Term
| The thorax consists anteriorly of what? |
|
Definition
| Sternum, manubrium, xiphoid process, and costal cartilages |
|
|
Term
| The thorax consists lateraly of what? |
|
Definition
|
|
Term
| The thorax consists posteriorly of what? |
|
Definition
|
|
Term
| Which ribs attach anteriorly to the sternum? |
|
Definition
|
|
Term
| Where do ribs 8,9, and 10 attach anteriorly? |
|
Definition
| Join with the costal cartilages just above them |
|
|
Term
| Which is greater in adults: Transverse diameter or Anteroposterior diameter? |
|
Definition
|
|
Term
| What are the primary muscles of respiration? |
|
Definition
| Diaphragm and intercostal muscles |
|
|
Term
| What happens when the diaphragm contracts? |
|
Definition
| Moves downward, lowering abdominal contents to increase the intrathoracic space |
|
|
Term
| What happens when the External intercostal muscles contract? |
|
Definition
| increase the AP chest diameter |
|
|
Term
| What happens when the internal intercostal contract? |
|
Definition
| Decrease the transverse diameter during expiration |
|
|
Term
| Name the "accessory" muscles used in respiration. When are they used? |
|
Definition
SCM and Trapezium
Used when there are pulmonary problems and compromise |
|
|
Term
| What does the mediastinum contain? |
|
Definition
| All the thoracic viscera except the lungs |
|
|
Term
| How many lobes do each lung have? |
|
Definition
|
|
Term
| The Lingula is located in which lung? What is its counterpart? |
|
Definition
| Lingula is located on the left lobe and is the counter part of the right middle lobe |
|
|
Term
| Where is the lesser horizontal fissure of the right lobe located? |
|
Definition
| At the level 5th rib in the axilla and the 4th rib anteriorly |
|
|
Term
| How many alveoli in a adult lobe? |
|
Definition
|
|
Term
| What limits the entire lung parenchyma's extension? |
|
Definition
| elastic subpleural tissue |
|
|
Term
| How much further up/anterior is the apex of the lung located in respect to the 1st lung? Posteriorly? |
|
Definition
4 cm above the 1st rib anteriorly
Level of T1 posteriorly |
|
|
Term
| Lowers borders of the lungs are _____ during inspiration and ______ during expiration |
|
Definition
| Lowers borders of the lungs are T12 during inspiration and T9 during expiration |
|
|
Term
| How long is the trachea? Its diameter? |
|
Definition
| 10 to 11 cm long, 2 cm in diameter |
|
|
Term
| What lies anterior to the esophagus and posterior to the isthmus of the thyroid? |
|
Definition
|
|
Term
| Where does the trachea divide into the right and left main bronchi? |
|
Definition
| T4 or T5 and just below the manubriosternal joint |
|
|
Term
| Which bronchus is wider, shorter, and more vertically placed? |
|
Definition
| The right bronchus is wider, shorter, and more vertically placed |
|
|
Term
| How many branches does the right main bronchi have? the left? |
|
Definition
| Right has 3 and left has 2 |
|
|
Term
| Name the breakdown of trachea |
|
Definition
| trachea --> R/L bronchus --> bronchial branches --> terminal bronchioles --> respiratory bronchioles --> acinus or terminal respiratory unit |
|
|
Term
| What does the acini consist of? |
|
Definition
| Respiratory bronchioles, alveolar ducts, alveolar sac, and alveoli |
|
|
Term
| What are some functions of the bronchi? |
|
Definition
| Transport air, trap noxious foreign particles in the mucus of their cavities and sweep them toward the pharynx with their cilia |
|
|
Term
| Where do the bronchial arteries come off? |
|
Definition
| Anterior thoracic aorta and the intercostal arteries |
|
|
Term
| Where is the bronchial vein formed? |
|
Definition
|
|
Term
| Most of the blood supplied by the bronchial arteries is returned via what? |
|
Definition
|
|
Term
| Which lung is higher anteriorly? |
|
Definition
| The right lung due to the fullness of the liver |
|
|
Term
| Anterior view of the right lung is mostly |
|
Definition
| RUL and RML and a Inferior lateral triangle made of RLL |
|
|
Term
| Anteriorly the oblique fissure is located |
|
Definition
| Stretching from the 5th rib at the axilla to the 6th rib at the midclavicular line |
|
|
Term
| The posterior view mainly consists of? How far do they extend? |
|
Definition
Lower lobes, except for at the apex
T3 to T10 or T12 during the respiratory cycle |
|
|
Term
| On a right lateral view, where is the lung located? |
|
Definition
| Extending from the peak of the axilla to the 7th or 8th rib. |
|
|
Term
| In a right lateral view, the upper lobe is demarcated at what rib level? |
|
Definition
5th rib at the mid-axillary line
6th rib more anteriorly |
|
|
Term
| On a left lateral view, the entire expanse is bisected by the oblique fissure where? |
|
Definition
| Level of the 3rd rib medially to the 6th rib anteriorly |
|
|
Term
| Posteriorly, what are the anatomical landmarks of the oblique fissure? |
|
Definition
| Starts at T3, follows rib 4 and hits the angle of the scapula |
|
|
Term
| The movement of air back and forth from the deepest reaches of the alveoli to the outside is called |
|
Definition
|
|
Term
| Gas exchange across the alveolar pulmonary capillary membranes is called? |
|
Definition
|
|
Term
| What is very sensitive to the H levels in the blood and spinal fluid? |
|
Definition
| Chemoreceptors in the medulla oblongata |
|
|
Term
