Thorax/lungs/breast/axillae2

Front 1

is the movement of the thoracic diaphragm during breathing.Normal Diaphragmatic excursion should be 3-5 cm, but can be increased in well conditioned persons to 7-8 cm. This measures the contraction of the diaphragm. It is performed by asking the patient to exhale and hold it. The provider then percusses down their back in the intercostal margins (bone will be dull) starting below the scapula, until sounds change from resonant to dull (lungs are resonant,sSolid organs should be dull). That is where the provider marks the spot. Then the patient takes a deep breath in and holds it as the provider percusses down again, marking the spot where the sound changes from resonant to dull again. Then the provider will measure the distance between the two spots. Repeat on the other side, is usually higher up on the right side. If it is less than 3-5 cm the patient may have a pneumonia or a pneumothorax in which a chest x-ray is diagnostic for either.

Back 1

Diaphragmatic excursion

Front 2

exaggerated resonance on percussion.Greater than normal resonance, often of a lower pitch, on percussion of the body.

Back 2

hyperresonance

Front 3

Assessment of the movement of the chest during respiration; s expansion bilateral and symmetrical, is there restricted mobility? That sort of thing.

Back 3

Respiratory excursion:

Front 4

: an abnormal condition of the bronchial tree characterized by irreversible dilation and destruction of the bronchial walls. The condition is sometimes congenital but is more often a result of bronchial infection or of obstruction by a tumor or an aspirated foreign body. Symptoms include a constant cough producing copious purulent sputum; hemoptysis; chronic sinusitis; clubbing of fingers; and persistent moist, coarse crackles. Some of the complications of bronchiectasis are pneumonia, lung abscess, empyema, brain abscess, and amyloidosis. Treatment includes frequent postural drainage, expectorants, antibiotics, and, rarely, surgical resection of the affected part of the lungs

Back 4

Bronchiectasis

Front 5

acute or chronic inflammation of the mucous membranes of the tracheobronchial tree. Caused by the spread of upper respiratory viral or sometimes bacterial infections to the bronchi, it is often observed with or after childhood infections, such as measles, whooping cough, diphtheria, and typhoid fever. See also chronic bronchitis, chronic obstructive pulmonary disease, respiratory syncytial virus.

Back 5

Bronchitis:

Front 6

-----listed as Cheyne-Stokes respiration (CSR): [ John Cheyne: William Stokes, Irish physician, 1804-1878] an abnormal pattern of respiration, characterized by alternating periods of apnea and deep, rapid breathing. The respirator cycle begins with slow, shallow breaths that gradually become abnormally rapid and deep. Breathing gradually becomes slower and shallower and is followed by 10-20 seconds of apnea before the cycle is repeated. Each episode may last from 45seconds to 3 minutes. Underlying CSR is a complex alteration in the functioning of the respiratory center in the brain, caused by dysfunction of the diencephalon or by bilateral hemispheric lesions. The respiratory center may have a reduced sensitivity to the concentrations of the blood gases, as is seen in cerebrovascular disease, in tumors of the brainstem, and in sever head injury. CSR may be triggered by changes in blood chemical processes, especially in elderly patients with degenerative arterial disease or respiratory diseases, such as bronchopneumonia. In an otherwise healthy person, CSR may be caused by hyperventilation, exposure to high altitudes, or an overdose of a narcotic or hypnotic drug. CSR occurs more frequently during sleep. Also called agonal respiration, periodic breathing

Back 6

Cheyne-Stokes

Front 7

:a. the combining of separate parts into a single whole. 2. a state of solidification. 3.(in medicine) the process of becoming solid, as when the lungs become firm and inelastic in pneumonia

Back 7

Consolidation

Front 8

: a common, abnormal respiratory sound consisting of discontinuous bubbling noises heard on auscultation of the chest during inspiration. Fine crackles have a popping sound produced by air entering distal bronchioles or alveoli that contain serous secretions, as in congestive heart failure, pneumonia, or early tuberculosis. Coarse crackles may originate in the larger bronchi or trachea and have a lower pitch. Crackles are not cleared by coughing. Formerly called rale, Compare rhonchus, wheeze

Back 8

Crackle

Front 9

: 1. flatulence or the noisy discharge of fetid gas from the intestine through the anus. 2. a sound or feel that resembles the crackling noise heard when rubbing hair between the fingers or throwing salt on an open fire. Crepitus is associated with gas gangrene, rubbing of bone fragments, air in superficial tissues, or crackles of a consolidated area of the lung in pneumonia.

Back 9

Crepitation/crepitus

Front 10

: a distressful subjective sensation of uncomfortable breathing that may be caused by many disorders, including certain heart and respiratory conditions, strenuous exercise, or anxiety. Also spelled dyspnea. Also called breathlessness

Back 10

Dyspnea

Front 11

an abnormal condition of the pulmonary system, characterized by overinflation and destructive changes in alveolar walls. It results in a loss of lungs elasticity and decreased gas exchange. When emphysema occurs early in life, it is usually related to a rare genetic deficiency of serum alpha-1-antitrypsin, which inactivates the enzymes leukocyte collagenase and elastase. More common causes are air pollution and cigarette smoking. Acute emphysema may be caused by the rupture of alveoli during severe respiratory efforts, as may occur in acute bronchopneumonia, suffocation, whooping cough, and occasionally, labor. Patients with chronic emphysema may also have a component of chronic bronchitis. Emphysema also occurs after asthma or tuberculosis, conditions in which the lungs are over-stretched until the elastic fibers of the alveolar walls are destroyed. In old age the alveolar membranes atrophy and may collapse, producing large, air-filled spaces and a decreased total surface area of the pulmonary membranes.

