Ce Lungs

Front 1

muscles that help inspire, how do they move the chest

Back 1

external intercostals
- increase the AP chest diameter during inspiratiton

Front 2

muscles that help expire, how do they move the chest

Back 2

internal intercostals
-decrease the lateral diameter during expiration

Front 3

upper limit of the lungs anteriorly and posteriorly

Back 3

antriorly- 4cm above the first rib

posteriorly- T1

Front 4

lover limit of the lungs anteriorly and posteriorly

Back 4

anteriorly - T6
postrioely- T10

Front 5

dimensions of trachea

Back 5

10 to 11 cm long and 2cm in diameter

Front 6

blood supply of the lungs

Back 6

bronchial arteries from anterior thoracic aorta and intercostal arteries

Front 7

reasons and dysfunctions associated with barrel chest

Back 7

Reason: compromised respiration and air trapping
dysfunctions- chronic asthma, emphysema, cystic fibrosis

Front 8

define bradypnea
dysfunctions

Back 8

- breath rate slower than 12 bpm

- neurologic or electrolyte disturbance, infection or response to pain or other irritative phenomena

Front 9

define hyperventilation
dysfunction

Back 9

- faster than 20 bpm, deep breathing

- exercise, anxiety, CNS leasion or metabolic disease

Front 10

define Kussmaul breathing
dysfunction

Back 10

- deep, rapid and labored

- associated with metabolic acidosis

Front 11

define chyne-stokes respiraiton (periodic breathing)
dysfunction

Back 11

- varying periods of increasing depth interspersed with apnea

- in patients who are seriously ill, brain damage at cerebral level, drug-associated respiratory compromise

Front 12

define Sigh
dysfunction

Back 12

frequently interspersed deeper breath (sigh)

- emotional distress, incipient episode of hyperventilation

Front 13

define air trapping
dysfunction

Back 13

increasing difficulty in getting breath out. rate of respiration increases, amoutn of air getting trapped in lungs increase

- result of prolonged but inefficient expiratory effort

Front 14

define Biot
dysfunction

Back 14

irregularly interspaced periods of apnea in a disorganized sequence of breaths

- severe and persistent increased intracranial pressure, respiratory compromise from drug poisoning, brain damage at medulla

Front 15

define ataxic breath

Back 15

significant disorganization with irregular and varying depths of respiration ( extreme Biot)

Front 16

describe primary apnea

Back 16

self-limiting condition usually happens after a blow to the head or newly porn babies. respiration continues after enough carbon dioxide accumulates

Front 17

describe secondary apnea

Back 17

breathing stops and doesn't begin spontaneously unless resuscitative measures are immediately instituted

Front 18

describe reflex apnea

Back 18

when irritating and nausea-provoking vapors or gases are inhaled, there can be an invlountary, temporary halt to respiration

Front 19

define retractions

Back 19

when the chest wall seems to cave in at various points

Front 20

type of breathing heard when obstruction is high on the respiratory tree

Back 20

stridor

Front 21

describe paradoxical breathing

why does it happen

Back 21

- on inspiration, lower thorax is drawn in. on expiration, it buldges

- happens when negative intrathoracic pressure is transmitted to the abdomen by a weakened, poorly functioning diaphragm, obstructive airway disease or during sleep in upper airway obstruction

Front 22

a foreign body in bronchus causes what type or retraction

Back 22

unilateral

Front 23

retraction of lower chest happens in what

Back 23

asthma and bronchiolitis

Front 24

signs of upper airway obstruction

Back 24

inspiratory stridor
hoarse cough or cry
flaring of the alae or cry
retraction at the suprasternal notch

Front 25

signs of severe obstruction

Back 25

stridor is inspiratory or expiratory
cough is barking
retractions in substernal and intercostal spaces
cyanosis is obvious even with supplemental oxygen

Front 26

when obstruction is above glottis

Back 26

stridor is quieter
voice is muffled
swallowing is more difficult
no cough
head and neck akward