| Where are the chemoreceptors that respond to changes in the Oxygen and Carbon dioxide located? |
|
Definition
| Carotid body at the bifurcaiton of the common carotid |
|
|
Term
| Nerve impulses in the Medulla are sent to where? |
|
Definition
| 2 subcenters in the pons, which regulate respiratory muscles |
|
|
Term
| Excessive levels of Carbon dioxide stimulate what? |
|
Definition
| The rate and depth of respiration |
|
|
Term
| What is the point in which the second rib articulates with the sternum called? |
|
Definition
| Angle of Lous ( Manubriosternal junction) |
|
|
Term
| How is the costal angle formed? |
|
Definition
| Formed by the blending together of the costal margins at the sternum |
|
|
Term
| Vertebra perominens refers to? |
|
Definition
|
|
Term
| Spinous process from which level down project obliquely? |
|
Definition
|
|
Term
| First breath of the Infant is more often accompanied by which emotional feeling? |
|
Definition
|
|
Term
| The lung is a groove on the ventral wall of the gut at which week of gestation? |
|
Definition
|
|
Term
| After birth, the decrease in pulmonary pressure causes what? |
|
Definition
| Closure of the foramen ovale within minutes |
|
|
Term
| After birth, the increased oxygen tension in the arterial blood stimulates what? |
|
Definition
| Contraction and closure of the ductus arteriosus |
|
|
Term
| When is the lungs fully developed? |
|
Definition
|
|
Term
| Newborn's is generally what shaped? What is the circumference equal to? |
|
Definition
Round, AP=Transverse,
The circumference is equal to the head |
|
|
Term
| Pregnant women's Transverse diameter increase by ____, and an increase in circumference by _______. |
|
Definition
| Pregnant women's Transverse diameter increase by 2 cm, and an increase in circumference by 5 to 7 cm. |
|
|
Term
| Subcostal angle in pregnant women is increased to what? |
|
Definition
|
|
Term
| How high does the diagphragm at rest rise in pregnant women? |
|
Definition
|
|
Term
| Minute ventilation increases by _____ with a corresponding ______ increase in alveolar pressure |
|
Definition
| Minute ventilation increases by 30% to 50% with a corresponding 50% to 70% increase in alveolar pressure |
|
|
Term
| In pregnant women, increased tidal volume appears to account for the increase in what? |
|
Definition
|
|
Term
| What occurs as a result from loss of muscle strength in the thorax and diaphragm in older adults coupled with the loss of lung resiliency? |
|
Definition
|
|
Term
| Skeletal changes in older adults tend to emphasize what curve? Which results in what? |
|
Definition
Dorsal curve of the thoracic spine
Results in increased AP chest diameter |
|
|
Term
| Decrease in the alveolar surface available for gas exchange and loss of some tensile strength in the muscles of respiration results in ? |
|
Definition
| Under ventilation of the alveoli in the lower lung fields and a decreased tolerance for exertion |
|
|
Term
| In older adults, the changes seen has a net result in? |
|
Definition
decrease in Vital Capacity
Increase in residual volume |
|
|
Term
| Chest pain does not generally originate in the heart when? |
|
Definition
1. There is a constant achiness that lasts all day
2. It stays in one position
3. It is made worse by pressing on the precordium
4. It is a fleeting, needle like jab that lasts only a second or two
5. It is situated in the shoulders or between the shoulder blades in the back. |
|
|
Term
| What drug can cause tachycardia, hypertension, coronary arterial spasm (with infarction), and pneumothorax with severe acute chest pain being the common result |
|
Definition
|
|
Term
| What is the sequnce of steps in examination of the chest and lungs? |
|
Definition
Inspection
Palpation
Percussion
auscultation |
|
|
Term
| Dullness with percussion is present in which two examples? |
|
Definition
| pleural effusion and lobar pneumonia |
|
|
Term
| How can you differentiate between pleural effusion and lobar pneumonia? |
|
Definition
| Breath sounds are absent in pleural effusion and breath sounds are bronchial in lobar pneumonia |
|
|
Term
| Tactile fremitus is absent when what exists? Increased with? |
|
Definition
Absent with effusion
Increased with lobar pneumonia |
|
|
Term
| Barrel chest is the result of what? Give 3 examples |
|
Definition
compromised respiration
1. Chronic asthma
2. emphysema
3. cystic fibrosis |
|
|
Term
| Describe how the trachea, ribs, spine, and sternal angle looks in a barrel chest |
|
Definition
Trachea is posteriorly displaced
Ribs are more horizontal
Spine some what kyphotic
Sternal angle more prominent |
|
|
Term
| What is the expected "thoracic ratio"? At what ratio is there most often a problem? |
|
Definition
Normal .7 to .75
Problem >1 |
|
|
Term
| Prominent sternal protrusion is called |
|
Definition
| Pectus carinatum aka pigeon chest |
|
|
Term
| Funnel chest aka pectus excavatum is the _______________ |
|
Definition
| indentation of the lower sternum above the xiphoid process |
|
|
Term
| Where should you check for cyanosis or pallor? |
|
Definition
| Skin, nails, lips, and nipples |
|
|
Term
| Intrathoracic infection will often make the breath smell _________ |
|
Definition
|
|
Term
| Supernumerary nipples are often a sign of congenital abnormalities in ____ children |
|
Definition
| Supernumerary nipples are often a sign of congenital abnormalities in White children |
