fill with pus) Increased fremitus on palpation Dullness in percussion
38
Crepitus
Sounds like bubble-wrap, air enters subcut. tissue
39
Percussion notes
1. Resonance (should predominate) 2. Hyperresonance (too much air) 3. Dullness (abnormal density in lungs, pneumonia) 4. Tympany (abdominal area)
40
Expected breath sounds (Auscultation)
- Bronchial (tracheal) = insipration < expiration - Bronchovesicular: insipration = expiration - Vesicular: insipration > expiration, hear it everywhere
41
Adventitious Breath Sounds (Auscultation)
1. Crackles 2. Wheezes 3. Rubs 4. Stridor
42
Crackles
Adventitious Breath Sounds (Auscultation) ``` Fine = sounds like hair rubbing together Coarse = sounds like velcro ```
43
Wheezes
Adventitious Breath Sounds (Auscultation) Inspiratory and Expiratory
44
Rubs
Pleural friction rub (inflamed, unlubricated pleura) Sounds like leather
45
Stridor
Narrowing of upper airway, sounds like a whale or dolphin
46
Abnormal/unexpected breath sounds
- Diminished, decreased or absent sounds | - Increased sounds
47
Bronchophony
Tests for consolidation (pneumonia) Say "99" Expected: hear sound but can't tell what's been said Unexpected: you can hear "99" on auscultation
48
Egophony
Tests for consolidation (pneumonia) Say "eeeee" Expected: hear "eeeee" Unexpected: you "aaaaaa" on auscultation
49
Whispered Pectoriloquy
Tests for consolidation (pneumonia) Whisper "1, 2, 3" Expected: hear faintly, muddled, inaudible Unexpected: hear it clearly and distinctly

Health Assessment (8 decks)

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