Term
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Definition
| C7- T1 (bony prominence at base of neck) |
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Term
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Definition
| 3-4 cm above inner third of clavicles |
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Term
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Definition
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Term
|
Definition
| T10-T12 (with inspiration) |
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Term
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Definition
Apex of axilla to 7th - 8th rib midaxillary line |
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Term
Anterior Tracheal Bifurcation |
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Definition
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Term
Posterior Tracheal Bifurcation |
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Definition
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Term
Lower lobes of lungs are most visible from the: |
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Definition
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Term
Upper/middle lobes of lungs are most visible from the: |
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Definition
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Term
Lateral view of lungs contains which lobes? |
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Definition
| Mixture of upper and lower |
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Term
The scapula corresponds to which ribs? |
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Definition
Top = Rib 3
Bottom/tip = rib 8 |
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Term
Xyphoid process approximates which rib? |
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Definition
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Term
Another name for Angle of Louis |
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Definition
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Term
| Which rib attaches at Angle of Louis? |
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Definition
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Term
Right and left oblique fissures are found where? |
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Definition
T3 - 5th rib midaxillary line
Anteriorly and medially to 6th rib MCL |
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Term
Right horizontal fissure is found where? |
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Definition
5th rib just posteriorly to midaxillary line to 4th rib at right sternal border |
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Term
| Normal findings for shape of thorax |
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Definition
AP diamter < transverse
AP transverse diamter ratio 1:2
In children up to 6 and eldery AP = T
Ribs should slope 45 degrees relative to spine
Spinous processes should be straight |
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Term
| Normal findings for nails |
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Definition
No clubbing, normal color
Surface slightly curved or flat (angle 160 degrees or less) |
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Term
Accessory muscles for thorax |
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Definition
Trapezius
Sternocleidomastiod
Scalenus |
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Term
Inspiratory wheeze audible without stethoscope |
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Definition
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Term
Sputum color for bronchitis/cold |
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Definition
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Term
| Sputum color for bacterial infection |
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Definition
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Term
Sputum color for fluid in pleural cavity |
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Definition
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Term
| Continuous cough indicates: |
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Definition
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Term
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Definition
| exporsure to irritants at work |
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Term
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Definition
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Term
|
Definition
| chronic bronchial infection of smokers |
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Term
| Normal findings for spine |
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Definition
| no scoliosis, kyphosis, or lordosis |
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Term
| To assess ___________, place thumbs 3-5 cm apart on chest. Anteriorly, place along ______________. Posteriorly, place hands at _______________. |
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Definition
Thoracic expansion
Costal margin
T9-T10 |
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Term
| To assess for _____________, have patient repeat "99." |
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Definition
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Term
| What causes decreased fremitus? |
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Definition
| Obstruction, or anything that creates barrier between lung and thoracic wall |
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Term
| What causes increased fremitus? |
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Definition
| compression/consolidation of tissue (pneumonia, lung tumor) |
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Term
| Ahen assessing diaphragmatic excursion, percuss which side, anterior or posterior? |
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Definition
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Term
| In diaphragmatic excursion, which side is normally higher, and why? |
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Definition
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Term
| Inspection findings for pneumonia |
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Definition
| Cyanotic, coughing, tripod, shortness of breath/increased respirations |
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Term
| Expansion findings for pneumonia |
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Definition
Shorter distance
unequal chest expansion
guarding
lag on expansion on affected side |
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Term
| Diaphragmatic excursion findings for pneumonia |
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Definition
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Term
| Percussion findings for pneumonia |
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Definition
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Term
| Tactile fremitus findings for pneumonia |
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Definition
Increased (bronchus becomes patent)
Decreased (bronchus obstructred) |
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Term
| Breath sounds findings for pneumonia |
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Definition
| Increased (consolidation yields dense area that enhances transmission of sounds from bronchi) |
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Term
| Voice sounds findings for pneumonia |
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Definition
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Term
| Adventitious sounds findings for pneumonia |
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Definition
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Term
| Inspection findings for pneumothorax |
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Definition
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Term
| Expansion findings for pneumothorax |
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Definition
| Unequal chest expansion (decreased on affected side) |
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Term
Palpation findings for pneumothorax
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Definition
Decreased BP
Increased HR |
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Term
| Diaphragmatic excursion findings for pneumothroax |
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Definition
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Term
| Percussion findings for pneumothroax |
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Definition
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Term
| Tactile fremitus for pneumothorax |
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Definition
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Term
| Breath sounds findings for pneumothorax |
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Definition
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Term
| Voice sounds findings for pneumothorax |
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Definition
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Term
| Normal percussion tone for lung |
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Definition
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Term
| Normal percussion tone for heart |
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Definition
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Term
| Normal percussion tone for bone/muscle |
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Definition
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Term
| Normal percussion tone for abdomen |
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Definition
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Term
| Where are vesicular sounds heard? |
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Definition
| majority of lung tissue, anterior and posterior |
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Term
| Where are bronchovesicular sounds heard? |
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Definition
Over bronchi
1st and 2nd ICS (esp. on R), between scapulae posterior |
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Term
| Where are bronchial sounds heard? |
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Definition