|
|
Term
| Superficial venous patterns over the chest indicates what? |
|
Definition
| Sign of heart disorders or vascular obstruction or disesase |
|
|
Term
| Inferior borders of the lungs cross which rib at the mid clavicular line? |
|
Definition
|
|
Term
| Anterior axillary lines begin at what? |
|
Definition
|
|
Term
| Scapular lines run through what? |
|
Definition
| inferior angle of the scapula when the patient is erect |
|
|
Term
| what is the normal respiration per min? What is the ratio of respiration to heart beat? |
|
Definition
12 to 20 respiration/min
1:4 |
|
|
Term
|
Definition
| difficult and labored breathing with shortness of breath |
|
|
Term
| Dyspnea is commonly observed with what? |
|
Definition
| Pulmonary or cardiac compromise |
|
|
Term
| Shortness of breath that begins or increase when the patient lies down is called |
|
Definition
|
|
Term
| If a patient needs to sleep on more than one pillow means that the patient has |
|
Definition
|
|
Term
Name condition:
A sudden onsite of shortness of breath after a period of sleep; sitting is helpful. |
|
Definition
| Paroxysmal nocturnal dyspnea |
|
|
Term
Name condition:
Dyspnea increase in the upright posture |
|
Definition
|
|
Term
| Name the 10 "P"s for the dyspnea of rapid onset |
|
Definition
Pneumonia
Pneumothorax
Pulmonary constriction/Asthma
Peanut
PUlmonary emobolus
Pericardial tamponade
Pump failure
Peak seekers
psychogenic
poisons |
|
|
Term
Name condition:
Varying periods of increasing depth interspersed with apnea |
|
Definition
|
|
Term
Name condition:
Slower thatn 12 breaths per min |
|
Definition
|
|
Term
Name condition:
Faster than 20 breaths per min |
|
Definition
|
|
Term
Name condition:
Faster than 20 breaths per min, deep breathing |
|
Definition
| hyperventilation, hyperpnea |
|
|
Term
Name condition:
Frequently interspersed deeper breath |
|
Definition
|
|
Term
Name condition:
Rapid, deep, labored |
|
Definition
|
|
Term
Name condition:
Irregularly intersperesed periods of apnea in a disorganized sequence of breaths |
|
Definition
|
|
Term
Name condition:
significant disorganization with irregular and varying depths of respiration |
|
Definition
|
|
Term
| Name conditions that increase the rate and depth of breathing |
|
Definition
Acidosis ( metabolic)
CNS lesion (Pons)
Anxiety
Aspirin poisoning
Oxygen need (hypoxemia)
Pain |
|
|
Term
| Name conditions that decrease the rate and depth of breathing |
|
Definition
Alkalosis ( metabolic)
CNS lesions ( cerebrum)
Myasthenia gravis
narcotic overdoses
obesity (extreme) |
|
|
Term
| What kind of breathing will you observe in a patient with trauma to the chest, like a broken rib or pleurisy? |
|
Definition
|
|
Term
| Massive liver enlargement or ascites will also cause ______ |
|
Definition
| Massive liver enlargement or ascites will also cause rapid shallow breathing |
|
|
Term
| ___________ is the eponym applied to the respiratory effort associated with metabolic acidosis |
|
Definition
| Kussmaul breathing is the eponym applied to the respiratory effort associated with metabolic acidosis |
|
|
Term
Name condition:
Abnormally shallow respirations |
|
Definition
|
|
Term
| A patient with pleuritic pain that limits excursion will often develop what kind of breathing? |
|
Definition
|
|
Term
| Cheyne stokes breathing is normally seen in who? |
|
Definition
| Children and older adults may breath in this pattern during sleep |
|
|
Term
| Patients who are serioulsy ill, particularly those with brain damage at the cerebral level or with drug caused respiratory compromise will exhibit what kind of breathing? |
|
Definition
| Cheyne stokes respiration |
|
|
Term
| An occasional deep, audible sigh that punctuates an other wise regular respiratory pattern is aossciated with what? |
|
Definition
| emotional disress or an incipient episode of more severe hyperventilation |
|
|
Term
| When are sighs significant? |
|
Definition
| Only when they exceed the infrequent and relatively inconsequential signs of daily life |
|
|
Term
| _______ is the result of a prolonged but inefficient expieratory effort |
|
Definition
| Air trapping is the result of a prolonged but inefficient expieratory effort |
|
|
Term
| Name 3 things that Biot respiration is usually associated with? |
|
Definition
Severe and peristent increased intracranial pressure
Respiratory compormise resulting from drug poisoning
brain damage at the level of the medulla |
|
|
Term
| Which muscle are used when breathing is labored? |
|
Definition
|
|
Term
| Thoracic respiration is primarily the result of the use of _____________ |
|
Definition
Thoracic respiration is primarily the result of the use of intercostal muscles
|
|
|
Term
| Diaphragmatic respiration is primarily the result of what? |
|
Definition
| Diaphragm responding to intrathoracic pressure |
|
|
Term
| _________ respiration involves contraction of the diaphragm and the interplay of the abdominal musles |
|
Definition
| Abdominal respiration involves contraction of the diaphragm and the interplay of the abdominal musles |
|
|
Term
| It is not unsual to see _________ respiration, particulary in very young infants |
|
Definition
| It is not unsual to see abdominal respiration, particulary in very young infants |
|
|
Term
Men are more likely to use what kind of respiration?
