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87 Cards in this Set
- Front
- Back
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Manubrio-sternal junction
Angle of Louis |
Visible & palpable angulation of sternum
Point where the 2nd rib articulates with the sternum |
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Mediastinum
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space that separates the lungs
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Left Lung
(# of lobes) |
2 lobes
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Right Lung
(# of lobes) |
3 lobes
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Left Upper Lobe
Lingula |
Inferior tongue-like projection
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Parietal pleura
Lines what? |
lines inside of thoracic cavity wall and upper surface of diaphragm
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Visceral pleura
Lines what? |
lines the outer surface of each lung
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Pleural space
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potential space between the visceral and parietal pleurae
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Compliance
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Refers to elasticity of the lung
Reflects a measure of ease of its distention or volume of change from pressure differences |
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Muscles of respiration
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Diaphragm
Intercostal muscles |
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External intercostal muscles
Function |
Increase the antero-posterior chest diameter during inspiration
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Internal intercostal muscles
Function |
Decrease the transverse diameter of chest during expiration
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Muscles of inspiration
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Diaphragm
External intercostals |
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Muscles of expiration
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Internal intercostals
Internal & External Obliques Transverse Abdominis |
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Right bronchus
Size |
Wider, shorter, and more vertically placed than left brochus
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Right bronchus
Susceptible to what?? |
Aspiration of foreign bodies due to location and size
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Airway resistance
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pressure required to drive air through the airways
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Respiration purpose
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to keep the body adequately supplied with oxygen and protected from excess accumulation of carbon dioxide
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ventilation
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movement of air back and forth from the deepest reaches of the alveoli to the outside
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Diffusion
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gas exchange across the alveolar-pulmonary capillary membranes
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Perfusion
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circulatory transport of oxygen to, and carbon dioxide from, the peripheral tissues
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PaCO2
Normal range |
35-45 mm Hg
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Hyperventilation
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increased minute volume ventilation that results in a lowered carbon dioxide level
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Inspiration
Results from... |
increasing the volume of the thoracic cavity by flattening the diaphragm and elevating the ribs
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Boyle's Gas Law
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inverse relationship between pressure and volume
increased volume results in decreased pressure |
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Oxygen moves from....
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from alveoli to the blood
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Carbon dioxide moves from....
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from blood to the alveoli
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Expiration occurs when...
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occurs passively as muscles relax
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Functional residual capacity
(FRC) |
volume of gas remaining in the lungs at the end of normal expiration
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Dead space ventilation
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gas in the conducting airways that does not participate in alveolar exchange
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Kussmaul's respiration
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rapid large-volume breathing indicating intense stimulation of respiratory center
Seen in metabolic acidosis |
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Cheyne-Stokes respiration
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rhythmic waxing and waning of both rate and depth that includes regular periods of apnea
Seen in pts with end-stage left ventricular failure or neruo disease |
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Apnea
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no respiration for > 20 seconds
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Tachypnea
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increased rate of breathing and is commonly associated with decrease in tidal volume
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Dyspnea
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difficulty breathing or shortness of breath
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Orthopnea
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dyspnea upon assuming a recumbent position; quantified by # of pillows the pts uses to sleep
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Paroxysmal nocturnal dyspnea
(PND) |
dyspnea that awakens the patient several hours after going to sleep
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Tactile fremitus
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palpable vibrations transmitted thru the broncopulmonary tree to the chest wall when patient speaks
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Percussion helps with...
