Nur 188- Exam 2- Lungs And Thorax Part 2

Front 1

What is kyphosis?

Back 1

hunchback

Front 2

What race has the largest size of thorax on average?

Back 2

adult caucasians

Front 3

What are some things you inspect on the thorax posteriorly?

Back 3

skin color changes, breathing observations (positions, accessory muscles), shape and configuration of chest, symmetry, kyphosis, COPD positioning changes, size of thorax

Front 4

What are some things you palpate on the thorax posteriorly?

Back 4

tenderness and sensation, surface characteristics, fremitus, chest expansion, pain, crepitus, lesions, masses, abnormalities from inspection

Front 5

What is the normal sound of the lungs?

Back 5

resonance

Front 6

What occurs to the lung sound with emphysema?

Back 6

hyperresonance

Front 7

What should diaphragmatic excursion be?

Back 7

bilaterally equal- 1-2 inches (3-5 cm) in adults

Front 8

What sound should be heard upon percussion of the scapula?

Back 8

flat

Front 9

What sound should be heard over the liver?

Back 9

dullness

Front 10

What are normal sounds you auscultate in the posterior lungs?

Back 10

bronchial, brochiovesicular, vesicular

Front 11

What should you do if you hear adventitious breath sounds?

Back 11

have the pt cough

Front 12

What are some adventitious sounds?

Back 12

crackles, wheezes, rhonchi, pleural friction rubs

Front 13

What is an increased AP to transverse chest diameter?

Back 13

barrel chest

Front 14

What should you asses for on the anterior chest inspection?

Back 14

shape and configuration, position of sternum, slope of ribs, quality and pattern of respirations, intercostal space, costal angle, accessory muscles, AP to transverse is 1:2, midline and straight, slope down symmetrically, rate of 12-20/min, no retraction or bulging, if they're using accessory muscles to breath

Front 15

KNOW RESPIRATORY PATTERNS

Back 15

Pg 342

Front 16

What is normal breathing rate?

Back 16

eupnea

Front 17

What is over 20 breaths per minute?

Back 17

tachypnea

Front 18

What is below 12 breaths per minute?

Back 18

bradypnea

Front 19

What is absence of breathing?

Back 19

apnea

Front 20

What is Kussmal respirations?

Back 20

deep, rapid breathing

Front 21

KNOW HOW TO IDENTIFY BREATHING PATTERNS BY PICTURE

Back 21

table 10-1

Front 22

What is pectus carinatum?

Back 22

pigeon chest- the front goes forward

Front 23

What is pectus excavatum?

Back 23

the lower sternum protrudes inward- funnel

Front 24

What is the ratio for barrel chested?

Back 24

2:2

Front 25

What should you palpate, percuss, and auscultate anteriorly on the lungs?

Back 25

tenderness and sensation, surface characteristics, thoracic expansion, tactile fremitus, percuss for tone, auscultate for normal and adventitious sounds, crepitus, free of lesions and masses, symmetric expansion, resonance tone

Front 26

What is the loudest normal breath sound?

Back 26

bronchial

Front 27

When do you hear bronchial sounds best?

Back 27

expiration

Front 28

What are bronchial sounds?

Back 28

high pitch, loud intensity, longer on expiration, located over trachea

Front 29

Where do you hear bronchial sounds?

Back 29

over the trachea

Front 30

What sound is heard best on inspiration and expiration?

Back 30

bronchiovesicular

Front 31

What lung sound is located over the main stem bronchi?

Back 31

brochiovesicular

Front 32

What lung sound is heard longest on inspiration?

Back 32

vesicular

Front 33

What is the softest lung sound?

Back 33

vesicular

Front 34

Where are vesicular breath sounds heard?

Back 34

over peripheral lung fields

Front 35

What are low pitch, soft, longer inspiration, peripheral lung fields sounds?

Back 35

vesicular breath sounds

Front 36

What adventitious breath sound is heard best over inspiration?

Back 36

crackles

Front 37

What adventitious breath sound MAY be affected by a cough?

Back 37

crackles

Front 38

What adventitious breath sound sounds like popping or fingers in your hair?

Back 38

crackles

Front 39

What is a loud, low adventitious breath sound heard over expiration?

Back 39

rhonchi

Front 40

Where would you hear rhonchi?

Back 40

larger airways

Front 41

What is a high pitched/musical/short/gurgle/
rattle sound during expiration?

Back 41

mild wheeze

Front 42

Where would you hear a wheeze?

Back 42

smaller airways

Front 43

Where might you hear a pleural friction rub?

Back 43

inspiration or expiration

Front 44

Is a pleural friction rub cleared by a cough?

Back 44

no

Front 45

What is a creaking grating sound heard on inspiration or expiration?

Back 45

pleural friction rub

Front 46

What is a crowing sound heard on inspiration?

Back 46

stridor

Front 47

What are some respiratory assistive devices?

Back 47

oxygen, incentive spirometer, endotracheal tube, tracheostomy tube, mechanical ventilation, pulse oximeter

Front 48

What are some gerontological variations in the lungs?

Back 48

limited chest wall expansion, decreased elasticity for less gas exchange, medulla less sensitive to oxygen and CO2 changes, less ciliary activity, increased susceptibility to infection, decreased cough reflex, increased risk of aspiration