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20 Cards in this Set
- Front
- Back
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Basic anatomy of the diaphragm |
1. 3,4,5 keeps the diaphragm alive
2. At T8 : IVC 3. At T10: Esophagus, vagus 4. At T12: Aorta, Thoracic Duct, and azygos vein 5. Pneumonic: I (IVC) ate (8) ten (10) eggs (esophagus) at (aorta) twelve (12) |
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Basic anatomy of the lungs |
1. Right lung: three lobes (upper, middle, lower)
2. Major/oblique and horizontal fissures 3. Step I pearl: The rights side of the body has 3 lung lobes, 3 main bronchi and the Tricuspid valve 4. Major/oblique fissure 5. Blood vessels 6. Lymphatics 7. Nerves 8. Alveolar ducts connecting to alveoli 9. Alveoli, as many as 300 million in adults |
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1. Bronchial aspiration risk and why
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1. The right bronchial tree
2. Because it is wider, shorter, and more vertically placed than left |
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Normal muscles of respiration |
1. Diaphragm
2. Passive |
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Normal muscles of respiration |
1. InSpiration – Scalene muscles, Sternocleidomastoids (SCM), and trapeziuS
2. Expiration – Internal intercostal muscles |
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1. Respiratory distress: when to assess for it and what to look for
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1. Increased respiratory rate/labored breathing
2. Retractions: chest appears to sink in just below the neck w/ each breath 3. Cyanosis 4. Accessory Muscle use 5. Nasal flaring 6. Lip pursing 7. tripoding |
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1. Different respiratory patterns: be able to differentiate them and what commonly causes them/when they might be seen
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Normal, Bradypnea, Tachypnea, Hyperventilation, Sighing, air trapping, Cheyne-Stokes, Kussmal, Biot, Ataxic |
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Viscerosomatic levels associated with lungs both sympathetic and parasympathetic |
1. Sympathetic: T2-T7
2. OA = Occiput/atlas junction 3. AA: Atlas/Axis junction |
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Cardiac vs non-cardiac angina (chest pain) |
1. Associated pressure on chest – “feels like an elephant is standing on my chest”
2. Pain radiates to the neck or down left arm 3. Cardiovascular disease 4. Obese 5. Hyperlipidemia 6. Diabetes 7. Lasts all day 8. Can point to the pain 9. Located in the shoulders or between scapula in back 10. Made worse w/ pressure on the precordium 11. Location: pt says chest pain but pain is more over the epigastric region |
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Auscultation # of points and location |
1. Auscultation with stethoscope provides important clues to the condition of the lungs and pleura
2. Character: resonant, flat, dull, tympanic, hyperressonant 3. Intensity: soft, medium, loud, very loud 4. Pitch: low, medium, high 5. Quality: hollow or dull 6. Duration: short, medium, long 7. ON BARE SKIN 8. 4 anterior 9. 4 posterior 10. 1 under each axilla (ie 2 more spots) |
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auscultation: character, intensity, pitch, quality, duration of crackles |
1. Character: fine, medium, or coarse crackling sound; high- pitched
2. When is it heard: inspiration 3. Cause: disruptive passage of air through the small airways (either upper or lower airway) 4. Possible pathologies: early inspiratory: chronic bronchitis; late inspiratory: pneumonia, CHF, or atelectasis |
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auscultation: character, intensity, pitch, quality, duration of rhonchi |
1. Character: coarse low pitched; may clear with cough
2. When is it heard: inspiration and expiration 3. Cause: passage of air through an airway obstructed by thick secretions, muscular spasm, new growth or external pressure 4. Possible pathologies: Asthma, COPD, Tumor |
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auscultation: character, intensity, pitch, quality, duration of wheezes |
1. Character: whistling, high pitched bronchus, musical-like sound/squeak
2. When: inspiration or expiration; generally louder on expiration 3. Cause: relatively high velocity air flow through a narrowed or obstructed airway 4. Possible pathologies: asthma (reactive airway ds), acute/chronic bronchitis, foreign body (very localized wheeze) |
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What is crepitus |
A crunch sound heard over the subcutaneous skin and joints |
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What is friction rub |
1. Outside the respiratory tree. Dry crackly grating, low pitched sound and is heard in both expiration and inspiration. Machine-like quality
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What is Mediastinal Crunch |
Found with mediastinal emphysema. A variety of sounds including crackles, clicking, and gurgling sounds that are synchronous with the heartbeat and not particularly so with respiration |
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What is consolidation |
Anything that can obstruct the airway |
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Result of consolidation when doing bronchophony |
Increase of sound while saying 99 |
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Result of consolidation when doing whisper pectoriloquy |
The ability to hear the patient say 1,2,3 |
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Result of consolidation when doing egophony |
The EEEE will change to the sound AAAAA |
