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Health Assessment
Chapter 18- Thorax and Lungs
112
Health Care
Undergraduate 1
04/06/2012

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Term
Thoracic cage
Definition

bony structure with a conical shape, which is narower at the top

 

Term
Alveoli
Definition
functional units of the lung, the thin-walled chambers surrounded by networks of capillaries that are the site of respiratory exchange of carbon dioxide and oxygen
Term
Angle of louis
Definition
manubriosternal angel, the articulation of the manubrium and body of sternum, continous with the second rib
Term
Apnea
Definition
cessation of breathing
Term
Atelectasis
Definition
abnormal respiratory condition characterized by collapsed, shrubken, deflated section of alveoli
Term
Bradypnea
Definition
slow breathing < 10 breaths per minute, regular rate
Term
Bronchiole
Definition
one of the smaller respiratory passageways into which the segmental bronchi divide
Term

 

Bronchitis

Definition
inflammation of the bronchi with partial obstruction of bronchi due to excessive mucus secretion
Term
Bronchophony
Definition
spoke voice sound hear through the stethoscope, which sounds soft, muddlef, and indistinct over normal lung tissue
Term
Bronchovesicular
Definition
normal breath sound heard over major bronchi, characterized by moderate pitch and an equal duration of inspiration and expiration
Term
Chronic obstructive pulmonary disease (COPD)
Definition
functional category of abnormal respiratory conditions characterized by airflow obstruction (emphysema, chronic bronchitis)
Term
Cilia
Definition
millions of hairlike cells lining the tracheobronchial tree
Term
Consolidation
Definition
solidification of portions of lung tissue as it fills up with infectious exudate (pneumonia)
Term
crackles
Definition
(rales), abnormal, adventitous lung sounds on inspiration
Term
Crepitus
Definition
coarse, crackling sensation that can be palpable when air abnormnally escapes from the lungs to subcutaneous tissue
Term
Dead space
Definition
passageways that transport air but are not available for gas exchange (trachea and bronchi)
Term
dyspnea
Definition
difficulty, labored breathing
Term
Egophony
Definition
the voice of "eeeeeee" heard through the stethoscope
Term
Emphysema
Definition
COPD disease characterized by enlargement of alveoli distal to terminal bronchioles
Term
Fissure
Definition
the narrow crack dividing the lobes of the lungs
Term
Fremitus
Definition
palpable vibration from the spoken voice felt over the chest wall
Term
Friction Rub
Definition
course, grating, adventituous lung sound hear when the pleurae are inflamed
Term
Hypercapnia
Definition
(hypercabia) increased levels of co2 in the blood
Term
Hyperventilation
Definition
increased rate annd depth of breathing
Term
Hypoxemia
Definition
decreased level of o2 in the blood
Term
intercostal space
Definition
space between the ribs
Term
Kussman respiration
Definition
type of hyperventilation that occurs with diabetic ketoacidosis
Term
orthopnea
Definition
ability to breathe easily only in an upright position
Term
Paroxysmal nocturnal dyspnea
Definition
sudden awakening from sleeping with shortness of breath
Term
Percussion
Definition
striking over the chest wall with short, sharp blows of the fingers to determine the size and density of the underlying organ
Term
Pleural Effusion
Definition
abnormal fluid  between the layers  of the pleura
Term
Rhonchi
Definition
low-pitched, muscle, snoring, adventitious lung sound caused by airflow obstruction from secretions
Term
Tachypnea
Definition
rapid, shallow breathing > 24 breaths per minutes
Term
Vesicular
Definition
the soft, low-pitched normal breath sounds heard over peripheral lung fields
Term
Vital capacity
Definition
the amount of air following maximal inspiration that can be exhaled
Term
Wheeze
Definition
high pitched, muscle, squeaking adventitious lung sound
Term
whispered pectoriloquy
Definition
a whispered phrase heard through the stethoscope that sounds faint and inaudible over normal lung tissue
Term
Xiphoid process
Definition
sword-shaped lower tip of the sternum
Term
diaphragm
Definition
is the floor of thoracic cage and sepates the thoracic cavity from abdomen
Term
Pleurae
Definition
thin, slippery serious membraned that form an envelope between the lungs and the chest wall
Term
four major functions of respiratory system
Definition