Front 27

when obstruction is below glottis

Back 27

stridor thends to be louder, more rasping
voice is hoarse
swallowing not affected
couch in harsh, barking
head position not a factor

Front 28

define crepitus
dysfunction

Back 28

cracly or crinkly sensation, can be both palapted and heard- gentle, bubbly feeling

- indicates air in subcutaneous tissue from a rupture somewhere in the respiratory system or by infection with a gas-producing organism

Front 29

define and causes of pleural frictions

Back 29

a palpable, coarse, grating vibration, usually on inspiration caused by inflammation of the pleural surface

Front 30

best place to feel fremitus

Back 30

parasternally at the second intercostal space at the level of the bifurcation of the bronchi

Front 31

hyperresonance associated with hyperinflation suggests what

Back 31

emphysema
pneumothorax
asthma

Front 32

dullness or flatness suggests what

Back 32

pneumonia
atelectasis
pleural effusion
pneumothorax
asthma

Front 33

sweet, fruity odor

Back 33

diabetic ketoacidosis, starvation ketosis

Front 34

fishy, stale odor

Back 34

uremia (trimethylamines)

Front 35

ammonia-like odor

Back 35

uremia (ammonia)

Front 36

musty, fishy, clover odor

Back 36

fector hepaticus; hepatic failure, portal vein thrombosis, portacaval shunts

Front 37

foul, feculent odor

Back 37

intestinal obstruction

Front 38

foul, putrid odor

Back 38

nasal/sinus pathology, infection, foreign body, cancer; respiratory infections; empyema, lung abscess, bronchiectasis

Front 39

halitosis odor

Back 39

tonsillitis, gingivitis, respiratory infections, vincent angina, gastroesophageal reflux

Front 40

cinnamon odor

Back 40

pulmonary tuberculosis

Front 41

describe resonant tone

Back 41

loud intensity
low pitch
long duration
hollow quality

Front 42

describe flat tone

Back 42

soft intensity
high pitch
short duration
very dull quality

Front 43

describe dull tone

Back 43

medium intensity
medium to high pitch
medium duration
dull thud quality

Front 44

describe tympanic tone

Back 44

loud intensity
high pitch
medium duration
drum like quality

Front 45

describe hyperresonant tone

Back 45

very loud intensity
very low pitch
longer duration
boom like quality

Front 46

define crepitus

when do you get crepitus

Back 46

crackly or crinkly sensation, can be palpated or heard- a gentle, bubbly feeling

indicated air in subcutaneous tissue from a rupture somewhere in the respiratory system or by infection with gas-producing organism

Front 47

patients symptoms and behavior when there is an anterior mediastinal mass

Back 47

may cause stridor
difficulty breathing
patients may sit up and lean forward to relieve compression

Front 48

describe vesicular breath sounds

Back 48

low pitched
low intensity
soft or short expirations
heard over healthy lung tissue

Front 49

describe bronchovesicular sounds

Back 49

moderate pitch
moderate intensity
expiration equals inspiration

Front 50

describe bronchial breath sounds

Back 50

highest pitch and intensity
long expirations
heard over trachea

Front 51

define amphoric breathing

Back 51

resembles noise made by blowing across the mouth of a bottle

Front 52

when do you hear amphoric breathing

Back 52

large, relatively stiffed-walled pulmonary cavity
tension pneumothorax with bronchopleural fistula

Front 53

define cavernous breathing

when is it commonly heard

Back 53

sounds as if coming from a cavern

over pumonary cavity in which wall is rigid

Front 54

when are breath sounds absent

Back 54

fluid or pus has accumulated in pleural space
secretions or a foreign body obstructs the bronchi
lungs are hyper inflated
breathing is shallow from splinting because of pain

Front 55

when are breath sounds heard easier

Back 55

lungs are consolidated

Front 56

describe fine crackles

Back 56

high-pitched, discrete, discontinuous cracking sound heard during the end of inspiration not cleared by couch

Front 57

describe medium crackles

Back 57

lower, more moist sound heard during the midstage of inspiration; not cleared by couch

