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Phys. Assess Ch. 18
Lungs & Thorax
| Question | Answer |
|---|---|
| What is the thoracic cage? | a body structure with a conical shape, narrower at top |
| What is the thoracic cage defined by? | the sternum, ribs and vertebrae |
| How many ribs are there? | 12 |
| How many thoracic vertebrae are there? | 12 |
| What is the floor of the thoracic cage? | diaphragm |
| What is the diaphragm? | a musculotendinous septum that separates the thoracic cavity from the abdomen |
| What ribs are floating? | 11 and 12 |
| What are costochondral junctions? | are the points at which the ribs join their cartilage |
| Where is the suprasternal notch? | between the clavicles |
| What are the 3 parts of the sternum? | manubrium, body, and xiphoid process |
| What is the angle of loius? | the articulation of the manubrium and body of the sternum |
| Where is the inferior border of the scapula? | lower tip is usually at the 7th or 8th rib |
| what is the mediatrinum? | The middle section of the thoracic cavity containing the esophagus, trachea, health and great vessels |
| What contain the lungs? | plureal cavities |
| Where is the apex of the lung? | just below the clavicle |
| Where is the base of the lung? | resting on the diaphragm |
| Which lung is shorter? | right |
| Which lung is narrower? | left |
| Which lung has 3 lobes? | right |
| The oblique fissure crosses? | the 5th rib in the midaxillary line and terminates at the 6th rib in the midclavicular line |
| The right lungs contains the horizontal fissure which divides the? | right upper and middle lobes |
| What does the pleurae form? | an envelope between the lungs and the chest wall |
| What does the visceral pleura line? | the outside of the lungs |
| What does that parietal pleura line? | inside of the chest wall and diaphragm |
| What is the pleural cavity filled with? | lubricating fluid |
| The trachea lies? | anterior to the esophagus |
| What does the trachea and bronchi do? | transport gases between the environment and the lung parenchyma |
| The bronchial tree protects? | alveoli from small particulate matter in the inhaled air |
| What do goblet cells secrete? | mucus that entraps the particles |
| What is an acinus? | a functional respiratory unit that consists of the bronchioles, alveolar ducts, alveolar sacs and the alveoli |
| What are the four main functiosn of the resp. system? | supply oxygen, remove carbon dioxide, maintaining homeostatsis, and maintaining heat exchange |
| Hypoventilaation causes carbon dioxide to? | build up in the blood, slow breathing |
| Hyperventilation causes carbon dioxide to be? | blown off, fast breathing |
| what is hypercapnia? | increases carbon dioxide in the blood |
| What is hypoxemia? | decreased oxygen in the blood |
| The mechanical expansion and contraction of the chest caviity alters the size of the thoracic container in 2 dimiensions? | ther vertical diameter lengthens or shortens, and the anteroposterior diameter increases or decreases |
| What is surfactant? | the complex lipid substance needed for sustained inflation of the air sacs |
| How many aveoli do we have at adolesence? | 300 million |
| An aging lung is? | more rigid and harder to inflate |
| A growing fetus increases? | oxygen demand |
| aging lung changes result in? | small airway closure, and that yields a decreased vital capacity |
| What is vital capacity? | the maximum amount of air that a person can expel from thel ungs after first filling the lungs to maximum |
| What is increased residual volume? | the amount of air remaining in the lungs even after the most forceful expiration |
| The size of the thoracic cavity influences? | pulmonary functioning as determined by vital capacity and forced expiratory volume |
| subjective data on the lungs? | cough, shortness of breath, chest pain, history of infections, smoking, environmental exposure, self care |
| Continuous throughout the day cough? | acute illness |
| Afternoon/evening? | may reflect exposure to irritants at work |
| Night cough? | post nasal drip |
| Early morning cough? | chronic bronchial inflammation on smokers |
| Chronic bronchitis is characterized by? | a hx of porductive cough |
| white or clear mucoid? | bronchitis |
| Yellow or green mucoid? | bacterial infection |
| rust color mucoid? | TB |
| Pink frothy mucoid? | pulmonary edema |
| How to describe cough? | dry, hacking, barking, hoarse |
| Determine how much activity causes? | shortness of breath |
| What is orthopena? | difficulty breathing when supine |
| What is paroxysmal nocturnal dyspnea? | is awakening from sleep with SOB and needing to be upright to achieve comfort |
| Carbon monoxide causes? | headache, dizzy |
| sulfer dioxide causes? | cough, congestion |
| What are self care behaviors for the lung? | last TB shot, pnemonia |