1) supplying o2 to the body for energy production

2) removed CO2 as a waste product of energy reactions

3) maintains homeostasis (acid-base balace) of arteriial blood

4) maintains heat exchange (less important to humans)

Term
hypoventilation
Definition
this causes co2 to build up in the blood
Term
hyperventilation
Definition
causes carbon dioxide to blow off
Term
brainstem (pons and medulla)
Definition
involuntary control of respirations is mediated by the respiratory center in the
Term
negative pressure
Definition
when air fills in with inspiration there is
Term
passive
Definition

expiration is primarily

 

Term
neck
Definition
forced inspiration after a heavy excercise or distress the ______muscles are used (accessory muscles), which are the sternomastoids, scaleni, and traspezii
Term
surfactant
Definition
lipid substance needed for sustained unflation of the air sacs
Term
elevates; 4 cm
Definition
in the pregnant woman the enlarging uternus ______the diaphragm ___cm during pregnancy
Term
tidal volume
Definition
because the fetus is increasing oxygen demand, it can be easily met by increasing______with deep breathing
Term
rigid
Definition
the aging lung is more _________that it's harder to inflate
Term
respiratory muscle strength
Definition
the in the aging adult, after 50 years old this declines and continues to decrease in the 70's
Term
gain inhalation, pesticide inhalation
Definition
farmers are at risk for
Term
histoplasmosis exopsure
Definition
People in the rural midwest have a risk for
Term
coccidiomycosis
Definition
mexico and southwest have a risk for
Term
pneumoconiosis
Definition
coal miners are at risk for
Term
silicosis
Definition
stone cutters, miners, and potters have a risk for
Term
CO2
Definition
which gas produces these symptoms: dizziness, fatique, and headaches?
Term
sulfer dioxide
Definition
which gas produces these symptoms: cough and congestion
Term
4 to 6
Definition
how many uncomplicated upper respiratory infections per year is expected during early childhood?
Term

sedentary or bedridden

Definition
these type of people are at risk for respiratory dysfunction
Term
rib fracture or muscle injury
Definition
if there is a precisely localized pain, considered that it may be a
Term
less than
Definition
the anteroposterior diameter should be _____than the transverse diameter (1:2 to 5:7)
Term
barrel chest
Definition
this is when the AP = transverse diameter, costal angle is > 90 degrees
Term
tripod
Definition
people with COPD often sit in a _____________position, leaning forward with arms braced against their knees, chair, or bed, to help aid in expiration
Term
hypoxia
Definition
cyanosis occurs with
Term
right
Definition
Between the scapulae fremitus may feel stronger in the ________ side
Term
Decreased fremitus
Definition
occurs when anything obstructs transmissions of vibration
Term
increased fremitus
Definition
occurs with compression or consilidation of lung tissue (lobar pneumonia)
Term
Rhonchal Fremitus
Definition
palpable with thick bronchial secretions
Term
Pleural friction fremitus
Definition
palpable with inflammation of the pleura and has a grating sensation with breathing
Term
Hyperresonance
Definition
lower-pitched, booming sound found when too much air is present (emphysema or pneumothorax)
Term
dull note
Definition
this is a soft and muffled thud that signals abnormal density in the lungs (pneumonia, pleural effusion, atelectasis, tumor)
Term
3-5 cm or 7 to 8cm
Definition
diaphragmatic excursion should be measured from
Term
Bronchial
Definition
has a high pitched and loud sound, inspiration < expiration, the quality harsh and hollow tubular, and it's found in the trachea and larynx
Term
bronchivesicular
Definition
Has a moderate pitch and amplitude, inspiration = expiration, mixed quality, and its found over major bronchi
Term
Vesicular
Definition
low pitch soft sound, inspiration > expiration, the quality is rustling (wind in trees), found over peripheral over terminal bronchi
Term
obstructed bronchial tree from secretions, emphysema, obstruction transmission (pleurisy or pleural thickening)
Definition

There can be decreased breath sounds or absent breath sounds where there is:

 

Term
increased breath sounds
Definition
very loud, high pitched, long with expiration, when there's consolidation (pneumonia) or compression (fluid in intrapleural space)
Term
accessory neck muscles
Definition
what do you use when there is acute airway obstruction and massive atelectasis (abnormal)
Term
noisy breathing
Definition

this type of breathing occurs with severe asthma and chronic bronchitis

 

