Lungs

Front 1

obstructive pulmonary diseases

Back 1

increase in resistance to airflow, owing to partial or complete obstruction at any level (trachea to resp. bronchioles)

PFTs with limitation of max airflow rates during forced expiration

**FEV1 is decreased**

(1) emphysema
(2) bronchitis
(3) asthma
(4) bronchiectasis

Front 2

restrictive pulmonary diseases

Back 2

reduced expansion of lung parenchyma, with decreased total lung capacity

PFTs with reduced total lung capacity and normal/proportionately reduced expiratory flow rate

**FEV1 is normal/reduced proportionately to lung capacity**

(1) chest wall disorders
(2) chronic interstitial diseases
(3) chronic infiltrative diseases

Front 3

pink puffers vs. blue bloaters

Back 3

pink puffers - pt overventilates and so they remain well oxygenated - primary pathology is emphysema

blue bloaters - pt is hypercapneic, hypoxemic, and cyanotic - primary pathology is chronic bronchitis

Front 4

what are the causes of death in COPD?

Back 4

1) respiratory acidosis and coma
2) right sided heart failure
3) lung collapse from pneumothorax

Front 5

pulmonary embolism (PE)

Back 5

occlusion of large pulmonary arteries is nearly always caused by a thromboembolism (95% originate in deep veins of the legs)

responsible for >50,000 deaths/year and is the sole or major contributor in 10% of acute hospital deaths

Front 6

pathogenesis of pulmonary embolism (PE)

Back 6

pt almost always has an underlying disorder or is ill or has a hypercoagulable state

primary - thrombus builds up in veins via coagulation cascade

secondary - recent surgery, central lines, pregnancy or BCP, cancer, or obesity

Front 7

What is a hemothorax?

Back 7

noninflammatory pleural effusion that results from escape of blood into the pleural cavity, which forms large clots

caused by vascular trauma or ruptured aortic aneurysms

Front 8

at what vertebral level does the trachea bifurcate?

Back 8

T4/5

Front 9

main bronchi are divided into ____ branches on the right and ____ on the left

Back 9

3; 2

Front 10

most of the blood from the lungs is drained via the:

Back 10

pulmonary veins

Front 11

chemoreceptors are found in these 2 places and each is stimulated by what

Back 11

medulla oblongota (H+) and carotid body (low O2 and high CO2)

Front 12

chemoreceptors send signals to the respiratory center in this part of the brain

Back 12

medulla oblongota

Front 13

posterior lung is mainly which lobe(s)?

Back 13

lower lobe

Front 14

the number of each intercostal space corresponds to that rib immediately below/above it?

Back 14

above

Front 15

what predisposes older adults to respiratory infections?

Back 15

aging mucous membranes become drier and can't get rid of mucous

Front 16

difficult and labored breathing with SOB

Back 16

dyspnea

Front 17

SOB that begins or increases when the patient lies down

Back 17

orthopnea

Front 18

sudden onset of SOB after a period of sleep

Back 18

paroxysmal nocturnal dyspnea

Front 19

dyspnea that increases in upright posture

Back 19

platypnea

Front 20

regular period of breathing with intervals of apnea followed by crescendo/decrescendo sequence of respr

Back 20

Cheyne-Stokes (periodic) breathing

Front 21

Dx: stridor

Back 21

obstruction high in resp tree

Front 22

3 diseases associated with clubbing

Back 22

lung fibrosis, CHD and CF

Front 23

Dx: crepitus

Back 23

air in subcut tissue from ruptured resp tract or infection by gas-producing org

Front 24

palpable, coarse, grating vibration during inspiration

Back 24

pleural friction rub

Front 25

posteriorly at what vertebral level do you place your hands to eval thoracic expansion?

Back 25

T10

Front 26

where is tactile fremitus best felt?

Back 26

parasternally at the 2nd intercostal space at the level of the bifurcation of the bronchi

Front 27

The top of the lung is called?

Back 27

Apex

Front 28

What is Egophony?

Back 28

increased resonance of voice sounds with a high pitched nasal or bleating quality, heard especially over lung tissue that is compressed or consolidated by pleura effusion. if the patient says "E"

Front 29

What is Stridor?

Back 29

a harsh, high pitched breath sound such as the one often heard on inhalation with an acute laryngeal obstruction

Front 30

What is wheezing?

Back 30

the sound of air flowing through narrowed airways as in asthma often heard best in expiration

Front 31

What is bronchophony?

Back 31

whispered pectoriloquy spoken or whispered sounds are heard distinctly over consolidated areas of the lung but are usually muffled in normal lungs

Front 32

What is dyspnea?

Back 32

shortness of breath

Front 33

What are crackles?

Back 33

or rales both fine and coarse, literally higher pitched sounds that crackles

Front 34

What are rhonchi?

Back 34

coarse rales or lower pitched sonorous sounds, sort of like a snore

Front 35

What is fremitus?

Back 35

the palpable vibrations transmitted through bronchopulmonary tree to the chest wall. as the patient is speaking

Front 36

What is orthopnea?

Back 36

DIFFICULT BREATHING EXCEPT IN AN UPRIGHT POSITION

Front 37

Residual volume

Back 37

Volume of air that will never be expelled from the lumgs

Front 38

Vital capacity

Back 38

Volume of air breathed in when exercising

Front 39

Expiratory volume

Back 39

Volume of air breathed out in a deep breath

Front 40

Volume of air breathed in in a deep breath

Back 40

Volume of air breathed in in a deep breath

Front 41

What are changes you will see in older adults (5)

Back 41

1. Increased AP chest diameter

2. Barrel Chested

3. Retain more mucus

4. Alveoli less elastic and more fibrous

5. Decrease in vital capacity and increase in residual volume.

Front 42

What is deep, usually rapid breathing associated with metabolic acidosis?

Back 42

Kussmaul breathing

Front 43

What is Biot respiratation?

Back 43

Irregular breathing that varies in depth and is interrupted irregulary by intervals of apnea.

Front 44

What is just below the manubriosternal joint?

Back 44

This is where the trachea divide - T4 and T5

Front 45

What is another name for the manubriosternal joint?

Back 45

Angle of Louis (rib 2 or T2)

Front 46

Average respirations of an adult?

Back 46

12-20 breaths per min

Front 47

What is the tetralogy of fallot?

Back 47

Stenosis of pulmonary valve

Hypertrophy of Right Ventricle

Overriding the aortic valve (the aortic valve moves toward the right side.)

Ventricular septal defect

Front 48

Where do you evaluate thoracic expansion?

Back 48

posterior ribs at tenth rib

Front 49

What is a condition in which the lungs lose elasticity and alveoli enlarge in a way that disrupts function?

Back 49

Emphysema