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105 Cards in this Set
- Front
- Back
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adventitious breath sound
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added breath sound that is superimposed on normal breath sounds
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agonal respirations
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irregularly irregular respirations that signal impending death
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air trapping
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abnormal respiratory pattern with rapid , shallow respirations and forced expirations (barrell chest)
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alveoli (of the lung)
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smallest functional unit of the respiratory; where gas exchange occurs
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angle of Louis( sternal angle)
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junction of the manubrium and the sternum *sternal angle*
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anterior axillary line
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vertical line drawn from the origin of the anterior axillary fold along the anterolateral aspect of the thorax
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apex ( of the lung)
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top of the lung
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apnea
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lack of spontaneous respirations for 10 or more seconds
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apneustic respirations
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prolonged gasping in inspiration followed by a very short, inefficient pause that can last 30-60 seconds
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ataxic respirations
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irregularly irregular respiratory pattern caused by damage to the medulla
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barrell chest
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abnormal thorax configuration where the ratio of the antero posterior diameter to the transverse diameter of the chest is approximately 1:1
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base ( of the lung)
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bottom of the lung
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Biot's respirations
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ataxic respirations *damage to the medulla*
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bradypnea
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respiratory rate under 12 breaths per minute in a resting adult
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bronchial breath sound
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breath sound that is high in pitch and loud in intensity and that is heard best over the trachea, has a blowing or hollow quality heard longer in expiration than inspiration
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bronchophony
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voice sound where the patient says "99" or "123" to determine if the lung is filled with air, fluid , or a solid
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bronchovesicular breath sound
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breath sound that is moderate in pitch and intensity and that is heard best between the scapula and the 1st & 2nd intercostal spaces lateral to the sternum heard equally in inspiration & expiration
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Cheyne-Stokes respirations
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crescendo and decrescendo respiratory pattern interspersed between periods of apnea
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coarse crackle
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adventitious breath sound ( abnormal)
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costal angle
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angle formed by the intersection of the costal margins at the sternum
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costal margin
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medial border created by the articulation of false ribs
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cough
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tussive frenitus
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crepitus
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subcutaneous emphysema, beads of air escape from the lungs and create a crackling sound when palpated
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diaphragmatic excursion
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technique used to assess the patient's depth of ventilation
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dyspnea
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subjective feeling of shortness of breath
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egophony
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voice sound where the patient says the letter "ee" to determine if the lungs are filled with air, fluid, or a solid
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eupnea
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normal breathing, 12-20 respirations/minute
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false ribs
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rib pairs 8-10
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fine crackle
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groove separating the different lobes of the lungs
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fissure
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groove separating the different lobes of the lungs
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floating ribs
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rib pairs 11-12, they do not articulate at their anterior ribs
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hyperpnea
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breath that is greater in volume that the resting tidal volume
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intercostal space
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area between the ribs
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interpleural space
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mediastinum
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Kussmaul's respirations
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characterized by extreme increased rate and depth, as in DIABETIC KETOACIDOSIS
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kyphosis
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excessive convexity of the thoracic spine known as *Humpback*
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manubriosternal junction
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angle of Louis
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manubrium
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upper bone of the sternum, it articulates with the clavicles and the 1st pair of ribs
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mediastinum
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interpleural space
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midaxillary line
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vertical line drawn from the apex of the axilla, it lies midway between the anterior and posterior axillary lines
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midclavicular line
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vertical line drawn from the midpoint of the sternum
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midspinal line
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vertical line drawn from the midpoint of the spinous processes
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midsternal line
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vertical line drawn from the midpoint of the sternum
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orthopnea
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difficulty breathing except in an upright position
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parietal pleura
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lining of the chest wall and the superior surface of the lung
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pectus carinatum
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abnormal thorax configuration in which there is a marked portrusion of the sternum, known as *pigeon chest*
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pectus excavatum
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abnormal thorax configuration in which there is a depression in the lower body of the sternum known as *Funnel chest*
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pleura
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serous sac that encases the lung
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pleural friction frenitus
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palpable grazing that feels more pronounced on inspiration when there is and inflammatory process between the pleura
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pleural friction rub
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~continous~ adventitious breath sound caused by inflammed parietal & visceral pleura, it resembles a creaking or grating sound
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posterior axillary line
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vertical line drawn from the posterior axillary fold
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rhonchal frenitus
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coarse palpable vibration produced by the passage of air through thick exudate in the large bronchi or the trachea
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scapular line
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vertical line drawn from the *inferior* angle of the scapula
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scoliosis
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lateral curvature of the thoracic or lumbar vertebrae
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sibilant wheeze (ABS)
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high pitched, musical, adventitious breath sound
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sighing
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normal respiratory interrupted by a deep inspiration and followed by a deep expiration
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sonorous wheeze (ABS)
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low pitch, snoring, adventitious breath sound
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sputum
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substance produced by the respiratory tract and can be expectorated or swallowed, composed of mucous, blood, and purulent material, microorganisms cellular debris, & foreign objects
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sternal angle
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angle of Louis
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stridor (ABS)
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crowing adventitious breath sound
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suprasternal notch
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visible and palpable depression in the midsternal line superior to the manubrium
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tachypnea
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respiratory rate greater than 20 breaths/min!