Back 11

Emphysema:

Front 12

: tactile/ vocal: a tremulous vibration of the chest wall caused by vocalization that is primarily palpated during physical examination. Kinds of fremitus include tactile fremitus and vocal fremitus.

Back 12

Fremitus

Front 13

: an exaggerated deep, rapid, or labored respiration. It occurs normally with exercise and abnormally with aspirin overdose, pain, fever, hysteria, or any condition in which the supply of oxygen is inadequate, such as cardiac disease and respiratory disease. Also spelled hyperpnoea.

Back 13

Hyperpnea

Front 14

: pulmonary ventilation rare greater than that metabolically necessary for gas exhange, resulting from an increased respiration rate, an increased tidal volume, or both. Hyperventilation causes an excessive intake of oxygen and elimination of carbon dioxide and may cause hyperoxygenenation. Hypocapnia and respiratory alkalosis then occur, leading to dizziness, faintness, numbness of the fingers and toes, possibly syncope, and psychomotor impairment. Causes of hyperventilation include asthma or early emphysema; increased metabolic rate caused by exercise, fever, hyperthyroidism, or infection; lesions of the central nervous system, as in cerebral thrombosis, encephalitis, head injuries, or meningitis; hypoxia or metabolic acidosis; use of hormones and drugs, such as epinephrine, progesterone, and salicylates; difficulties with mechanical respirators; and psychogenic factors, such as acute anxiety or pain.

Back 14

Hyperventilation

Front 15

:abnormally deep, very rapid sighing respirations characteristic of diabetic ketoacidosis.

Back 15

Kussmaul’s breathing

Front 16

:an abnormal condition in which a person must sit or stand to breathe deeply or comfortably. It occurs in many disorders of the cardiac and respiratory systems, such as asthma, pulmonary edema, emphysema, pneumonia, congestive heart failure, and angina pectoris. Assessment includes noting the number of pillows used by the patient. Patients with orthopnea also report sleeping in recliners. Also spelled orthopnea

Back 16

Orthopnea

Front 17

----pleural pericardial rub: an abnormal coarse, grating sound heard on auscultation of the lungs during the late inspiration and early expiration. It occurs when the visceral and parietal pleural surfaces rub against each other. The sound is not affected by coughing. A pleuropericardial rub indicates primary inflammatory, neoplastic, or traumatic pleural disease or inflammation secondary to infection or neoplasm. Also called pleural friction rub.

Back 17

Pleural friction rub

Front 18

: the presence of air or gas in the pleural space, causing the lung to collapse. Pneumothorax may be the result of an open chest wound that permit the entrance of air, the rupture of an emphysematous vesicle on the surface of the lung or sever bout of coughing. It may also occur spontaneously without apparent cause.

Back 18

Pneumothorax

Front 19

: 1.an echo or other sound produced by percussion of an organ or cavity of the body during a physical exam. 2. the process of energy absorption by an object that is tuned to absorb energy of a specific frequency. Other frequencies have no effect. 3. (in magnetic resonance0 the frequency at which a nucleus absorbs radio energy when placed in a magnetic field.

Back 19

Resonance

Front 20

an abnormal sound heard on auscultation of an airway obstructed by thick secretions, muscular spasm, neoplasm, or external pressure. The continuous rumbling sound is more pronounced during expiration and characteristically clears on coughing, whereas gurgles do not.

Back 20

Rhonchus/rhonchi(pl.):

Front 21

: an abnormal high pitched musical sound caused by an obstruction in the trachea or larynx. It is usually heard during inspiration. Stridor may indicate several neoplastic or inflammatory conditions, including glottic edema, asthma, diphtheria, laryngospasm, and papilloma.

Back 21

Stridor

Front 22

an abnormally rapid rate of breathing (more than 20 breaths per minute in adults), such as seen with hyperpyrexia. Also spelled tachypnea.

Back 22

Tachypnea:

Front 23

1. a form of rhonchus, characterized by a high-pitched or low-pitched musical quality. It is caused by a high-velocity flow of air through a narrowed airway and is heard during both inspiration and expiration. It may be caused by bronchospasm, inflammation, or obstruction of the airway by a tumor or foreign body. Wheezes are associated with asthma and chronic bronchitis. Unilateral wheezes are characteristic of bronchogenic carcinoma, foreign bodies, and inflammatory lesions. In asthma, expiratory wheezing is more common, although inspiratory and expiratory wheezes are heard. 2. to breathe with a wheeze.

Back 23

Wheeze:

Front 24

: pertaining to the bronchi or bronchioles. : pertaining to the trachea

Back 24

Bronchial/tracheal

Front 25

: pertaining to the bronchi, bronchioles, and alveoli.

Back 25

Bronchovesicular

Front 26

: pertaining to a blister like condition.

Back 26

Vesicular

Front 27

an increase in the intensity and clarity of vocal resonance that may result from an increase in lung tissue density, such as in the consolidation of pneumonia. Assessed by having the patient repeat a phrase such as 99 during auscultation.

Back 27

Bronchophony: