Term
| ___ rib starts at sternal angle. |
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Definition
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Term
| vertebral line is same as midsternal line, its just on the back. |
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Definition
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Term
| primary muscles of respiration: |
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Definition
- diaphragm
- external intercostal muscles
- internal intercostal muscles |
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Term
| The diaphragm ___ and moves ___ during inspiration. |
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Definition
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Term
| ___ ___ muscles increase the AP diameter during inspiration. |
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Definition
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Term
| ___ ___ muscles decrease the ___ diameter during expiration. |
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Definition
Internal intercostal
lateral |
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Term
| external intercostals help with: |
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Definition
|
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Term
| internal intercostals help with ___ |
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Definition
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Term
People in respiratory distress use accessory muscles like sternocleidomastoid or trapezius muscles.
Also may see retractions b/w ribs if working hard to breathe |
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Definition
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Term
| Three major chest cavities: |
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Definition
- right pleural cavity
- left pleural cavity
- mediastinum- contains all thoracic viscera except lungs |
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Term
| With the right lobe, the horizontal fissure that divides the upper and middle lobes is located at the __ rib/ the nipple. |
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Definition
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Term
Normal respiratory rate is 12-20 per minute. Higher for kids.
Normal heart rate is 60-100 bpm Higher for kids. |
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Definition
|
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Term
| barrel chest may be a sign of : |
|
Definition
- chronic bronchitis
- COPD |
|
|
Term
|
Definition
- chronic bronchitis
- COPD
- cyanotic around lips and fingers b/c not enough air exchange
- often have barrel chest |
|
|
Term
|
Definition
- emphysema and COPD
- thin b/c breathing takes so much work
- x-ray shows a long heart and flattened diaphragm |
|
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Term
|
Definition
- aka pigeon chest
- develop normal lungs and heart
- often associated with congenital heart disease, but if no disease at birth, they should develop well
- poor exercise tolerance b/c can't expand lungs as they should be able to
- can be fixed by bracing when young |
|
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Term
|
Definition
- Funnel chest
- compresses right ventricle so impaired pulmonary circulation, so reduced stroke volume of right ventricle
- cannot be fixed by bracing
- can be surgically fixed if cardiopulmonary problems |
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Term
|
Definition
| deviation of spine posteriorly |
|
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Term
|
Definition
| marked kyphosis resulting in a hunchback deformity |
|
|
Term
| lumbar lordosis is normal, but can become excessive |
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Definition
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Term
| Tactile Fremitus palpation: |
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Definition
tactile fremitus= palpable vibration of chest during speech
- use palmar aspects of MCP of hands or ulnar aspect of hands
- check bilateral simultaneously
- patient instructed to say "99" or "mickey mouse" each time hands are moved
- increased vibrations could be due to consolidation, fluid in lung, solid mass
- decreased vibrations could be due to air being trapped |
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Term
| Percussion of the chest should be done in a __ __ pattern, from __ to __, __ to __, __ to ___. |
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Definition
- zig-zag
- side to side
- top to bottom
- medial to lateral |
|
|
Term
|
Definition
|
|
Term
| effusion, thickening or cancer: |
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Definition
|
|
Term
| COPD, added air in lungs: |
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Definition
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|
Term
| Diaphragmatic excursion by percussion: |
|
Definition
- ask patient to take in deep breath and hold it
- percuss along scapular line until you locate the lower border, mark the lower border where the point changes from resonance to dullness
- repeat procedure on the other side
- then have patient take several breaths and then exhale as much as possible
- percuss up from the marked point and mark at change from dullness to resonance, repeat on other side
- space should be between 3-6 cm. |
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|
Term
| diaphragmatic excursion by percussion is limited by: |
|
Definition
- COPD
- pain
- tumor
- acites |
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Term
| The larger the airway, the louder the sound. List them from loudest to softest: |
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Definition
| - trachea> bronchiole> bronchiovesicular> vesicular (heard over most of lungs) |
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|
Term
| inspiration is normally longer than expiration. |
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Definition
|
|
Term
| breath sounds decrease when the normal lung is displaced by air or fluid. |
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Definition
|
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Term
|
Definition
| extra sounds, are always abnormal but not always significant |
|
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Term
|
Definition
| high pitched, discontinuous sounds, similar to sound produced by rubbing hair between your fingers |
|
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Term
|
Definition
| generally high pitched, muscial, whistling or sighing sounds |
|
|
Term
|
Definition
| - snoring, gurgling, or honking noise that is not a crackle or wheeze is probably a rhonchus |
|
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Term
|
Definition
| upper airway inspiratory obstructive "wheeze" associated with croup or epiglottitis |
|
|
Term
| Tests for vocal resonance: |
|
Definition
- bronchopony
- whispered pectoriloquy
- egophony |
|
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Term
|
Definition
during auscultation, patient says "99" or "Mickey Mouse"
- sound should be muffled
- positive bronchophony is loud, clear spoken sound= bad, consolidation, pleural effusion |
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Term
|
Definition
- patient whispers "99" or "1,2,3"
- sound should be faint or absent
- if sound is heard clearly through stethoscope, then whispered pectoriloquy is present |
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Term
|
Definition
- patient says "E" over each auscultated area
- auscultate mutliple symmetrical areas over each lung
- normal is a muffled "E" sound
- abnormal is an "ay" sound referred to as E to A or egophony |
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Term
|
Definition
Bony thorax
Skin exam for lesions, nodules
Tenderness
Pulsations
Palpable deformities
Tracheal Position
Chest expansion
Hands placed on posterior thorax
Thumbs at midline of lower thoracic region
Pt requested to inhale deeply as you observe expansion |
|
|
Term
|
Definition
kyphosis, osteoporosis
AP diameter of chest
Percussion tone
Marked bony prominences
Easy fatigability
Chest expansion ability |
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