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tactile frenitus
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palpable vibration of the chest wall that is produced by the spoken word
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thoracic expansion
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the extent and symmetry of the chest wall expansion
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true ribs
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vertebrosternal ribs
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tubular breath sound
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bronchial breath sound
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tussive frenitus
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palpable vibration produced by coughing
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vertebral line
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vertebrae
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vertebra prominens
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the long spinous process of the 7th cervical vertebra
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vertebrosternal ribs
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rib pairs 1-7 (true ribs), they articulate via the costal cartilage to the sternum
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vesicular breath sound
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low pitch and soft in intensity and is heard best over the peripheral lung, longer on inspiration than expiration
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visceral pleura
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lining of the sternal surface of the lungs
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vocal frenitus
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tactile frenitus
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voice sounds
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techniques used to assess whether the lungs are filled with fluid, air,or a solid
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vocal frenitus
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tactile frenitus
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whispered pectoriloquy
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where the pt whispers "99" or "123" to determine if lungs are filled with air, fluid, or solids
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xiphoid process
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cartilagenous process at the base of the sternum, it does not articulate with the ribs
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Where do lung apices extend?
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*anteriorly: 2.5-4cm superior to the inner 3rd clavicle
*posteriorly: near the T1 process |
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At what level is the border of lung?
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anteriorly at the MCl* 6th rib at the midclavicular line
*posteriorly on inspiration=level T12 *posteriorly on expiration=T10 |
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What is the normal shape of the thorax?
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Elliptical shape
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How do you determine the ratio of the AP diameter to the transverse diameter?
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Wider from side to side than front to back
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The normal costal angle is:
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<90* during exhalation and at rest.
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Bronchial sound...NORMAL breath
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Desc. HIGH PITCH, LOUD INTENSITY, BLOWING OR HOLLOW
Location: Trachea |
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Bronchovesicular sound...NORMAL breath
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Desc. MODERATE PITCH, MODERATE INTENSITY, COMBO OF BRONCHIAL & VESICULAR
Location: between scapulae 1st & 2nd ICS lateral to the sternum |
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Vesicular sound...NORMAL breath
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Desc. LOW PITCH, SOFT INTENSITY, GENTLE RUSTLING or BREEZY
Location: peripheral lung |
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Which 3 adventitious breath sounds do not clear with coughing?
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Fine crackle,
Pleural friction rub, Stridor |
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The 3 stimuli for breathing are:
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^CO2. v O2, ^Bph level
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Nailbed clubbing indicates...
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hypoxia
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Subcutaneous emphysema is also called...
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crepitus
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Risk factors for lung cancer include...
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smoking, second hand tobacco exporsure, smokers w/COPD, hereditary predisposition, occupational or environmental exposure to known carcinogens(asbestos, radon, heavy metals)
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Avoiding hyperventilation...
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Check for dizziness,
assess until pt's dizziness is gone and pt's breathing has returned to normal( baseline) |
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Adventitious Breath Sounds...
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1-Fine crackle, 2-coarse crackle, 3-sonorous wheeze, 4-sibilant wheeze, 5-pleural friction rub,6-stridor
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diaphragmatic excursion
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+4cm=normal distance
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Risk factors for Pneumonia...
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smoking, advanced age, underlying lung disease, malnutrition, intoxication, bedridden status, postoperative status, immunosuppressed status, decr. cough reflex, sedated or decr. consciousness, O2 therapy that is harboring bacteria
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Gerontological variations...
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anatomical changes, alveolar gas exchange, regulation of ventilation, lung defense mechanisms
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Thoracic landmarks ANTERIOR...
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sternum, clavicles, nipples
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Thoracic landmarks POSTERIOR...
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vertebra prominence, inferior angle of scapula, spine, 12th rib
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Lung cancer trends...
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Lung cancer is the primary cause of cancer death among men, and now surpases breast cancer as the No1 cause of cancer death among women
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Risk factors for TB!!
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Living in close contact or with another person who has active TB.
Malnourishment immunosuppressed status homelessness including living in shelters incarceration due to the close living quarters chronic diseases leading to decr. resistance IE. renal failure, COPD, alcoholism, diabetes mellitus, immigration from countries with TB prevalence*western europe* being a migrant farm worker |
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Abnormalities of shape of the thorax...
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barrell chest, pectus carinatum, pectus excavatum
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Respiratory rate EMERGENCIES!
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Extreme tachypnea >30breaths/min, bradypnea, and apnea require immediate intervention!!
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sleep apnea 2 types: 1st
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Central deep apnea, central respiratory drive is altered, leading to periods of respiratory cessation.
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sleep apnea 2nd:
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Obstructive sleep apnea, enlarged upper airway anatomy leads to a physical blockage in the oropharynx
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Cheyne-stokes respirations
(crescendo and decrescendo pattern) |
central cerebral or high brain stem lesions that occur in brain injury. This respirations are normal in children and elderly. periods of apnea last 15-30 seconds.
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Biot respirations or ataxic respirations
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indicates damage to the medulla, prolonged gasping during inspiration and very short inefficient expiration.
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