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Lungs and Resp - Assess.Test2
Lungs and Resp - Assess.Test2
95
Medical
Professional
03/31/2009

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Cards

Term
3 main structures in the chest
Definition
mediastinum, right and left pleural cavities
Term
mediastinum
Definition
positioned in middle of chest; contains heart, aorta, superior vena cava, lower esophagus, and lower trachea
Term
2 membranes lining the lungs
Definition
parietal and visceral
Term
parietal pleura protects...
Definition
chest wall and diaphragm
Term
viseral pleura protects...
Definition
outside of lungs
Term
lungs are not symmetric b/c...
Definition
right lung has 3 lobes and left has 2 lobes
Term
each lung extends anteriorly about how many inches?
Definition
1.5 inches
Term
each lungs extends...
Definition
above the first rib into the base of the neck in adults
Term
posteriorly, the lungs' apices rise to about the level of what?
Definition
T1 vertebra. on deep inspiration the lower borders expand down to about T12. On expiration about T9.
Term
the thoracic cage consists of
Definition
12 T vertebrae, 12 pairs of ribs, and the sternum
Term
the thoracic cage's function is...
Definition
protects most of the respiratory system
Term
the first seven ribs are connected to
Definition
the sternum by the costal cartilages
Term
the unattached ribs are...
Definition
the 11th and 12th ribs
Term
the adult sternum is how long?
Definition
7 inches
Term
the 3 components of the sternum
Definition
the manubrium, the body, and the xiphoid process
Term
what part of the sternum articulates with the first seven ribs
Definition
the body and the manubrium
Term
the clavicle is supported by the
Definition
manubrium of the sternum
Term
the area b/w the ribs is the...
Definition
intercostal space
Term
primary muscles of inspiration are
Definition
diaphragm and intercostals
Term
during inspiration the diaphragm...
Definition
contracts and pushes the abdominal contents down
Term
during inspiration, the intercostals...
Definition
push the chest wall outward
Term
during inspiration, the movements of the diaphragm and intercostal muscles help to...
Definition
decrease the intrathoracic pressure so the pressure w/i the lung in negative compared with the pressure outside the lung
Term
the pressure difference during inspiration causes
Definition
the lungs to fill with air
Term
during expiration...
Definition
muscles relax, expelling air as the intrathoracic pressure rises
Term

Other accessory muscles include...

 

Definition
sternocleidomastoid, scalenus, pectoralis minor, serratus anterior, rectus abdominus, serratus posterior superior, transverse thoracis, serratus posterior inferior
Term
trachea
Definition
flexible tube about 4 inches in adult
Term
air passes how?
Definition
through mouth or nose, through pharynx and larynx, to the trachea
Term
upper airway consists of
Definition
nose, pharynx, larynx, intrathoracic trachea
Term
upper airway's function in respiration...
Definition
1. conduct air to lower airway, 2. protect lower airway from foreign matter, 3. to warm, filter, and humidify inspired air
Term
lower airway consists of...
Definition
trachea, right and left mainstem bronchi, segmental and subsegmental bronchi, and terminal bronchioles
Term
what happens to trachea and T4 and T5
Definition
it splits into the left and right mainstem bronchus
Term
the right bronchus is...
Definition
shorter, wider, and more vertical than the left one
Term
each bronchiole opens into
Definition
an alveolar duct and terminates in multiple alveoli, where gas exchanges occur.
Term
the most important risk factor for lung cancer
Definition
smoking
Term
abestos
Definition
people who work with abestos are 7 times more likely to die of lung cancer
Term
radon
Definition
uranium breaks down to radon, possible risk for cancer
Term
women's lungs
Definition
more predispositioned to developing cancer when exposed to tobacco
Term
what chronic diseases affect respiration?
Definition
heart disease, renal disease, and diabetes mellitus
Term
cigarette consumption documented how?
Definition
pack years; # of years X # of packs/day
Term
Native American men
Definition
have higher cancer and mortality rates
Term
acute cough
Definition
sudden onset and lasting less than 3 weeks
Term
chronic cough
Definition
lasting longer than 3 weeks
Term
chronic cough commonly caused by
Definition
postnasal drip, GERD, asthma, bronichitis, cystic fibrosis, interstitial lung disease, smoking, and sarcoidosis
Term
increased sputum in the morning...
Definition
implies an accumulation of sputum at night and is common with bronchitis.
Term
sputum production with change in position
Definition
is suggestive of lung abcess and bronchiectasis
Term
white or clear sputum
Definition
colds, viral infections, or bronchitis
Term
yellow or green sputum
Definition
bacterial infections
Term
black in sputum
Definition
smoke or coal dust inhalation
Term
rust-colored sputum
Definition
tuberculosis, pneumococcal pneumonia, or possibly blood
Term
bright red or dark purple sputum
Definition
blood (hemoptysis)
Term
hemoptysis is
Definition
the expectoration of sputum containing blood
Term
pink frothy sputum accompanied with dyspnea is associated with
Definition
pulmonary edema
Term
foul smelling (fetid) sputum is associated with
Definition
bacterial pneumonia, lung abcess, or bronchiectasis
Term
sudden onset of shortness of breath associated with
Definition
pneumonia
Term
gradual onset of shortness of breath associated with
Definition
chronic heart failure
Term
inspiratory dyspnea associate with
Definition
obstruction of the upper airway
Term
expiratory dyspnea associated with
Definition
obstruction of smaller bronchi and bronchioles
Term
orthopnea
Definition
difficulty in breathing when the individual is lying down
Term
three-pillow orthopnea
Definition
the client needs to prop up with three pillows to relieve dyspnea
Term
paroxysmal nocturnal dyspnea
Definition
shortness of breath that awakens the individual in the middle of the night, usually in panic with felling of suffocation
Term
shortness of breath can also be a CV symptom as in
Definition
heart failure or sever heart murmur that may produce periphreal edema
Term
a sharp, abrupt pain associated with deep breathing may be indicative of
Definition
pleural lining irritation
Term
way of assessing severity of dyspnea is
Definition
counting clients words b/w breaths; severe dyspnea may take a breath after every third word; normally, a person can say 10 to 14 words before breath.  Documented as "three-word dyspnea".
Term
injured ribs cause
Definition
pain when breathing, as a result...shallow breathing, which may lead to respiratory congestion
Term
smoking is leading risk factor for
Definition