Pregnant women? |
|
Definition
Men, diaphragmatic respiration
Pregnant women, thoracic |
|
|
Term
| IF the costal angle is wider then 90 degrees what should you check for? |
|
Definition
| Tumor, aneurysm, enlarged heart |
|
|
Term
|
Definition
| Obstruction to inspiration at any point in teh respiratory tract |
|
|
Term
| Why does the musculature "pull back" in an effort to over come blockage? |
|
Definition
| Because the intrapleural pressure becoming increasingly negative |
|
|
Term
| When obstruction is high in the respiratory tree, breathing is characterized by ________ |
|
Definition
| When obstruction is high in the respiratory tree, breathing is characterized by Stridor |
|
|
Term
| When does paraodix breathing occur? |
|
Definition
| When a neg intrathoracic pressure is transmitted to the abdomen by a weakened poorly functioning diaphragm |
|
|
Term
| Clubbing is usually _____ and ______ |
|
Definition
| Clubbing is usually Symmetric and painless |
|
|
Term
Name condition:
Absence of spontaneous respiration |
|
Definition
|
|
Term
| Which is self limited, Primary or Secondary apnea? |
|
Definition
Primary apnea is self limited, not uncommon after a blow to the head
Secondary apnea is grave, it will not begin spontaneously unless resuscitatie measures are immediately instituted |
|
|
Term
| Any event that severely limited the absorpotion of oxgyen into the blood stream will lead to __________ |
|
Definition
| Any event that severely limited the absorpotion of oxgyen into the blood stream will lead to secondary apnea |
|
|
Term
| Apneustic breathing is characterized by what? |
|
Definition
| Long inspiration and what amounts to expiration apnea |
|
|
Term
| The neural center for control of respiration is where? |
|
Definition
|
|
Term
| The apnea of prematurity is a more intesne version of _______ |
|
Definition
The apnea of prematurity is a more intesne version of periodic apnea of the newborn
|
|
|
Term
| Upper airway is obstructed when there is |
|
Definition
1. Inspiratory Stridor ( with a ratio with expiration of more than 2:1)
2. A hoarse cough or cry
3. flaring of the alae nasi
4. retraction at the suprasternal notch |
|
|
Term
| When the upper airway is obstructed severely, patient will exhibit ____ |
|
Definition
1. Stridor is inspiratory and expiratory
2. Cough is barking
3. Retraction also involve the subcostal and intercostal spaces
4. cyanosis is obvious even with blow by oxygen |
|
|
Term
| What will the patient exhibit if the obstruction is above the glottis? |
|
Definition
1. Stridor tends to be quieter
2. The voice is muffled, as if there is a hot potato in the mouth
3. cough is not a factor
4. Head and neck may be awkwardly position ot preserve the airway (extended with retropharyngeal abcess, head to the affected side with peritonsillar absecess) |
|
|
Term
| When the obstruction is below the glottis, the patient will exhibit |
|
Definition
1. Stridor tends to be louder, more rasping
2. The voice is hoarse
3. swallowing is not affected, cough is harsh, barking
4. positioning of the head is not a factor |
|
|
Term
| Pursing of the lips is an accompaniment of _________ |
|
Definition
| Pursing of the lips is an accompaniment of increased expiratory effort |
|
|
Term
| Chronic fibrotic changes within the lung, chronic cyanosis of congenital heart disease, or cystic fibrosis is associated with what? |
|
Definition
|
|
Term
| _____ and _____ are not associated with clubbing |
|
Definition
| Asthma and emphysema are not associated with clubbing |
|
|
Term
| ______ is a common sign of air hunger, particularly when the alveoli are considerably involved |
|
Definition
| Flaring of the alae nasi duirng respiration is a common sign of air hunger, particularly when the alveoli are considerably involved |
|
|
Term
| Crepitus, a gentle bubbly feeling, indcates what? |
|
Definition
Air in the subcuatneous tissue from a rapture somewhere in the respiratory system
or
by infection with a gas producing organisim |
|
|
Term
| Palpable, coarse, grating vibration, usually on inspiration suggests what condition? |
|
Definition
| plearual friction rub caused by inflammation of the pleural surfaces. |
|
|
Term
| When evaluating thoracic expansion, where should you place your thumbs? |
|
Definition
| along the spinal process at the level of the 10th rib |
|
|
Term
| Fremitus is best felt parasternally at where? |
|
Definition
| 2nd intercostal space at the level of the bifurcation of the bronchi |
|
|
Term
| Decreased or absent fremitus may be caused by ? |
|
Definition
Excess air in the lungs
Emphysema
Pleural thickening
Effusion
Massive pulmonary edema
bronchial obstruction |
|
|
Term
| INcreased fremitus occurs with |
|
Definition
Presence of fluid or a solid mass within the lungs
heavy but no obstructive bronchial secretions
compress lung
tumor
lung consolidation |
|
|
Term
| With mediastinitis, the trachea is pushed _____ |
|
Definition
| With mediastinitis, the trachea is pushed forward |
|
|
Term
| Palpable pull out of midline with respiration is called a _________ |
|
Definition
| Palpable pull out of midline with respiration is called a tug |
|
|
Term
Type of Tone: Resonant
Intensity
Pitch
Duration
Quality |
|
Definition
Type of Tone: Resonant
Intensity: Loud
Pitch : low
Duration: Long
Quality: Hollow |
|
|
Term
Type of Tone: Flat
Intensity
Pitch
Duration
Quality |
|
Definition
Type of Tone: Flat
Intensity: Soft
Pitch : High
Duration : Short
Quality : Very dull |
|
|
Term
Type of Tone: Dull
Intensity
Pitch
Duration
