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88 Cards in this Set

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consists of the nasophaynx, oropharynx, laryngopharynx, and larynx
upper airway
consists of the trachea, bronchi, bronchioles, and alveoli
lower airway
How many lobes does the right lung have?
3
How many lobes does the left lung have?
2
How do women breathe?
thoracically
How do men and infants breathe?
abdominally
abnormality of the chest characterized by a rounded appearance, horizontal ribs, slight kyphosis of the thorax, and a prominent sternal angle

the chest appears in constant inspiration

Ex. infant's chest or an adult with pulmonary disease
barrel chest
abnormality of the chest in which the sternum projects foward

there is an increase in the AP diameter
pectus carinatum (pigeon chest)
abnormality of the chest in which the sternum points posteriorly and may cause abnormal pressure on the heart

if severe, it can cause respiratory failure
pectus excavatum (funnel chest)
an exaggerated curvature of the thoracic vertebrae

can cause significant backpain and limited mobility
kyphosis (humpback)
What has been found to decrease kyphosis?
adequate exercise
a lateral curvature of the thoracic and lumbar spine

reduces chest wall compliance
scoliosis
an exaggerated curvature of the lumbar vertebrae
lordosis
What angle should the ribs insert into the spine?
45 degrees
A horizontal slope of the ribs will be assessed on a person with:
emphysema
What can cause retraction or bulging of the interspaces during inspiration or expiration?
asthma
emphysema
pleural effusion
tension pneumothorax
What can cause tachypnea?
fever
pain
anxiety
anemia
pneumonia
pleurisy
lesion in the pons
Respirations increase about ____ breaths per minute for every 1 degree increase in temp above normal.
4
What can cause bradypnea?
increased intracranial pressure
diabetic coma
opiate narcotic overdose
brain tumor
total absence of breathing; may be periodic
apnea
increased depth of respirations
hyperpnea
What can cause hyperpnea?
strenuous exercise
diabetic ketoacidosis
increased rate and depth of respirations

offsets the O2-CO2 balance

often stress related
hyperventilation
What causes Cheyne-Stokes respirations?
increased intracranial pressure
severe congestive heart failure
renal failure
drug overdose
interrupted breathing like Cheyne-Stokes except that each breath is of the same depth
biots
What causes biots?
spinal meningitis
heat stroke
head trauma
encephalitis
a panting, labored kind of respiration with increased rate and depth
Kussmaul's respirations
tube-like structures opening onto the skin
sinus tracts
indicates subcutaneous air in the chest

feels like puffed rice cereal crackling under the skin

indicates air leaking from the airways/lungs
crepitus
performed to assess range and symmetry of respiratory movement
respiratory excursion
Where do you place your thumbs to assess for respiratory excursion?
at the level of and parallel to the 10th ribs
When testing for respiratory excursion, the thumbs should move _________ as the person inhales and __________ as the person exhales.
outward
inward
What can cause unequal chest expansion (as noted by respiratory excursion test)?
pleural effusion
rib fractures
pneumothorax
tumors
a vibration transmitted through the chest wall as the person speaks
fremitis
To assess for fremitis, what part of your hand do you touch the chest with?
the palmar surface (of your dominant hand)
With fremitis, where should vibrations be the strongest?
between the scapulae on the posterior chest
on either side of the sternum on the anterior chest
What causes decreased fremitis?
anything that obstructs the vibration:

obstructed bronchus
COPD
pleural thickening
pneumothorax
emphysema
pleural effusion
What causes increased fremitis?
Compression or consolidation of lung tissue caused by:

mass (tumor
consolidated area such as with pneumonia or other inflammatory processes
Where is fremitus no longer felt?
at the level of the diaphragm
What is the normal sound you will hear when you percuss the lung tissue?
resonance
Why do we percuss the posterior chest?
to determine whether the underlying tissue is air-filled, fluid-filled, or solid

(the normal lung should be air-filled)
What does resonance sound like?
loud intensity and low pitched
What does a dull sound indicate when you percuss the posterior chest?
abnormal density in the lung

(caused by lung tumor, pneumonia, pleural effusion, and atelectasis)
What does a hyperresonant sound indicate when you percuss the posterior chest?
too much air is present