Term
obstructed or collapsed
Definition
when there is an unequal chest expansion there may be part of the lung that is ________
Term
specialist
Definition
if there are any lumps found in the breast tissue, refer man to a
Term
75 % or greater
Definition
forced expiratory volume that is normal is
Term
60 to 70 percent
Definition
There is mild obstruction of airflow when the FCV is
Term
50 to 60 percent
Definition
moderate obstruction of FCV is
Term
less than 50%
Definition
severe obstruction of FVC is
Term
6 minute distance walk
Definition
safer, simple, inexpensive, clinical measure pf functional status for aging adult.  They have a pulse ox on and may slow or stop at anytime.
Term
below 85-88% of if there are extreme breathlessness
Definition
You want to ask the person to stop the walk if their pulse ox measure
Term
harrison's groove
Definition
this occurs in some children and is a horizontal groove n the rib cage at the level of insertion off the diaphragm
Term
infant
Definition
they have a rounded thorax (AP=transcerse dia.) chest cirumference is 30-36 cm, their chest wall skin is thin, so ribs and xiphoid process are prominent, and the chest wall is soft and flexible, sometimes their breasts may look enlarge on third day from maternal estrogen, sometimes their white fluid that goes away in a week
Term
Apgar scoring system
Definition

used for newborns respiratory assessment scored at 1 to 5 minutes.

for 1 minute it is normal when score is 7-10

Term
moderately depressed newborn
Definition
1 minute apgar score with 3-6 is a ______ that needs resuscitation and close observation
Term
full resuscitation, ventilatory assistance, and subsequent intensive care
Definition
1 minute apgar score with 0-2 newborn  is severely depressed and needs a
Term
nose
Definition
infant breathes through the __until 3 months
Term
upper
Definition
creakcles in the _______lung field occur with cytosic fibrosis
Term
lower
Definition

crackles in the _____lung it occurs with heart failure

 

Term
heart failure
Definition
an infant with tachypnea of 50+100 per minuted may have an early sign for
Term
aging adult
Definition
their chest cage commonly shows an increased anteroposterior diameter, giving a round barrel shape with khphosis, there are marked bony prominences because of decrease in subcutaneous fat, chest expansion may decrease (symmetric), and cartilages become calcified (less mobile_)
Term
holding
Definition
if aging adult feel faint, ______the breath for a few seconds will restore equilibrium
Term
stridor
Definition
high pitched inspiratory crowing sound hear without the stethscope occuring with upper airway obstruction
Term
diaphragmatic hernia
Definition
has persistent peristaltic sounds with diminished breath sounds on the same side may indicate
Term

pectus excavutum

 

Definition
markedley sunken sternum and adjacent cartilages( funny breast) and is the depression at the 2nd intercostal space is more noticeable on inspiration; congenital and usually not symptomatic
Term
pectus carinatum
Definition
protrusion of the sternum , with ribs sloping back at either side and vertical depression along costochondrol junctions (pigeon breast), less common, and required no treatment
Term
fever, fear, and excercise
Definition
with tachypnea it's normal when there is
Term
increases
Definition
the rate__________ for penumonia, alkalosis, pleurisy, and lesions in the pons
Term
drug-induced depression of the respiratory center in the medulla, increased intercranial pressure, and diabetic coma
Definition
with bradypnea, its occurs in
Term
irregular; naroctics and anesthetics
Definition
hypoventilation occurs when there is a _________shallow pattern caused by overdose of _______________. May also occur in prolonged bedrest or conscious splinting of the chest to avoid pain
Term
Cheyne-stokes respiration
Definition
cycle of respirations that gradullay wax and wane in a regular patter: increasing rate and depth and then increasing. Breathing last 30 to 45 seconds with apnea fo 20 seconds and it occurs normally in infants and aging persons during sleep
Term
severe heart failure, renal failure, meningitis, drug overdose, and increased intracranial pressure
Definition
the most common cause for cheyenne's stokes respiration is
Term
biot's respiration
Definition
similar to cheyenne's respiration except irregular, there will be series of normal respirations (about 3 or 4) and is followed by a period of apnea and cycle is variable ( 10 sec to 1 min)
Term
head trauma, brain abcess, heat stroke, spinal meningitis, and encephalitis
Definition
Biots respirations occur with
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