CV diseases, myocaridal infarction, coronary artery disease, stroke, periphreal vascular disease.

 

Also for lung disease, including COPD.

Term
tobacco use is one of the 10
Definition
leading health indicators
Term
Steps in resp examination
Definition

INSPECT general appearance, posture, breathing effort

INSPECT chest for shape symmetry, muscle development, anteroposterior diameter to transverse diameter, and costal angle.

INSPECT client's nails, skin, and lips for color

OBSERVE resp for rate, quality, pattern, and chest expansion.

AUSCULTATE for breath sounds

Term
Advanced Practice in Resp Examination
Definition

PALPATE trachea for positioning

PALPATE chest and thoracic muscles for tenderness, bulges, and symmetry.

PALPATE chest wall for thoracic expansion

PALPATE chest wall for vocal (tactile) fremitus

PERCUSS thorax for tone

PERCUSS throax for diaphragmatic excursion

AUSCULTATE chest for vocal sounds

Term
tripod position
Definition
leaning foward with arms braced against knees, against a chair, or against a bed...suggests respiratory distress; enchances accessory muscle use
Term
ribs should slope down at
Definition
45 degrees relative to the spine
Term
ratio of AP diameter to lateral diameter
Definition
1:2; AP should be 1/2 size of lateral diameter
Term
anteriorly, the costal angle should be
Definition
less than 90 degrees
Term
barrel chest may appear in
Definition
emphysema; ribs may appear more horizontal and chest looks like it is held in constant inspiration; the costal angle is more than 90 degrees
Term
Pectus carinatum
Definition
or pigeon chest...has prominent sternum
Term
pectus excavatum
Definition
or funnel chest...sternum is indented above xiphoid
Term
passive breathing
Definition
should be 12 to 20 breaths/minute; this is referred to as eupnea (or normal breathing)
Term
Men tend to use what type of breathing?
Definition
Abdominal breathing (or diaphragmatic breathing)
Term
Women use what type of breathing?
Definition
thoracic breathing
Term
Sigh
Definition
occasional interspersed deeper breath associated with a normal breathing pattern; frequent sighs are abnormal
Term
Clubbing of nails can be associated with
Definition
chronic hypoxia
Term
bradypnea
Definition
resp rate less than 12 breaths/minute
Term
trachypnea
Definition
resp rate greater than 20 breaths/minute; can be caused by fever, fear, or activity
Term
when hyperventilation occurs...
Definition
breathing is very deep and laborius...is termed Kussmaul breathing
Term
Biot breathing is characterized by
Definition
irregularly interspersed periods of apnea in irregular pattern, rate, or depth; may be associated with intracranial pressure, resp distress, or damage to medulla
Term
Cheyne stokes
Definition
intervals of apnea interspersed with a deep and rapid breathing pattern; seen with severe illness, brain damage, or drug overdose
Term
Air trapping
Definition
and abnormal resp pattern seen with COPD; characterized by  rapid inspirations with prolonged, forced expirations. Air is not fully exhaled, thus it becomes trapped in the lungs, which eventually leads to barrel chest.
Term
How to palpate the trachea
Definition
use thumbs of both hands
Term
If trachea is not midline, it could mean
Definition
chest mass, mediastinal shift, or some degree of lung collapse
Term
Palpate chest and thoracic muscles using
Definition
palmar surface of your fingers
Term
crepitus
Definition
feels like crinkly or crackly sensation under fingers; indicates air in the subcutaneous tissue caused by an air leak from somewhere in the respiratory tree
Term
Listen to lungs
Definition
10 landmarks on back; 8 landmarks on front
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