Assessment - Respiratory

Front 1

What is the upper airway composed of?

Back 1

Nose, mouth, laryngopharynx, larynx

Front 2

What is the lower airway composed of?

Back 2

trachea, bronchi, bronchioles, alveoli

Front 3

Which lung has 3 lobes, 2?

Back 3

right, left

Front 4

What do you observe for when assessing respiratory system?

Back 4

Deformities, Slope of ribs, Abnormal retraction or bulging, Local lag or impairment of respiratory movement, Rate, Rhythm

Front 5

What is characterized by a rounded chest appearance seen in infants and COPD patients?

Back 5

Barrel Chest

Front 6

What is it called when the sternum projects forward and the chest looks like that of a chicken or pigeon? Seen in Atrial or Ventricular defects that may cause pulmonary HTN.

Back 6

Pectus carinatum

Front 7

What is the disorder when the sternum points posteriorly and may cause abnormal pressure on the heart which could affect function. May cause respiratory failure.

Back 7

Pectus excavatum

Front 8

An exaggerated curvature of the thoracic vertebrae. Happens to women. Adequate exercise decreases it.

Back 8

Kyphosis

Front 9

A lateral curvature of the thoracic and lumbar spine. Unequal shoulder and scapulae height.

Back 9

Scoliosis

Front 10

An exaggerated curvature of the lumbar vertebrae

Back 10

Lordosis

Front 11

Ribs normal slope

Horizontal rib slope seen in what patients.

Back 11

45 degree angle

Emphysema

Front 12

What does abnormal retraction or bulging indicate?

Back 12

Asthma, emphysema, pleural effusion, tension pneumothorax

Front 13

What does unilateral local lag indicate?

Back 13

Respiratory movement impairment

Front 14

Whats the normal respiratory rate?

Back 14

12-20

Front 15

> 20 respiratory rate

seen when?

Back 15

tachypnea

fever, pain, anxiety, anemia, pneumonia, pleurisy, lesion in pons

Front 16

< 12 Respiratory rate

seen when?

Back 16

bradypnea

Increased ICP, diabetic coma, opiate OD, brain tumor

Front 17

total absence of breathing

Back 17

apnea

Front 18

increased depth of respirations that can result from exercise or DKA

Back 18

hyperpnea

Front 19

increase in rate and depth of respirations, blowing off co2 and taking in less o2.

Back 19

hyperventilation

Front 20

a gradual increase in respirations with rate and depth, then a decrease over a cycle of 30-45 seconds. Periods of apnea will alternate. CHF, RF, OD and end of life

Back 20

Cheyne-Stokes

Front 21

like cheyne-stokes but same depth of breathing

Back 21

Bitos

Front 22

Panting labored respiration with increased rate and depth

occurs in acidodic patients

Back 22

Kussmaul's respirations

Front 23

What part of your hand do you use to palpate for tenderness?

Back 23

Finger pads of dominant hand

Front 24

What indicates subcutaneous air under the skin?

Back 24

Crepitus

Front 25

What test is done this way:

o Performed to assess range and symmetry of respiratory movement. Place your thumbs at the level of and parallel to the tenth ribs. Your hands should be grasping the lateral rib cage. As you position your hands, slide them medially to raise loose skin folds between the thumbs and spine. Ask the person to inhale deeply as you note the chest move upward and outward. Watch for excursion of the thumbs (they should move outward as the person inhales and move inward when the person exhales). A picture with a more detailed description is provided in your Jarvis textbook. Unequal chest expansion can result from pleural effusion , rib fractures, pneumothorax, and tumors.

Back 25

Respiratory Excursion

Front 26

What is the test that occurs this way:

Have the patient fold their arms across their chest. This will shift the scapulae out of the way. Ask the person to repeat the words, ninety- nine or one-one-one, every time you touch the posterior chest using the palmar surface of your dominant hand. Jarvis textbook shows a picture of hand placement for the posterior chest. Your dominant hand is preferrable because this omits any discrepancies in the findings if there is a difference in the sensitivities of the examiner's hands. The examiner moves back and forth from one side of the posterior chest to the other covering first the upper lobes of the lungs to the lower lobes

Back 26

Vocal or tactile fremitus

Front 27

Where should vibrations be the strongest at with fremitus?

Back 27

tracheal bifrication and major bronchus

Front 28

When will you have decreased fremitus?

Back 28

Obstructed bronchus, COPD, pleural thickening, pneumothorax, emphysema, pleural effusion

Front 29

When will you have increased fremitus?

Back 29

mass, consolidated area such as in pneumonia

Front 30

What is the normal resonant sound?

Back 30

Loud and low pitched

Front 31

Lung tumors, pneumonia, pleural effusion, and atelectasis will elecit what kind of sound?

Percussing the chest

Back 31

Dull

Front 32

Emphysema or pneumothorax will elecit what kind of sound

Percussing the chest

Back 32

hyperresonant

Front 33

What's the normal range for diaphragmatic excursion for men and women

Back 33

Women 3-5cm

men 5-7cm

Front 34

What are normal breath sounds?

Back 34

Bronchial, Vesicular, Bronchiovesicular

Front 35

What are soft, low pitched rustling sounds over the periphery of the lungs? Occurs in inspiration. Most predominant breath sound.

Back 35

Vesicular

Front 36

What are high pitched tubular sounds located over the trachea and major bronchi. Louder and longer during expiration

Back 36

Bronchial

Front 37

What are moderately pitched breath sounds?

Back 37

Bronchiovesicular

Front 38

What breath sounds are heard posteriorly?

Anteriorly?

Back 38

Bronchiovesicular, Vesicular

Bronchiovesicular, Vesicular, Bronchial

Front 39

What are noises created when air is traveling through vessels containing abnormal moisture?

Back 39

Crackles

Front 40

What are soft and high pitched noises that sound like two hairs being rubbed together?

Back 40

Fine Crackles

Front 41

What are coarse rattling sounds more like a snore, moan, or groan caused by narrowed or constricted large airways. More pronounced on expiration.

Back 41

Rhonchi

Front 42

What are high pitches sounds produced by air passing through a narrowed passageway in the small airways.

Back 42

Wheezes

Front 43

 Crackling, grating sounds produced when two roughened or inflamed pleural spaces rub across each other during respiration. Heard on both inspiration and expiration. Painful.

Back 43

Friction rub

Front 44

 loud, high pitched crowing sound heard usually without a stethescope during inspiration. Caused by an upper airway obstruction. Requires immediate attention.

Back 44

Stridor

Front 45

Anxiety, dyspnea, stridor, wheezes, decreased or absent breath sounds, use of accessory muscles, inability to speak (complete obstruction), cyanosis, and seesaw movement of chest.

Back 45

Upper airway obstruction

Front 46

Person to say, "ninety-nine" while you auscultate the posterior chest. Normally, the sound should be muffled and indistinct. If the sound is clear, it is called

Back 46

bronchophony

Front 47

Instruct the person to say, "ee" while you auscultate the posterior chest. Normally, the sound should be muffled and indistinct. If the sound is heard as "ay", it is

Back 47

egophany

Front 48

Instruct the person to whisper "ninety-nine" while you auscultate. The sound should be very faint and indistinct. If the sound is louder and clear, it is called

Back 48

whispered pectoriloqy

Front 49

What do you examine the anterior chest for?

Back 49

Shape, Width of costal angle, Abnormal retraction or bulging, use of accessory muscles, local lag or impairment, Measure Anteroposterior (AP) to lateral diameter - should be 1:2

Front 50

When will you observe an increase in AP diameter?

Back 50

Older adults, barrel chest, pectus carinatum (pigeon chest)