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27 Cards in this Set
- Front
- Back
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Atelectasis |
Alveolar collapse. Results from no surfactant, reducing gas exchange because the alveolar surface area is reduced. |
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Pleura |
A continuous smooth membrane with two surfaces that totally enclose the lungs. |
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Dyspnea |
Shortness of breath, difficulty breathing, or breathlessness. |
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Orthopnea |
A shortness of breath occurring when lying down and is relieved by sitting up. |
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Nasal polyps |
Pale, shiny, gelatinous lumps or "bags" attached to the turbinates. |
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Deviated trachea |
Many lung disorders cause the trachea to deviate from the midline. Tension pneumothorax, large pleural effusion, mediastinal mass, and neck tumors push the trachea away from the affected area. Pneumonectomy, fibrosis, and atelectasis pull it toward the affected area. |
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Inspection: Examine the shape of the patient's chest |
Anteroposterior (AP or front-to-back) diameter with the lateral (side-to-side) diameter. This ratio is normally 1:1.5 depending on body build. Increases to 1:1 in patients with emphysema. |
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Palpation: crepitus |
Air trapped in and under the skin. Felt as a crackling sensation beneath the fingertips. |
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Palpation: pneumothorax |
Pleural space is filled with air. Fremitus is decreased. |
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Palpation: pleural effusion |
Pleural space is filled with fluid. Fremitus is decreased. |
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Percussion: resonance (Pitch,intensity,quality, duration, findings) |
Pitch: low. Intensity: moderate to loud. Quality: hollow. Duration: long. Findings: characteristics of normal lung tissue. |
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Adventitious breath sounds. |
Abnormal, additional breath sounds superimposed on normal sounds. They indicate pathologic changes in the lung. Crackles, wheezing, rhonchus, and pleural friction rub. |
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Normal breath sounds. |
Produced as air vibrates while moving through the passages from the larynx to the alveoli. Identified by location, intensity, pitch, and duration. |
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Bronchial |
Normal breath sound. Pitch: high. Amplitude: loud. Duration: inspiration < expiration. Quality: harsh, hollow, tubular, blowing. Normal location: trachea and larynx. |
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Bronchovesicular |
Normal breath sound. Pitch: moderate. Amplitude: moderate. Duration: inspiration = expiration. Quality: mixed. Location: major bronchi; posterior, between scapulae; anterior, around upper sternum |
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Vesicular |
Normal breath sound. Pitch: low. Amplitude: soft. Duration: inspiration > expiration. Quality: rustling, like the sound of the wind in the trees. Location: where air flows through smaller bronchioles and alveoli. |
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Fine crackles |
Adventitious breath sound. Character: popping, discontinuous sounds caused by air moving into previously deflated airways. (Sounds like hair being rolled between the fingers near the ear.) Association: asbestosis, atelectasis, interstitial fibrosis, bronchitis, pneumonia, chronic pulmonary diseases. |
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Coarse crackles |
Character: lower-pitched, coarse, rattling sounds caused by fluid or secretions in large airways; likely to change with coughing or suctioning. Association: bronchitis, pneumonia, tumors, pulmonary edema. |
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Wheezing |
Character: squeeky, musical, continuous sounds associated with air rushing though narrow airways. Association: inflammation, bronchospasm, edema, secretions, pulmonary vessel engorgement (as in cardiac "asthma"). |
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Rhonchus (rhonchi) |
Character: lower-pitched, course, continuous snoring sounds. Arise from the large airways. Association: thick tenacious secretions, sputum production, obstruction by foreign body, tumors. |
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Pleural friction rub |
Character: loud, rough, grating, scratching sounds caused by the inflamed surfaces of the pleura rubbing together; often associated with pain on deep inspirations. Heard in lateral lung fields. Association: pleurisy, tuberculosis, pulmonary infarction, pneumonia, lung cancer. |
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PETCO2 |
Partial-pressire of end-tidal carbon dioxide. Normal value ranges between 20-40 mm Hg. Change reflect changes in breathing effectiveness and gas exchange. |
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Capnometry and capnography |
Methods that measure the amount of CO2 present in exhaled air, which is an indirect measurement of arterial CO2 levels. Measure PETCO2 in intubated pts and those breathing spontaneously. |
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Pulmonary function test. |
PFT. Assess lung function and breathing problems. Measure lung volumes and capacities, flow rates, diffusion capacity, gas exchange, airway resistance, and distribution of ventilation. Most common reason for PFT is to determine the cause of dyspnea. |
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PFT preparation |
Explain purpose of test, no smoking 6-8 hours before test. Bronchodilator drugs may be withheld for 4-6 hours before test. Help reduce anxiety by describing what will happen during and after the test. |
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PFT procedure |
Can be performed at the bed side or respiratory lab by a respiratory therapist or tech. Patient is asked to breathe through mouth only. Nose clip may be used to prevent air from escaping. Different breathing maneuvers are performed and measurements are obtained. |
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Common PFTs |
FVC (forced vital capacity)- records the max amt of air that can be exhaled as quickly as possible after max inspiration. FEV1 (forced expiratory volume in 1 sec) - max amt of air that can be exhaled in first sec of expiration. FEV1/FVC- the ratio of expiratory volume in 1 sec to FVC. FEF25%-75%- forced expiratory flow over the 25%-75% volume (middle half) of the FVC. FRC (functional residual capacity)- amt of air remaining after normal expiration. Requires use of the helium dilution, nitrogen washout, or body plethysmography technique. TLC (total lung capacity)- amt of air at end of Max inhalation. RV (residual volume)- amt of air remaining at the end of full, forced exhalation. DLCO (diffusion capacity of the lung for carbon monoxide)- reflects the surface area of the alveolocapillary membrane. |