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Term
| What is the sound for vesicular and how does inspiration relate to exhalation? |
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Definition
Soft and low-pitched
I > E |
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Term
| What is the sound for bronchovesicular, and how does inspiration relate to exhalation? |
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Definition
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Term
| What is the sound for bronchial, and how does inspiration relate to exhalation? |
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Definition
Loud and high-pitched
I < E |
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Term
| What are crackles (rales) and what do they suggest? |
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Definition
Cracking, popping sound
Suggest secretions in periphery
May be normal after sleep or in elderly |
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Term
| What are ronchi, and what do they suggest? |
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Definition
Low-pitched wheeze, sonorous bubbling sound
Suggest secretions in large airways |
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Term
| What are wheezes, and what do they suggest? |
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Definition
Whistle-like sound
Suggest narrowed airways from secretions |
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Term
| What is friction rub, and what do they suggest? |
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Definition
cracking, grating sound
Secondary to pleural irritation or inflammation |
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Term
| When are breath sounds absent? |
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Definition
| Seen in pneumothorax, obstruction, mass |
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Term
| When a patient repeats a word or number while you listen through a stethoscope, what are you assessing and what is a normal finding? |
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Definition
Vocal resonance
Voice should be soft, muffled, indistinct |
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Term
|
Definition
Tricuspid
Mitral (bicuspid) |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
| Which ventricle covers most of the anterior cardiac surface? |
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Definition
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Term
| Location of apex of heart: |
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Definition
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Term
| Location of base of heart |
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Definition
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Term
| Sternum covers most of heart. The assessment is just a tiny bit of ____________ |
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Definition
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Term
|
Definition
Superior/inferior vena cava
Pulmonary artery
Pulmonary vein
Aorta |
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Term
| What assessment do you not perform on the heart? |
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Definition
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Term
| What do you look for during cardiac inspection? |
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Definition
| retractions, lifts, heaves |
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Term
| Pulling in of tissue on precordium related to position, activity of heart (slight amount at apical impulse normal) |
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Definition
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Term
| Sustained forceful thrust of ventricle during systole |
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Definition
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Term
| What do you look for during cardiac palpation? |
|
Definition
palpate apical impulse
Approx. 1-2 cm in diameter
Felt as short, gentle tap
Heave/retractions/lifts/thrills abnormal |
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Term
| Which side of the stethoscope do you use during cardiac auscultation? |
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Definition
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Term
| Areas and locations to auscultate for cardiac |
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Definition
"A point to memorize"
Aortic: 2nd ICS RSB
Pulmonic: 2nd ICS LSB
Tricuspid: 4th ICS LSB
Mitral: 5th ICS L MCL
(Erb's point - A&P - 3rd ICS LSB) |
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Term
| Which cardiac auscultation point is best heard on the right side? |
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Definition
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Term
|
Definition
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Term
|
Definition
Beginning of ventricular systole
Synchronous with carotidpulse
"lub" sound |
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Term
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Definition
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Term
|
Definition
Beginning of ventricular diastole
"dub" sound |
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Term
|
Definition
| asynchronous closure of mitral and tricuspid valves |
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|
Term
The etiology of _______________ is higher L ventricular pressure than R.
Also, depolarization is faster on the L. |
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Definition
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Term
|
Definition
| Delayed pulmonic valve closure plus early aortic valve closure |
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|
Term
| The etiology of ____________ is moRe to the Right, Less to the Left |
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Definition
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Term
|
Definition
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Term
|
Definition
| After S2, when tricuspidand mitral valves open, and blood pours into the ventricle during diastole |
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Term
| Is physiologic S3 normal? |
|
Definition
In kids and young adults.
Abnormal after age 40 |
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Term
| What causes pathologic S3? |
|
Definition
Fluid overload
Mitral/tricuspid valve incompetence
Noncompliant cardiac muscles
High CO states (pregnancy, anemia, cardiac failure) |
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Term
|
Definition
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Term
|
Definition
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Term
| The atrial kick is associated with which heart sound? |
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Definition
|
|
Term
| What is the etiology of S4? |
|
Definition
| Inflow of blood vibrates valves and structures of walls |
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|
Term
| When does physiologic S4 occur? |
|
Definition
| Middle-aged adults after exercise |
|
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Term
| What is the cause of pathologic S4? |
|
Definition
Decreased compliance of ventricle,
Vascular disease |
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Term
|
Definition
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Term
| Inflammation of the pericardial and visceral surfaces (best heard at apex) |
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Definition
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|
Term
|
Definition
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Term
| Murmur without pathologic or structural abnormalities |
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Definition
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Term
| Physiologic alteration present causing murmur |
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Definition
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Term
| Murmurs common in childhood and adolescence |
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Definition
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Term
| Murmur due to structural abnormality |
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Definition
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Term
|
Definition
| I (softest) - VI (audible with stethoscope barely on chest) |
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Term
| Best jugular for assessment |
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Definition
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|
Term
What assessment is this:
Place ruler on angle of louis. Measure vertical distance between sternal angle and highest level of pulsation. |
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Definition
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Term
| Pulmonary backup and respiratory symptoms indicate which kind of heart failure? |
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Definition
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Term
| Etiology of left-sided heart failure |
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Definition
| Since blood from the lungs enters the Leftside of the heart, any issues with this side will cause blood to backup in the lungs, leading to respiratory symptoms |
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Term
| Lower-extremety edema, swollen liver, and swollen jugular vein indicate what kind of heart failure? |
|
Definition
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|
Term
| Etiology of right-sided heart failure |
|
Definition
Blood is drained from the liver and lower extremeties by the inferior vena cava into the right side of the heart.
Right-sided failure leads to drainage problems, causing edema in the liver & lower extremeties |
|
|
Term
| 9 Risk Factors for heart disease |
|
Definition
- Diet high in sat/trans fats and cholesterol
- Smoking
- Heavy Drinking
- Physical inactivity
- Obesity
- HTN
- DM
- Age
- Heredity
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|
|
Term
| #1 preventable cause of heart failure |
|
Definition
|
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Term
|
Definition
sustained forceful thrusting of ventricle during systole.
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