Quality |
|
Definition
Type of Tone: Dull
Intensity : Medium
Pitch : Medium to High
Duration : Medium
Quality : dull thud |
|
|
Term
Type of Tone: Tympanic
Intensity
Pitch
Duration
Quality |
|
Definition
Type of Tone: Tympanic
Intensity : Loud
Pitch : High
Duration : medium
Quality : drumlike |
|
|
Term
Type of Tone: Hyperresonant
Intensity :
Pitch :
Duration :
Quality : |
|
Definition
Type of Tone: Hyperresonant
Intensity : Very loud
Pitch : Very low
Duration : longer
Quality : booming |
|
|
Term
| What is the expected sound? |
|
Definition
|
|
Term
| Hyperresonance associated with hyperinflation may indicate what? |
|
Definition
Emphysema
Pneumothorac
asthma |
|
|
Term
| Dullness or flatness suggests? |
|
Definition
Atelectasis
Pleural effusion
Pneumothorax
asthma |
|
|
Term
| Percussion over the abdomen is associated with which type of tone? |
|
Definition
|
|
Term
Name condition associated with:
Sweet, fruity |
|
Definition
|
|
Term
Name condition associated with:
fishy, stale |
|
Definition
|
|
Term
Name condition associated with:
ammonia-like |
|
Definition
|
|
Term
Name condition associated with:
Musty fish, clover |
|
Definition
| fetor hepaticus: Hepatic failure, portal vein thrombosis, portacaval shunts |
|
|
Term
Name condition associated with:
Foul, feculent |
|
Definition
| Intestinal obstruction/diverticulum |
|
|
Term
Name condition associated with:
Foul, putrid |
|
Definition
Nasal/sinus pathology: infection, foreign body,
cancer:
respiratory infeciotns: empyema, lung abscess, bronchiectasis
|
|
|
Term
Name condition associated with:
halitosis |
|
Definition
| Tonsilitis, gingivits, respiratory infections, vincent angina, gastroesophageal reflux |
|
|
Term
Name condition associated with:
Cinnamon |
|
Definition
|
|
Term
| What kind of sound might be lost if using a stethoscope instead of directly listening to it with your ear? |
|
Definition
|
|
Term
| What sound is heard over most of the lung fields; is low pitch; is soft and short expiration; more prominent in a thin person or a child, diminished in the overweight or very muscular patient |
|
Definition
|
|
Term
| What sound is heard over main bronchus area and over upper right posterior lung filed; medium pitch; expiration equals inspiration? |
|
Definition
|
|
Term
| What type of sound is heard only over trachea; is high pitch; loud and long expiration, sometimes a bit longer than inspiration? |
|
Definition
| Bronchial/tracheal (tubular) |
|
|
Term
| Which side of the stethoscope is used for listening to the lungs? Why |
|
Definition
| The diaphgram, it transmit the ordinarily high pitched sounds better and because it provides a broader area of sound |
|
|
Term
| If a patient have CHF, where should you begin auscultation? |
|
Definition
| At the base of the lung to detect crackles that may disappear with continued exaggerated respiration |
|
|
Term
| Where is the right middle lung and lingula best heard? |
|
Definition
| IN the respective axillae |
|
|
Term
| Breathing that resembles the noise made by blowing across the mouth of a bottle is defined as? |
|
Definition
|
|
Term
| Amphoric sound is most often heard with what? |
|
Definition
| large, relatively stiff walled pulmonary cavity or a tension pneumothorax with bronchopleural fistula |
|
|
Term
| Cavernous breathing is commonly heard over a pulmonary cavity in which the wall is __________ |
|
Definition
|
|
Term
| _______ sound are discontinuous while _____ and ________ are continuous |
|
Definition
| crackles sound are discontinuous while Ronchi and Wheezes are continuous |
|
|
Term
| What is a abnormal respiratory sound heard more often duirng inspiration and characterized by discrete discontinous sounds, each lasting just a few milliseconds? |
|
Definition
|
|
Term
| High pitched crackles are called _____, the more low pitched are termed _________. |
|
Definition
| High pitched crackles are called sibilant, the more low pitched are termed sonorous. |
|
|
Term
| Crackles with a dry quality, more crips than gurgling, are apt to occur where? |
|
Definition
| Higher in the respiratory tree |
|
|
Term
| What sound is deeper, more rumbling, more pronounced during expiration, more likely to be prolonged and continous, and less discrete than crackles? |
|
Definition
| Rhonchi (sonorous wheezes) |
|
|
Term
|
Definition
| Passage of air thorugh an airway obstructed by thick secretions, muscular spasm, new growth, or external pressure |
|
|
Term
Name sound:
High pitched, discrete, discontinuous crackling sounds heard during the end of inspiration; not cleared by a cough |
|
Definition
|
|
Term
Name sound:
Lower, more moist sound heard during mid-stage of inspiration; not cleared by a cough |
|
Definition
|
|
Term
Name sound:
Loud, bubbly noise heard during inspiration; not cleared by a cough |
|
Definition
|
|
Term
Name sound:
Loud, low, coarse sounds like a snore most often heard continuously during inspiration or expiration, coughing may clear sound ( usually means mucus accumulation in trachea or large bronchi) |
|
Definition
| Rhonchi ( Sonorous wheeze) |
|
|
Term
Name sound:
Musical noise sounding like a squeak; most often heard continuously during inspiration or expiration; usually louder during expiration |
|
Definition
| Wheeze ( sibilant wheeze) |
|
|
Term
Name sound:
Dry, rubbing, or grating sound, usually caused by inflammation of pleural surfaces; heard during inspiration or expiration; loudest over lower lateral anterior surface |
|
Definition
|
|
Term
| What is termed white noise? |
|