Front 58

describe coarse crackles

Back 58

loud, bubbly noise heard during inspiration; not cleared by a cough

Front 59

describe rhonchi (sonorous wheezing)

Back 59

loud, low coarse sounds like a snore most often heard continuously during inspiration or expiration; couching may clear sounds

Front 60

describe wheeze (sibilant wheeze)

Back 60

musical noise sounding like a squeak; most often heard continuously during inspiration or expiration; usually louder during expiration

Front 61

define mediastinal crunch (Hamman sign) and when is it found

Back 61

variety of sounds- loud crackles, clicking, gurglung and are synchronous with heart beat. more pronounced towards the end of respiration

found in mediastinal emphysema

Front 62

what causes moist couch

what causes dry couch

Back 62

moist- caused by infection and can be accompanied by sputum production

dry- variety of causes

Front 63

acute onset of cough with fever suggest?

absence of fever

Back 63

with fever- infection

without fever- foreign body or inhaled irritants

Front 64

infrequent cough suggests what

Back 64

caused by allergens or environmental insults

Front 65

snoring and gurgling suggest what location

Back 65

nasopharynx

Front 66

stridor suggest what location

Back 66

glottis

Front 67

wheezing suggests what location

Back 67

lower respiratory tree

Front 68

sputum characteristics of bacterial infection

Back 68

yellow, green, rust, clear, or transparent, purulent, blood streaked; mucoid, viscous

Front 69

sputum characteristics of viral infection

Back 69

mucoid, viscid,; blood streaked (not common)

Front 70

sputum characteristics of chronic infectious disease

Back 70

all characteristics, particularly abundant in the morning

Front 71

sputum characteristics of carcinoma

Back 71

slight, persistent, intermittent blood streaking

Front 72

sputum characteristics of infarction

Back 72

blood clotted; larger amounts of blood

Front 73

sputum characteristics of tuberculous cavity

Back 73

occasional large amounts of blood

Front 74

when are lung sounds best heard

Back 74

when consolidation

Front 75

Apneustic breathing

Back 75

characterized by a long inspiration and what amounts to expiration apnea. neural center for control is pons. breathing can become gasping because inspirations are prolonged and expiration constrained

Front 76

lesion in pons will do what to breathing

Back 76

increase rate and depth

Front 77

lesion in cerebrum will do what to breathing

Back 77

decrease the rate and depth of breathing

Front 78

if a patient has CHF where should you start to osculate and why

Back 78

at the base of the lung to detect crackles that may disappear with continued exaggerated respiration

Front 79

what can a patient have in sickle cell disease

Back 79

pulmonary infarction and pulmonary crisis

Front 80

a regular paroxysmal cough is heard in what

Back 80

pertussis

Front 81

when does a change to erect posture cause cough

Back 81

with nasal drip or pooling of secretions in the upper airway

Front 82

what causes brassy cough

Back 82

compression of respiratory tree

Front 83

what causes hoarse cough

Back 83

coup

Front 84

what is the quality of pertussis cough

Back 84

inspiratory whoop at the end of paroxysm of cough in older children and adults

Front 85

dimensions of the chest of a newborn

Back 85

30 to 36 cm

Front 86

newborn resp

Back 86

30 to 80

Front 87

1 year resp

Back 87

20 to 40

Front 88

3 year rsp

Back 88

20 to 30

Front 89

6 year rsp

Back 89

16 to 22

Front 90

10 year rsp

Back 90

16 to 20

Front 91

17 year rsp

Back 91

12 to 20

Front 92

leading ddxs if the roundness of chest persists past 2 years

Back 92

COPD
cystic fibrosis

Front 93

how does a pregnant woman increase ventilation

Back 93

by breathing more deeply

Front 94

signs of acute bacterial pneumonia

Back 94

flaring of nasi
tachypnea
possible productive cough in absence of crackles

Front 95

unexplained by persistent tachycardia may clue what

Back 95

minimal pneumothorax