| How many colds is expected for child? | 4-6 a year |
| What are skeletal deformities of the thoracic cage? | scoliosis, kyphosis |
| How do you confirm symmetric chest expansion? | placing hands on the posterolater chest wall with thumbs at the level of T9 or T10 |
| Unequal chest expansion occurs with? | atelectasis or pneumonia |
| What are fremitus? | palpable vibration |
| Where is fremitus most prominate? | between the scapulae and around the sternum |
| Rhonchal fremitus is palpable with? | thick bronchial secretions |
| Pleural friction fremitus is palpable with? | inflammation of the pleura |
| What is crepitus? | coarse crackling sensation palpable over the skin surface |
| What is resonance? | low pitched, clear, hollow sound that predominates in healthy lung tissue in the adult |
| What is hyperresonance? | lower pitched booming sound found when too much air is present |
| What is the first step in diaphragmatic excursion? | exhale and hold it |
| What is the second step in the diaphragmatic excursion? | take a deep breath and hold it |
| What should diaphragmatic excursion be? | 3-5 |
| What are the 3 types of breath sounds? | bronchial, Bronchovesicular, and vesicular |
| What are adventitious sounds? | added sounds tha tare not normally heard in the lungs |
| Adventitious sounds are caused by? | moving air colliding with seretions in the tracheocronchial passageways |
| What are rales? | crackles |
| What is a wheeze? | rhonchi |
| What are atelectatic crackles? | short, popping, crackling sounds that sound like fine crackles but do not last beyond a few breaths |
| Atelectatic crackles are only heard in the? | periphery |
| Normal voice transmission is? | soft, muffled and indistint |
| Pathology that increases lung density enhances? | transmission of voice sounds |
| Sonsolidation of compression of lung tissue will? | enhance the voice sounds, making words more distinct |
| Cerebral hypoxia is? | excessive drowsiness or by anxiety, restlessness or irritability |
| What is clubbing? | distal phalanx occurs with chronic repiratory disease |
| Normal relaxed breathin is? | automatic and effortless, regular, even and no noise |
| Noisy breathing occurs with? | asthma or chronic bronchitis |
| Enequal chest expansion occurs with? | part of the lung is obstructed or collapsed |
| retraction suggests? | obstrution of respiratory tract or increased inspiratory effect is needed |
| What is used to force expiration is COPD | rectus abdominis and intertal intercostal |
| Abnormally wide costal angle with little inspiratory variation occurs with? | emphysema |
| A lag of expansion occurs with? | atelectasis, pneumonia, and postoperative guarding |
| What is forced expiratory time? | the number of seconds it takes for the person to exhale from total lung capacity to residual volume |
| What is the normal time for full expiration? | 4 seconds |
| A forbed expiration of 6 seconds or more occurs with ? | obstructive lung disease |
| What is a pulse ox? | noninvasive method to assess arterial oxygen saturation |
| What is the 6 minute distance walk? | safer, simple, enexpensive, clinical measure of functional status in aging aduts |
| What is the 6MD used for? | as an outcome measure for people in pulmonary rehabilitation |
| What is harrisons groove? | horizontal groove in the rib cage at the level of the insertion of the diaphragm |
| What does the apgar scoring system measure? | the successful transition to extrauterin life |
| Harrisons groove also occurs from? | rickets |
| What is a newborn's major respiratory muslce? | diaphragm |
| What is normal resp rates for a newborn | 30-40 bpm |
| rapid resp. rates accompany? | pnemonia, fever, pain, heart disease and anemia |
| tachpnea 50-100 in an infant during sleep may be early sign of? | heart failure |
| Rachitic rosary is common in children with? | rickets or scurvey |
| crackles only in upper lung occur with? | cystic fibrosis |
| Crackles only in lower lung fields occur with? | heart failure |
| What is stridor? | high pitched inspiratory crowing sound heard without the stethoscope, occurring in upper airway obstruction |
| What is kyphosis? | outward curvature of the thoracic spine |
| What is barral chest? | equal anteroposterior to transverse diamete and ribs are horizontal instead of the normal downward slope |
| What is pectus excavatum? | sunken sternum and adjacent cartilages |
| What is pectus carinatum? | forward protrusion of the sternum, with ribs sloping back at either side and vertical depression along costochondral junctions |
| Wha is scoliosis? | lateral S shaped curvature of spine |
| What is kyphsis? | an exaggerated posterior curvature of the spine (humpback) |
Created by:
alicia.rennaker
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