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60 Cards in this Set
- Front
- Back
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Another name for chest area
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Thorax - cage of bone, cartilage & muscle that surrounds the lungs when they expand
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primary muscles respiration
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diaphram
Intercostal muscles |
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diaphram
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contracts and moves down during inspiration
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intercostal muscles
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increase the anterior-posterior chest diameter during inspiration
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accessory muscles
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sternocleidomastoid, trapezius, & abdominal muscles
only used for respiration during pulmonary compromise or exercise |
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3 major spaces interior of thorax
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right plueral cavity
left plueral cavity mediastinum |
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mediastinum
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region between pleural cavities
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pleural cavities enclose the lungs and they help
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provide lubrication for respiratory organs to prevent chafing.
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interior thorax
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right & left pleural cavities
mediastinum lungs trachea |
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how many lobes
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2 - left
3 - right |
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trachea branches into
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bronchi
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Bronchus shorter/wider, move vertical and thus more susceptible to aspiration; what side?
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Right bronchus
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Landmarks
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right/left anterior axillary line
right/left midclavicular line midsternal line posterior axillary line midaxillary line anterior axillary line vertebral line scapular line |
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suprasternal notch
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depression, easily palpable & most often visible at the base of the ventral aspect of the neck, just superior to the manubriosternal junction
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inspect
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respiration
sputum breath skin & nails observation of chest |
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respirations
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rates 12-20 (1:4)
note pattern, depth & ease of breathing |
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abnormal patterns include
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bradypnea
tachypnea cheye-stokes kussmaul apnea |
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sputum
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produced with cough
more than small amount indicates disease process |
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sputum bacterial infection
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yellow, green, rust, clear, mucoid, viscid
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sputum viral infection
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mucoid, viscid, may be blood streaked
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tuberculosis sputum
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large amounts of blood (browninsh)
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carcinoma
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slight amounts, streaking of blood
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malodorous breath
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infection
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fruity breath
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ketoacidosis
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fishy breath
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uremia
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feculent breath
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intestinal problems
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cinnamon breath
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pulmonary tb
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inspection (observation) of chest
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have pt. sit upright without support
naked to the waist warm room bright tangential light (side) |
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shapes of chest
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kyphosis
scoliosis lordosis |
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barrel chest results from
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compromised respirations as seen in asthma, COPD, cystic fibrosis, chronic emphysema
Ribs horizontal, AP=transverse diameter |
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tactile fremitus
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normal lung stransmits a palpable vibratory sensation to the chest wall.
99 |
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abrnormal findings with femitus
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more vibrations in one lung
fewer vibrations |
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more vibrations in one lung may indicate
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inflammation
infection congestion |
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fewer vibrations in lung may indicate
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obstructed bronchus
pleural effusions pneumothorax emphysema |
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thoracic expansion
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confirms symmetrical chest expansion
thumbs should move apart equally as they inhale |
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asymmetry chest expansion
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caused by collapsed lung or fluid or mass
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percussion is used to
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elicit a sound which reflects density of underlying tissue
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findings with percussion
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intensity & pitch throughout lung fields
resonance flat dullness tympany hyperresonance |
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resonance (hollow)
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normal
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flat (very dull)
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large pleural effusion
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dullness (dull thud)
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lobar pneumonia
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tympany (drumlike)
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large pneumothorax
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hyperresonance (booming)
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emphysema, pneumothorax
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vesicular breath sounds
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low pitch; heard over lung field
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bronchovesicular
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heard over main bronchus & upper right posterior lung; medium pitch
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bronchial
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heard over trachea; high pitch
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normal breath sounds
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vesicular
bronchovesicular bronchial |
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abnormal breath sounds (adventitous sounds)
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crackles
rhonchi wheezes friction rub |
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crackles
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inspiration
fine, high pitched; caused by disruptions of air through small airways; pneumonia, CHF, bronchitis |
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rhonchi
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expirations - may disappear after coughing
rumbling sounds; obstruction (thick secretions, growth, external pressure) |
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wheezes
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inspiration or expiration
whistle-like; narrowed airway (asthma, bronchitis, tumor) |
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friction rub
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inspiration & expiration
grating like sandpaper (pericarditis or pleurisy) |
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keys to auscultation
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side to side
quiet environment proper position bare skin always compare |
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pulmonary embolism
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blood clot, plaque, cobular fat, bubble air
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atelectasis
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collapse of aveloi
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pleuisy
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two layers of the pleural membrane become inflamed, their roghened surfaces rub painfully together like two pieces of sandpaper
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pneumonia
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inflammation of the lung usually caused by an infectious agent
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diagnostic test
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chest x-ray
bronchoscopy thoracentesis pulmonary functions sputum cultures SaO2 |
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thoracentesis
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a procedure in which fluid is removed from the pleural space by needle
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pulmonary functions test
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determine how much of the air a person exchanges is of functional use & how easily it can be moved in & out.
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