Chest And Lungs

Front 1

Chest anatomy terms

Back 1

Manubrium, suprasternal notch, sternal angle (angle of Louis), 1st and 2nd ribs, xyphoid process.

Front 2

Pectus excavatum

Back 2

Depression in the lower sternum

Front 3

Pectus carinatum

Back 3

Anteriorly displaced sternum

Front 4

Traumatic flail chest

Back 4

Multiple rib fractures resulting in paradoxical movements of the thorax. On inspiration injured area caves inward and expiration outward

Front 5

Thoracic kyphoscoliosis

Back 5

Abnormal spine curve and vertebral rotation causing chest deformities.

Front 6

2nd rib

Back 6

From suprasternal notch move about 5 cm inferiorly to the sternal angle and then laterally (start counting interspaces)

Front 7

2nd intercostal space is location for...

Back 7

Tension pneumothorax needle insertion

Front 8

4th intercostal space is location for...

Back 8

Chest tube insertion

Front 9

Where ribs articulate...

Back 9

7th rib is last to articulate with sternum
8-10th ribs articulate with costal cartilage
11th and 12th ribs are free floating

Front 10

12th rib

Back 10

Palpable posteriorly and can start counting ribs/interspaces

Front 11

Inferior tip of scapula

Back 11

Lies at the level of the 7th rib/interspace.
T7-T8 interspace is location for thoracentesis

Front 12

C7

Back 12

With neck flexed the most protruding process is usually C7

Front 13

Describing location on the chest

Back 13

Use:
-Vertical axis – by noting rib level (counting ribs)
-Circumference around the chest – using boney land marks and vertical lines

Front 14

Vertical lines

Back 14

Midsternal line, Midclavicular line, Axillary lines, Anterior, Midaxillary, Posterior axillary, Vertebral line, Scapular line

Front 15

Lung apex

Back 15

Rises 2-4cm above clavicles

Front 16

Lung bases

Back 16

Extend
-6th rib midclavicular
-8th rib midaxillary
-T10 spinous process posteriorly

Front 17

Oblique fissure

Back 17

Find spinous process of T3

Front 18

Horizontal fissure

Back 18

Near 4th rib to midaxillary line near 5th rib

Front 19

Tracheal bifurcation

Back 19

At sternal angle anteriorly and T4 posteriorly

Front 20

Common chest complaints

Back 20

-Chest pain
-Shortness of breath
-Wheezing
-Cough
-Hemoptysis

Front 21

Chest pain - general

Back 21

History gives you significant direction for cause, always ask questions that can include or exclude sources

Front 22

Chest pain - possible causes

Back 22

Cardiovascular, pulmonary, GI, musculoskeletal, skin, anxiety, and others

Front 23

Chest pain - questions to ask

Back 23

Location, quality, quantity, timing/onset, setting, associated manifestations, aggravating/alleviating factors

Front 24

Cardiovascular chest pain - location

Back 24

Substernal, shoulder, jaw, neck

Front 25

Cardiovascular chest pain - quality

Back 25

Pressure, ache, heavy, "crushing", "ripping or tearing", sharp

Front 26

Cardiovascular chest pain - quantity

Back 26

Mild to severe (typically more significant)

Front 27

Cardiovascular chest pain - timing

Back 27

1-20 min and intermittent (angina), constant (pericarditis and dissection)

Front 28

Cardiovascular chest pain - aggravating

Back 28

Exertion (angina/MI), breathing and position (pericarditis)

Front 29

Cardiovascular chest pain - alleviating

Back 29

Rest, sitting forward (pericarditis)

Front 30

Cardiovascular chest pain - associated symptoms

Back 30

Dyspnea, nausea, diaphoresis (angina/MI)

Front 31

Levine sign

Back 31

A clenched fist over the anterior chest typical in coronary syndrome.

Front 32

Tracheobronchitis

Back 32

Upper chest, burning, mild-moderate, aggravated by cough/deep breathing, alleviated by lying on involved side

Front 33

Pleuritic pain

Back 33

Any chest wall area, sharp/stabbing, mod-severe, constant, aggravated by cough/breathing/chest wall motion

Front 34

Bronchospasm

Back 34

Substernal, sharp to ache, mild-severe, episodic, aggravated by cough/breathing deep, associated with wheezing/dyspnea

Front 35

GERD

Back 35

Substernal and to back, burning/squeezing, mild-severe, worse after meals and lying down, alleviated with antacids (some)

Front 36

Esophageal spasm

Back 36

Substernal to jaw or back, squeezing, mild-severe, aggravated with swallowing, improved occasionally with belching and antacids

Front 37

Peptic ulcer

Back 37

Substernal to back/abdomen, ache to burn, mild-severe, initially may improve with food then worsen later

Front 38

Gallbladder

Back 38

Substernal to back/abdomen, ache to burn, mild-severe, initially may improve with food then worsen later, worse with greasy meals.