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29 Cards in this Set
- Front
- Back
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What are the structures in the upper respiratory system?
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-nose
-pharynx -adenoids -tonsils -epiglottis -larynx -trachea |
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What are the structures in the lower respiratory system?
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-bronchi
-broncioles -alveolar ducts -alveoli |
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What are the respiratory structures in the chest wall?
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-ribs
-pleura -muscles of respiration |
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List some subjective data and cues that suggest respiratory problems?
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-dyspnea
-wheezing -cough -hemoptysis -voice change -fatigue -past history of respiratory infections |
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What is the objective data that you look for or inspecting during a respiratory assessment?
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-Nose: note any nasal flaring, discharge, and patency
-Mouth and pharynx: tongue and tonsils -Neck: symmetry, tender, or swollen areas -Thorax configuration:barrel chest *absence of accessory muscle use * -skin: even skin tone, clubbing |
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What is the objective data that can be obtained during palpation of the respiratory system?
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-tracheal position (normally mid line)
-thoracic expansion -tactile fremitus |
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What are some possible findings with the tracheal position?
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-normally midline
-place index fingers on either side of trachea just above suprasternal notch -gently press backwards -if deviates away from neck mass or tension pneumothorax -if deviates towards atelectasis or pneumonectomy |
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What are the factors to be considered during inspection of thoracic expansion?
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-posterior thorax
-T9-T10 area -small pinch of skin between thumbs -Deep breath -thumbs move apart symmetrically one inch |
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What is tactile fremitus and the possible findings?
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-palpable vibration
-transmitted signs: "blue moon or 99" -prominent around sternum and scapula -increases with more dense tissue -decreases with less or no tissue |
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What is ausculation of the respiratory system and how is done?
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-breathe slowly. Deeply through the mouth
-compare symmetry of like locations -stethoscope over lung tissue, not bony prominences -one cycle/one site -Anterior to 6th rib at the MCL, and 8th rib at MAL -posterior 10th at scapular line, 12th with a deep breath |
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What is a useful place to use to start counting ribs?
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The angle of Louis or sternal angle
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What marks the site of bifurcation of trachea into right and left main bronchi?
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The angle of Louis or sternal angle
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What are broncial sounds and where are they found?
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-found over large airways like trachea and manubrium
-high pitched, loud, hollow pipe sounds -short pause between inspiration and expiration -I<E expiratory sounds last longer than inspiratory sounds |
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What are bronchiovesicular sounds and where are they found?
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-2nd/3rd ICS
-Between scapula -softer than bronchial sounds, tubular quality -mainstem bronchi -I=E |
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What are vesicular sounds and where are they located?
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-soft, low pitched
-I>E -found in the periphery of lungs |
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How do you listen for bronchophony and what does it usually signify?
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-place stethopscope on chest
-patient says "99" *the sound is muffled/unclear in health -sound becomes clear with consolidation/patholgy |
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How do you listen for egophony and what does it signify?
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-place stethoscope on chest
-have patient say "eeeeeeeeee" -with consolidation it becomes "aaaaaaaaaaa" -prominent with pneumonia and pleural effusion |
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How doe you listen to whispered pectoriloquy and what does it signify?
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-place stethoscope on chest
-patient whispers: one, two, three -becomes more audible or distinct with pathology ex. pneumonia |
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List the adventitious breath sounds?
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-crackles fine or coarse
-pleural friction rub -rhonchi -wheezes -stridor -absent breath sounds |
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What are fine crackles?
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-high pitched sounds of short duration
-heard on inspiration -early inspration=obstructive disease -late inspiration=restrictive disease |
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What are coarse crackles?
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-low pitch sounds of long duration
-bubbling or gurgling sounds like blowing through a straw under water -Start with inspiration and may progress to expiration -may clear with coughing or suctioning -decreased surfactant -caused by pulmonary edema, decreased cuogh reflex with terminally ill |
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What is a pleural friction rub and what does it sound like?
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-pleural inflammation
-pleural surfaces rub together during respiration -heard on I and E --low pitch, grating quality -painful -caused by pleurisy, pneumonia, pleural effusion |
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What is rohonchi and what causes it?
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-large airway obstructed with secretions
-heard primarily on expiration -changes with cough or suctioning -a rumbling, snoring or rattling sound -caused by COPD or cystic fibrosis |
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What are wheezes and what causes them?
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-high pitched
-vibration of bronchial walls -starts with expiration and may progress to inspiration as obstruction increases -sometimes audible without stethoscope -caused by bronchospasm, asthma included, COPD |
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What is stridor and what causes it?
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-crowding sound, constant pitch, loud
-partial obstructon of larynx or trachea (upper airway obstruction) -lodged foreign body, croup, epiglottis, vocal cord edema after extubation |
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What controls the respirations?
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-chemoreceptors->responds to change in chemical composition (CO2 and pH)
-mechanical receptors-> stimulated by physiological factors |
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What are the respiratory's defense mechanisms?
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-filtration of air
-mucocilliary clearence -cough reflex -reflex bronchoconstriction -alveolar macrophages |
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What are some factors that could have an effect on our patient's respiratory system?
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-age
-past medical history -past surgical history -employment history -current medicatons |
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T or F
Respirations completely rely on pressure. |
True
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