Definition
| Radio static like sound lacking musical pitch |
|
|
Term
| What disease is associated with the ever present concern about pulmonary infarction and a pulmonary crisis? |
|
Definition
|
|
Term
| Clue: patient instinctiely sits up and learn forward to breath easier |
|
Definition
|
|
Term
Name sound:
This sound is someitmes thought as a form of rhonchus. It is continous, high-pitched, muscial sound ( almost a whistle) heard during inspiration or expiration. |
|
Definition
| Wheeze ( sibilant wheeze) |
|
|
Term
| Wheeze is caused by air flowing through what? |
|
Definition
| Narrowed or obstructed airway |
|
|
Term
| Bilaterally heard wheeze is normally caused by what? If unilateral? |
|
Definition
Bilateral: brochospasm of asthma
Unilateral: foreign body |
|
|
Term
| Consistent wheezing or whistle of single pitch at the site of compession can be caused by what? |
|
Definition
| Tumor compressing part of the bronchial tree |
|
|
Term
| If infection is the source of wheezing, the organism is usually a what? |
|
Definition
|
|
Term
| Friction rub heard of liver or spleen has no________ |
|
Definition
| Friction rub heard of liver or spleen has no significance |
|
|
Term
| Friction rub heard over ther lungs is caused by what? |
|
Definition
|
|
Term
| Friction rub over the pericardium suggests ________ ; over the lungs ________ |
|
Definition
| Friction rub over the pericardium suggests percardidtis ; over the lungs pleurisy |
|
|
Term
| Where is the hamman sign found? |
|
Definition
| AKA mediastinal crunch is found with mediastinal emphysema |
|
|
Term
| What sounds are synchronous with the heartbeat and not particularly so with respiration, but the sounds can be more pronounced toward the end of expiration? |
|
Definition
| Mediastinal crunch ( Hamman sign) |
|
|
Term
| The mediastinal crunch is best heard when the patient _______ |
|
Definition
The mediastinal crunch is best heard when the patient leans to the left or lies down on the left side
|
|
|
Term
| If air and fluid is simulatneously present and you shake the patient, what will you hear? |
|
Definition
|
|
Term
| vocal resonance is greater in ____ |
|
Definition
| vocal resonance is greater in men |
|
|
Term
|
Definition
| greater clarity and increased loudness of spoken sound |
|
|
Term
| When e sounds like stuffy broad a |
|
Definition
|
|
Term
If your patient comes in with flu like fever, achiness, sniffles, pleural effusion and little else they might have what?
If you dont catch it in time what else would they develope? |
|
Definition
Anthrax
Respiratory distress, cyanosis, shock and coma |
|
|
Term
| What profession has a higher risk of contracting anthrax? |
|
Definition
Postal workers
People who handle wool or animal hides, wastes, hair |
|
|
Term
Name disease:
Generally transmitted patient to patient and presents with a prodrome lasting 3 to 4 days, characterized by nonspecific headache, chills, fever, and generalized aches and pains. |
|
Definition
|
|
Term
| When do the skin lesions begin to appear in small pox? Where do they first appear? |
|
Definition
After the temperature drops
1st in the face and upper extremity |
|
|
Term
| What is a common complication of small pox? |
|
Definition
|
|
Term
Name the disease:
Begins with nonspecific fever and malaise, and even mental confusion and a possible staggering gait. |
|
Definition
|
|
Term
| _________ is a valuable indicator of the amount of air that is expelled after the patient takes a maximal inspiration and follows that with a maximal expiration |
|
Definition
| Vital Capacity is a valuable indicator of the amount of air that is expelled after the patient takes a maximal inspiration and follows that with a maximal expiration |
|
|
Term
| What variables influence vital capacity? |
|
Definition
Dimensions of chest cage
posture
gender
age
height
degree of physical fitness |
|
|
Term
| __________ a measure of the maximum flow of air that can be achieved during forced expiration |
|
Definition
| Peak expiratory flow rate a measure of the maximum flow of air that can be achieved during forced expiration |
|
|
Term
|
Definition
| Ask the patient to exhale and hold the breath. count the seconds until breath must be taken and multiply by 50 to get the number of cc's of FVC |
|
|
Term
Name the cause:
Sputum is yellow, green, rust ( blood mixed with yellow sputum), clear, or transparent; purulent; blood streaked; mucoid, viscid |
|
Definition
|
|
Term
Name the cause:
Sputum is Mucoid, viscid; blood streaked ( not common) |
|
Definition
|
|
Term
Name the cause:
Sputum particularly abundant int he early morning; slight, intermittent blood streaking, occasionally large amounts of blood |
|
Definition
| chronic infectious disease |
|
|
Term
Name the cause:
slight persistent blood streaking |
|
Definition
|
|
Term
Name the cause:
blood clotted; large amounts of blood |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Depressed respiration often has its origins where? |
|
Definition
| In the maternal environment during labor, such as sedatives or compromised blood supply to the child; or it may result from mechanical obstruction by mucus |
|
|
Term
| Can a apgar score be considered absolute? |
|
Definition
|
|
Term
| Healthy, full term infant has a chest circumference of what? |
|
Definition
|
|
Term
| How many centimeters less is a newborn's chest circumference to that of it's head? |
|
Definition
|
|
Term
| Difference between the chest and head circumference of a newborn increase with what? |
|
Definition