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establish whether the underlying tissues are air-filled, fluid-filled, or solid
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Normal breath sounds
Different types |
Vesicular
Bronchovesicular Bronchial |
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Vesicular Breath Sounds
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heard over periphery of lung
soft, low-pitched sounds heard in inspiration & expiration with no pause |
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Bronchiovesicular Breath Sounds
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inspiratory and expiratory sounds about equal in length, sometimes seperated by a silent interval
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Bronchial Breath Sounds
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Louder & higher in pitch, with a short silence between inspiratory & expiratory sounds
Expiratory phase lasts longer than inspiration |
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Adventitious Breath Sounds
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Abnormal lung sounds
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Wheeze
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high-pitched, musicaly sounds with distinct whistling quality
Occur in inspiration & expiration |
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Rhonchi
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lower-pitched, snoring sounds that may have gurgling quality
Due to excessive secretions Frequently clear after cough |
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Discontinuous
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AKA: Crackles or Rales
Brief, discrete, non-musical sounds with a popping quality |
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Coarse crackles
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louder, lower-pitched, slightly longer in duration
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Coarse crackles
when heard... |
pneumonia
obstructive lung disease late pulmonary edema |
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Fine crackles
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soft, high-pitched and crisp
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Fine crackles
Heard in.... |
Interstitial disease
Early pulmonary edema |
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Stridor
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high-pitched, noisy respiration
Indicates upper respiratory obstruction |
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Inspiratory stridor
Obstruction where... |
indicates obstruction above vocal cords
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Expiratory stridor
Obstruction where... |
indicates obstruction below vocal cords
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Grunting
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Usually occur during expiratory phase and are specific to lower respiratory tract disease
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Bronchophony
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Louder, clearer voice sounds heard thru chest wall when patient says "ninety-nine"
Normal = muffled & indistinct sounds |
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Whispered petroliloquy
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Louder, clear whispered sounds when patient whispers "ninety-nine"
Normal = voice is heard faintly and indistinctly |
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Egophony
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Patient says "ee" and it is heard as "ay" or the E changes to A with nasal sound
Normal = muffled long E sound |
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Cyanosis
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blue or bluish-gray discoloration of the skin or mucous membranes caused by increased amounts of unsaturated hemoglobin in capillary blood
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Central Cyanosis
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results from insufficient oxygenation of hemoglobin in the lungs
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Evaluation of cyanosis where...
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Tongue
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Peripheral cyanosis
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results from insufficient cardiac output, obstruction of blood flow, or vasoconstriction due to cold temp
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Pulse Oximetry
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state-of-the-art, inexpensive, non-invasive, simple method to monitor a patient's % hemoglobin saturation with oxygen
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Spirometry
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measure of the movement of air into and out of lungs during various breathing maneuvers
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Spirometry = predicted values based on...
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normal individuals grouped by gender, age, and height
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Spirometry
Normal ranges |
80-120% of predicted value
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Spirometry -- Uses
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-Distinguish obstructive lung dz from restrictive lung dz
-Diagnostic test and monitoring tool -Determines the severity of functional impairment and to assess response to tx |
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Tidal Volume
(Vt) |
volume of air inhaled and exhaled with each resting breath during normal, quiet breathing
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Tidal Volume
Normal values |
500 to 800 mL
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Inspiratory Reserve
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amount of air that can be inhaled after normal inspiration
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Expiratory Reserve
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amount of air that can be exhaled after expiration
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Vital Capacity
(VC) |
total amount of air that can be exhaled following a maximal inhalation
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Residual volume
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volume of air left in the lungs after maximal expiration that cannot be exhaled due to the limit of elasticty
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Total Lung Capacity
(TLC) |
vital capacity and residual volume together
-total amount of air in the lungs after a maximal inhalation |
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Forced vital capacity
(FVC) |
maximum volume of air that can be expelled from the lungs following max inspiration, performed rapidly and forcefully
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Forced expiratory volume in one second
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-volume of air that is forcefully expired during the first second after a deep breath
-portion of FVC exhaled in one second |
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Obstructive disease
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increase in airway resistance as a result of reduction of elastic recoil &/or compromise of air passage
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Expiratory airflow
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reduced more than expiratory volume, and there is a prolonged expiratory time
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Examples of obstructive disease
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-Chronic obstructive pulmonary disease (COPD)
-Chrnoic bronchitis -Emphysema -Asthma |
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Restrictive disease
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reduction in lung capacity, secondary to scarring or extraneous material
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Expiratory volume
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reduced more than expiratory airflow, the expiratory time is very short, and chest expansion is poor
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Most common type of chest XRay
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Postero-anterior (PA) and lateral view series
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Characteristics of PA view CXR
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-Markings on film are oriented so they can be read without reversing the film
-Clavicles are superimposed over the upper lungs |
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Type of CXR used for unstable patients
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AP -- portable antero-posterior view
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Characteristics of AP view CXR
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-Identification markings and writing are reversed
-Heart appears slightly large -Clavicles are usually higher than in PA views |
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Good inspiration effort show what on CXR
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-9-10 posterior ribs
-5-6 anterior ribs |
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Poor inspiration effort show what on CXR
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-large appearing and poorly defined heart
-enlarged pulmonary vessels -blunting of lung bases |
