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17 Cards in this Set
- Front
- Back
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Visual examination of the chest is of value in assessing...
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Thoracic Configuration
Vent. Pattern and Effort Central Cyanosis (Thoracic area, caused by hypoxemia) Scars |
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Normal Adult Thorax
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Antrposterior diameter is less than transverse diameter
Normally about 1:2 ratio |
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Barrel-chested Thorax
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Anterposterior diamter becomes equal to transverse diameter
1:1 ratio Severe COPD (most common) Ribs loose angle of slope and become horizontal |
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Pectus Carinatum
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Sternal Protrusion anteriorly
Abnormal prominence of the sternum AKA Pigeon breast or chicken breast |
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Pectus Excavatum
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Depression of all or part of the sternum
Causes a restrictive lung defect Congenital (born with) |
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Kyphosis
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Spinal deformity in which the spine has an abnormal anterposterior curvature
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Scoliosis
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Spinal deformity in which the spine has a lateral curvature
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Kyphoscoliosis
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Combo of Kyphosis and Scoliosis
May produce severe restrictive lung defect Poor lung expansion |
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What should you see with normal inspiration and exhalation?
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Slight rise in upper abdomen 2ndary contraction of diaphragm muscle
Lateral costal expansion progressing upward 2ndary contraction of external intercostal muscles Chest wall expands equally and bilaterally Pause |
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Prolonged Inspiratory Time 2:1 could be caused by?
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Upper airway obstruction (croup, epiglottitis)
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Prolonged Exhalaiton 3:1 or 4:1 could be caused by?
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small airways obstruction (COPD, Asthma)
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Resp. Failure
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When breathing muscles fail
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Abnormal Patterns and Effort
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Use of Acc. muscles of Insp.
Use of Ab. muscles during exhalation Rapid & Shallow - Restrictive Lung Disease Slow and prolonged exhaltation - obstruction of Intrathoracic airways (COPD, Asthma) |
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Paradoxical Patterns/Effort
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Abnormal Pattern and Effort
Acc. muscles of inspiration pull chest wall upward Diaphragm fatigues- gets pulled upward on inspiration causing abdomen to sink inward on inspiration IE. muscle paralysis, diaphragmatic fatigue *Neonates will have a sunken chest and abs pull out |
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Respiratory Alternans
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Abnormal Pattern and Effort
Periods of breathing using only the chest wall muscles alternating with Periods of breathing normal breathing using the diaphragm muscle Indicative of diaphragmatic fatigue |
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Hoover's Sign
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Abnormal Pattern and Effort
Typically seen in severe COPD -diaphragm muscle is flattened -severe hyperinflation due to air trapping Contraction of the diaphragm muscle pulls lower lateral rib margins inward on inspiration |
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Central Cyanosis
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Skin color of the chest (trunk) is cyanotic
May also be seen in oral mucosa |