| Increase with prematurity |
|
|
Term
| In what circumstance will the newborn's chest circumference be relatively larger? |
|
Definition
| Infant of a poorly controlled diabetic mother |
|
|
Term
| The distance between the nipples is about what? |
|
Definition
| 1/4 the circumference of the chest |
|
|
Term
| What is the incidence of supernumerary nipples in black is ______ of 1000; in whites its ________ in 1000. |
|
Definition
Blacks: 11.4 / 1000
Whites: 0.9 / 1000 |
|
|
Term
| Supernumerary nipples in whites are associated with what? |
|
Definition
| Variety of congenital abnormalities |
|
|
Term
| Cyanosis of the hands and feet is called what? |
|
Definition
|
|
Term
| Is acrocyanosis in the newborn a cause of concern? |
|
Definition
| No, common in the newborn and can persist for several days in a cool environment |
|
|
Term
| Do Babies delivered by C-section generally have a more rapid rate than babies delivered vaginally? |
|
Definition
|
|
Term
| Babies are obligate ________ breathers. |
|
Definition
| Babies are obligate NOSE breathers |
|
|
Term
| What type of breathing is common in newborns? |
|
Definition
|
|
Term
| When does periodic breathing become a cause of concern? |
|
Definition
| If the apneic episodes tend to be prolonged and the baby becomes centrally cyanotic |
|
|
Term
| In term infants, when should periodic breathing stop? |
|
Definition
|
|
Term
APGAR score 0
Heart Rate:
Resp effort:
Muscle tone:
Response to catheter in nostril:
Color: |
|
Definition
APGAR score 0
Heart Rate: Absent
Resp effort: Absent
Muscle tone: Limp
Response to catheter in nostril: NO response
Color: Blue or pale |
|
|
Term
APGAR score 1
Heart Rate:
Resp effort:
Muscle tone:
Response to catheter in nostril:
Color: |
|
Definition
APGAR score 1
Heart Rate: Slow (< 100 bpm_
Resp effort: Slow or irregular
Muscle tone: Some flexion of extremities
Response to catheter in nostril: grimace
Color: body pink, extremities blue |
|
|
Term
APGAR score 2
Heart Rate:
Resp effort:
Muscle tone:
Response to catheter in nostril:
Color: |
|
Definition
APGAR score 2
Heart Rate: > 100 bpm
Resp effort: Good crying
Muscle tone: active motion
Response to catheter in nostril: cough or sneeze
Color: completely pink |
|
|
Term
| ______ is rare in the newborn and should be considered a problem |
|
Definition
| Coughing is rare in the newborn and should be considered a problem |
|
|
Term
| Frequent hiccuping can indicate what? |
|
Definition
| Seizures, drug withdrawl, encephalopathy |
|
|
Term
| Newborns rely primarily on what to breath? |
|
Definition
|
|
Term
| If Gastrointestinal gurgling sounds are persistently heard in the chest, what should you suspect? |
|
Definition
|
|
Term
| How often does a diapgragmatic Hernia occure? |
|
Definition
|
|
Term
| Name 2 conditions that can be differentiated and their sites localized using a double-bell stethoscope in a newborn |
|
Definition
| Atelectasis and pneumothorax |
|
|
Term
| A mechanism by which the infant tries to expel trapped air or fetal lung fluid while trying to retain air and increase oxygen levels. |
|
Definition
|
|
Term
Give the Resp per Min
Newborn:
1 yr:
3 yr:
6 yr:
10 yr:
17 yr: |
|
Definition
Give the Resp per Min
Newborn: 30 to 80
1 yr: 20 to 40
3 yr: 20 to 30
6 yr: 16 to 22
10 yr: 16 to 20
17 yr: 12 to 20 |
|
|
Term
| What should you be concerned with if the roundness of the child's chest persists past the 2nd year of life? |
|
Definition
Chronic obstructive pulmonary problem,
exp : cystic fibrosis |
|
|
Term
| The breath sound of the young child may sound _____, ________, and more _____ than those of the adult |
|
Definition
| The breath sound of the young child may sound louder, harsher , and more bronchial than those of the adult |
|
|
Term
| What kind of sound is common in the young child? |
|
Definition
|
|
Term
T/F
Loss of resonance in a young child is of no imporance |
|
Definition
False;
if you sense some loss of resonance, give it as much importance as you would give frank dullness in the adolescent or adult |
|
|
Term
| Pregnant women have a ____ in FRC |
|
Definition
| Pregnant women have a decrease in FRC |
|
|
Term
| IN pregnant women, therie is a increase of ____ to _____ in vital capacity |
|
Definition
| IN pregnant women, therie is a increase of 100 ml to 200ml in vital capacity |
|
|
Term
| How much does the tidal volume increase? |
|
Definition
|
|
Term
| HOw does a pregnant women increase her ventilation? |
|
Definition
| By breathing more deeply, not more frequently |
|
|
Term
| In older adults, thoracic spine is _____ with _____ of the lumbar curve |
|
Definition
| In older adults, thoracic spine is prominent with flattening of the lumbar curve |
|
|
Term
|
Definition
|
|
Term
Name the condition:
Mucus of the bronchi is chronically inflammed, recurrent bacterial infections are common. Dyspnea is present although not severe, and cough and sputum are impressive |
|
Definition
|
|
Term
| What condition can result in right ventricular failure with dependent edema? |
|
Definition
|
|
Term
Named condition:
Chronic dilation of the bronchi or bronchioles is caused by repeated pulmonary infections and bronchial obstruction |
|
Definition
|
|
Term
| What is the Kartagener syndrome and what is it characterized by? |
|
Definition
| An Autosomal recessive condition, characterized by bronchiectasis, sinusitis, dextrocardia, and male inferitility |
|
|
Term
Name the condition:
Most severe COPD, a condition in which air may take over and dominate space in a way that disrupts fxn.
