Lungs & Respiratory System

Front 1

Ventilation

Back 1

process of moving gas in and out of the lungs with inspiration and expiration

Front 2

Diffusion

Back 2

movement of O2 and CO2 from an area of high concentration to low concentration across the alveolar capillary membrane to the pulmonary capillaries

Front 3

structures w/in thorax

Back 3

mediastinum, right and left pleural cavities

Front 4

Mediastinum contains:

Back 4

heart, aorta, superior vena cava, lower esophagus, and lower part of the trachea

Front 5

Parietal pleura

Back 5

protects the chest wall and the diaphragm

Front 6

Visceral pleura

Back 6

protects the outside of the lungs

Front 7

Outer boundaries of lungs

Back 7

anteriorly: 1.5 inches above first rib into base of the neck

posteriorly: apices rise to about T1, lower borders on deep inspiration expand to approx T12, and rise to T9 on expiration

Front 8

Rib anatomy

Back 8

12 pairs of ribs, connect posteriorly to 12 thoracic vertebrae. 7 pairs of ribs attached to sternum anteriorly.

costal cartilage of 8, 9, 10th ribs connect immediately superior to the ribs.

11th & 12th ribs "floating" anteriorly.

Tip of 11th rib in lateral thorax, tip of 12th rib in posterior thorax.

Front 9

muscle action during inspiration

Back 9

diapragm contracts and pushes abdominal contents down while intercostal muscles push chest wall outward.

Decreases interthoracic pressure for neg. lung pressure which causes lungs to fill with air.

Front 10

muscle action during expiration

Back 10

muscles relax, expelling air as interthoracic pressure rises.

Front 11

Upper airway consists of

Back 11

nose, pharynx, larynx, intrathoracic trachea

Front 12

upper airway functions in respiration

Back 12

conduct air to the lower airway

protect lower airway from foreign matter

warm, filter, and humidify inspired air

Front 13

Lower airway consists of

Back 13

trachea, right and left mainstem bronchi, segmental and subsegmental bronchi, and the terminal bronchioles

Front 14

Trachea bifurcates where?

Back 14

at T4/T5. Right bronchus is shorter, wider and more vertical than the left, so aspirated object more likely to lodge on the right.

Front 15

Bronchi divides to

Back 15

increasingly smaller bronchioles, each of which opens to an alveolar duct and terminates in multiple alveoli, where gas exchange occurs

Front 16

costal angle

Back 16

intersection of the costal margins, should be <90 degrees

Front 17

vertebra prominens

Back 17

spinous process of C7, visible and palpable with head bent forward

Front 18

pack-year history

Back 18

number of years client has smoked x number of packs of cigarettes smoked each day

Front 19

highest lung cancer incidence and mortality rate amongst

Back 19

native american men

Front 20

tripod position

Back 20

leaning forward with arms braced on knees, against chair or against a bed, opens up chest cavity in attempt to get more air - a sign of respiratory distress

Front 21

Antero-posterior diameter to lateral diameter ratio

Back 21

AP:L 1:2

Front 22

Barrel chest

Back 22

abnormal finding
costal angle >90 degrees
increased AP diameter
horizontal ribs

possible indicator of emphysema.

Front 23

Pectus carinatum

Back 23

pigeon chest - prominent sternum

Front 24

Pectus excavatum

Back 24

funnel chest, sternum indented above xiphoid process

Front 25

normal rib angle

Back 25

45 degrees relative to spine

Front 26

cyanosis or pallor of nails, skin or lips

Back 26

sign of inadequate oxygenation of tissues caused by underlying respiratory or cardiovascular condition

Front 27

clubbing of nails

Back 27

associated with chronic hypoxia

Front 28

Normal BPM

Back 28

12-20 (eupnea), smooth, easy and without effort.

chest wall should rise symmetrically. occasional sighing normal (deep breath) but frequent is abnormal.

Front 29

Bradypnea

Back 29

respiratory rate of less than 12 bpm, still smooth and even

Front 30

Tachypnea

Back 30

resp. rate of >20 bpm, still smooth and even

can be caused by fever, fear or activity

Front 31

hyperventilation (hyperpnea)

Back 31

increased rate AND depth of respiration

Front 32

Kussmaul breathing

Back 32

hyperventilation combined with ketoacidosis

deep and laborious

Front 33

Biot breathing pattern

Back 33

irregularly placed periods of apnea in disorganized and irregular pattern, rate, or depth.

may be caused by persistent intercranial pressure, resp. distress, or damage to medulla

Front 34

Cheyne-Stokes

Back 34

intervals of apnea interspersed with deep and rapid breathing.

severe illness, brain damage or drug overdose

Front 35

Air trapping

Back 35

abnormal resp. pattern

seen in clients with COPD. Rapid inspirations with prolonged, forced expirations. Air not fully exhaled, becomes trapped in lungs, eventually leads to barrel chest.

Front 36

Trachea not midline

Back 36

could indicate chest mass, mediastinal shift or some degree of lung collapse

Front 37

Crepitus

Back 37

crinkly or crackly sensation under fingers on PE.

indicates air in subcut tissue causes by leak somewhere in resp. tree.

Front 38

pleural friction rub

Back 38

felt as coarse, grating sensation during inspiration, secondary to inflammation of pleural surface

Front 39

assymetric muscle development or unstable chest wall

Back 39

indicates a thoracic disorder

Front 40

location to palpate posterior chest wall for thoracic expansion

Back 40

T9/T10, thumbs on either side of spinous prodesses, extend fingers laterally. Thumbs should move apart symmetrically with deep breaths.

Front 41

abnormal thoracic expansion findings

Back 41

unilateral or unequal movement could be caused by pain, Fx ribs or chest wall injury, pneumonia, and/or collapsed lung.

Front 42

Vocal/tactile fremitus

Back 42

vibration felt on palpation as a result of vocalization (1,2,3 or 99,99,99)

should be equal bilaterally

Front 43

abnormal tactile fremitus

Back 43

absent when vibrations blocked, could be emphysema, pleural effusion, pulmonary edema or bronchial obstruction.

increased when vibrations enhanced - occurs when lung tissue congested or consolidated (pneumonia, tumor)

Front 44

client position for percussion of thorax posterior

Back 44

sitting with arms folded in front of them, head bent forward

Front 45

thorax percussion normal finding

Back 45

resonance - loud intensity, low pitch, long duration, hollow quality.

Front 46

client position for percussion of thorax anterior

Back 46

arms raised above the head, percuss down anterior and lateral aspects of chest moving from side to side

Front 47

abnormal thorax percussion findings

Back 47

hyperresonance - overinflation of the lungs. Loud resonance of low pitch, lasts longer than normal and seems booming. Could be emphysema.

Dull tones in pneumonia, pleural effusion, atelectasis.