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105 Cards in this Set

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