Alveolar walls are permanently damaged and reduced in number.
Chornic bronchiectasis is a precursor |
|
Definition
|
|
Term
Name the condition:
Overinflated lungs tend ot be hyperresonsnat on percussion.
Prolongerd expiraotry effort, longer than 4 to 5 seconds to expel air
Dyspnea is common even at rest
Unproductive cough |
|
Definition
|
|
Term
Name Condition:
Coughs, chronic and often excessive sputum production, an dyspnea are prominent features |
|
Definition
|
|
Term
| When should you expect airway obstruction? |
|
Definition
| When forced expiration is greater than 4 to 5 seconds |
|
|
Term
| Bronchiolitis occurs most often in what age group? |
|
Definition
| Infants younger than 6 months |
|
|
Term
Name condition:
Hyperinflation of the lungs
Expiration is difficult
Viral |
|
Definition
|
|
Term
Name condition:
Floppiness of the trachea or airway, a lack of rigidity |
|
Definition
|
|
Term
Name condition:
Infant has trouble breathing |
|
Definition
| respiratory distress syndrome |
|
|
Term
| Who has the highest risk of RDS? |
|
Definition
| White males and the 2nd twin |
|
|
Term
Name condition
Child awakens suddenly, frightened, with a harsh, bark like cough |
|
Definition
|
|
Term
| Does fever accompany CROUP? |
|
Definition
|
|
Term
| What is the age range of CROUP? Who gets it more? |
|
Definition
|
|
Term
Name Condition:
Acute, life threatening disease almost always caused by H. influenzae type B. |
|
Definition
|
|
Term
Name condition:
Begins suddenly and progress rapidly, often to full obstruction of the airway and resulting in death.
Occurs most often between the ages of 3 and 7 |
|
Definition
|
|
Term
Name condition:
Child is sitting straight up with neck extended and head held forward, appears very anxious and ill, unable to swallow, and is drooling from an open mouth; cough is not common. Fever may be high. Epiglottis appears beefy red |
|
Definition
|
|
Term
Name condition:
Autosomal recessive disorder of exocrine glands involving lungs, pancreas, and sweat glands |
|
Definition
|
|
Term
Name condition:
Older than 40 yrs, history of venous thromboembolism, surgery with anesthesia, longer than 30 mins, heart disease, cancer, fracture of the pelvis and leg, obesity, and acquired or genetic thrombophilia |
|
Definition
|
|
Term
Name condition:
Pleuritic chest pain in the absence of dyspnea |
|
Definition
|
|
Term
Name condition:
Massive disease of the lungs causes gradual obstruction that produces a more gradual hypertrophy of the right ventricle, increased stress and ultimate heart failure. |
|
Definition
|
|
Term
| Lung cancer generally refers to_______ |
|
Definition
|
|
Term
Name condition:
Presence of blood in the pleural cavity |
|
Definition
|
|
Term
| Coin click will be absent in what condition? |
|
Definition
| Hemothorax, with no air or if blood predominates |
|
|
Term
Name condition:
Presence of air or gas in the pleural cavity |
|
Definition
|
|
Term
Name condition:
Positive coin click |
|
Definition
|
|
Term
Name condition:
Unexplained but persistent tachycardia may be a clue to what? |
|
Definition
|
|
Term
Name condition:
Entire resp tract may be overwhelmed by interstitial inflammation and necrosis extending throughout the bronchiolar and alveolar tissue |
|
Definition
|
|
Term
Name condition:
Inflammatory response of the bronchioles and alveolar space to an infective agent
Exudates lead to lung consolidation, resulting in dyspnea, tachypnea, and crackles |
|
Definition
|
|
Term
Name condition:
Well defined, circumscribed mass defined by inflammation, suppuration, and subsequent central necrosis |
|
Definition
|
|
Term
Name condition:
Percussion note is dull and breath sounds distant or absent over the affected area |
|
Definition
|
|
Term
Name condition:
Fluid collected in the pleural spaces is purulent exudate, arising most commonly from adjacent infected, sometimes traumatized tissue |
|
Definition
|
|
Term
Name condition:
Breath sounds are distant or absent in the affected area, the percussion note is dull, vocal fremitus is absent, and the patient is often febrile and tachypneic and appears ill |
|
Definition
|
|
Term
| What is Grocco's triangle? |
|
Definition
| Right angled area of dullness over the posterior chest, which can sometimes be percussed opposite a large pleural effusion, the diaphragm on the horizontal of the triangle, the spinous process the vertical. |
|
|
Term
| Name condition: excessive nonpurulent fluid in the pleural space can result in permanent fibrotic thickening |
|
Definition
|
|
Term
Name condition:
Inflammatory process involving the visceral and parietal pleura, often the result of pulmonary infections, bacterial or viral, and sometimes associated with neoplasm or asbestosis. |
|
Definition
|
|
Term
Name condition:
Pleura becomes dry, actually edematous and fibrinous, making breathing difficult |
|
Definition
|
|
Term
Name condition:
inflammation of the mucous membranes of the bronchial tube |
|
Definition
|
|
Term
Name condition:
incomplete expansion of the lungs at birth or the collapse of the lung at any age |
|
Definition
|
|
Term
| A high birth weight ( > 4.5 kg) babies is in increased risk of what? |
|
Definition
|
|
Term
Name condition:
COPD characterized by airway inflammation and generally resulting from airway hyperactivity triggered by allergens, anxiety, upper resp infection, smoke, or exercise. |
|
Definition
|
|