(caused by emphysema or pneumothorax)
When you percuss the posterior chest, when the sound changes from ________ to _________, you are at the estimated level of the diaphragm.
resonance
dullness
the movement of the diaphragm as it descends on inspiration and rises on expiration
diaphragmatic excursion
With diaphragmatic excursion, the 2 lines on the right side may be slightly higher due to:
the presence of the liver
The normal range for diaphragmatic excursion in females is:
3-5 cm
The normal range for diaphragmatic excursion in males is:
5-7 cm
When auscultating the lungs posteriorly, what part of the stethoscope do you use?
diaphragm
soft, low-pitched fine rustling sounds located over the periphery of the lungs

they are loud on inspiration and soft/absent on expiration
vesicular breath sounds
most predominant breath sounds
vesicular breath sounds
Decreased vesicular breath sounds over the periphery may indicate:
pneumonia
emphysema
pleural effusion
atelectasis
loud, high-pitched tubular sounds located over the trachea (suprasternal area) and major bronchi

they are louder and longer during EXPIRATION
bronchial/tracheal breath sounds
If bronchial/tracheal breath sounds are heard over the periphery, this may indicate:
consolidation or atelectasis
moderately pitched breath sounds located between the scapulae posteriorly and on either side of the sternum at the first and second intercostal space anteriorly

no pause between inspiration and expiration
bronchovesicular breath sounds
If bronchovesicular breath sounds are heard over the periphery, it may indicate:
consolidation (lungs are filled with exudate)
Which breath sounds are heard on the posterior chest?
bronchovesicular
vesicular
Which breath sounds are heard on the anterior chest?
bronchial
bronchovesicular
vesicular
Inaudible breath sounds may indicate:
atelectasis
pneumothorax
adventitious breath sound created when air is traveling through vessels containing abnormal moisture

more pronounced on inspiration
crackles (rales)
What are the 2 types of crackles?
fine
coarse
type of crackle that is soft and high pitched

it sounds like 2 hairs being rubbed together
fine
type of crackle that is louder and lower pitched

has a bubbly quality
coarse
high pitched sound produced by air passing through a narrowed passageway in the small airways

may occur during inspiration, expiration, or both
wheezes (sibilant rhonchi)
What causes wheezes?
mucous plug
bronchospasms
tumor
coarse rattling sounds more like a snore, moan, or groan

louder and lower in pitch than crackles and caused by narrowed or constricted large airways

more pronounced on EXPIRATION
rhonchi (sonorous rhonchi)
What causes rhonchi (sonorous rhonchi)?
asthma
bronchitis
bronchospasm
high pitched sound produced by air passing through a narrowed passageway in the small airways

may occur during inspiration, expiration, or both
wheezes (sibilant rhonchi)
What causes wheezes?
mucous plug
bronchospasms
tumor
coarse rattling sounds more like a snore, moan, or groan

louder and lower in pitch than crackles and caused by narrowed or constricted arge airways

more pronounced on EXPIRATION
rhonchi (sonorous rhonchi)
What causes rhonchi (sonorous rhonchi)?
asthma
bronchitis
bronchospasm
crackling, grating sounds produced when 2 roughened or inflamed pleural spaces rub across each other during respiration

heard on both inspiration and expiration

sounds like sand paper
friction rub
loud high-pitched crowing sound heard usually without a stethescope during inspiration

requires immediate attention!
stridor
What causes stridor?
upper airway obstruction
What are the S/S of upper airway obstruction?
anxiety
dyspnea
stridor
wheezes
decreased/absent breath sounds
use of accessory muscles
inability to speak
cyanosis
seesaw movement of chest
Sound carries best through __________, not as well through _________, and poorly through _________.
solid
fluid
air
Instruct the person to say 99 while you auscultate the posterior chest. Normally the sound should be muffled and indistinct. If the sound is clear, it is called:
bronchophony
Instruct the person to say "ee" while you auscultate the posterior chest. Normally the sound should be muffled and indistinct. If the sound is heard as "ay", this is called:
egophony
Instruct the person to WHISPER 99 while you auscultate. The sound should be faint and indistinct. If the sound is louder and clear, it is called:
whispered pectoriloquy
What should the width of the costal angle be?
less than 90 degrees
When you inspect for the use of accessory muscles, which muscles are you looking at?
trapezius
sternocleidomastoid
abdominal muscles
In a normal adult, what is the ratio of the anterioposterior (AP) diameter to the lateral diameter?
1:2
Does the AP diameter usually increase or decrease in the older adult?
increase (b/c of barrel chest or pectus carinatum)
When palpating the anterior chest for respiratory excursion, where do you place your thumbs?
along the costal margins pointing toward the xyphoid process
The assessment of fremitis differs anteriorly due to the decreased or absent vibration over the _____________.
precordium
When you percuss over the liver and heart, what sound will you hear?
dull
When you percuss over the stomach, what sound will you hear?
tympany