Term
| the angle of louis is also called? Where is it located? |
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Definition
| Angle of louis is located where the manubrium o the sternum and main sternal body meet. It is also called the manubriosternal angle. |
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Term
| The top of the diaphragm when the pat is at rest, (diap is up) is located behind what intercostal space |
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Definition
| behind 5th intercostal space |
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Term
| The costal angle describes |
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Definition
| The angle between the costal margins at the posterior sections spanning out from the xiphoid process |
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Term
| the junction from the ribs to the sternum is known as |
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Definition
| the costochondrial junciton |
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Term
ribs __ to ___ articulate with the sternum
Ribs ___ to ___ articulate together/by themselves
Ribs __ to ___ are free floating |
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Definition
Articulate on sternum: ribs 1-7
Articulate byself: Ribs 7-10
free floating ribs: 11-12 |
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Term
| For a thorancentisis you can use a landmark on the posterior back which is? It aligns with what vertebrae? |
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Definition
| Inferior angle of the scapula is between T7-T8 |
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Term
| The most prominent spinous process on the posterior spine is? |
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Definition
|
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Term
| scapula sits between ribs __ and ___ |
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Definition
| ribs 1 and 8 sits the scapula |
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Term
| What landmark on the posterior spine is whree the right and left upper lobes of the lung are separated from the lower |
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Definition
|
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Term
| lungs are divided in half by the |
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Definition
|
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Term
| The right lung has three lobes which are sperated by |
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Definition
| horizontal fissure and oblique fissure |
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Term
| the right mainstem is more likely to be intubated because its angle is ____ (larger or smaller?) |
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Definition
| right main stem is smaller angle. More direct route. |
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Term
| at what anteiror landmarks and posterior landmarks does the trachea bifurcates into the left and right mainstem bronchi? |
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Definition
| At the sternal angle (angle of louis) and T4. |
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Term
| describe the layers of the chest as you penetrate from outside to in. |
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Definition
| Epidermis --> dermis --> fascia --> rib -->parietal pleura -->pleural cavity --> visceral pleura --> lung |
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Term
| Pleural rubs are common in |
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Definition
| Pleural rubs are common in pneumonia, pulmonary embolism, and pleurisy (pleuritis). |
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Term
| if you auscultate and hear what sounds like walking on snow the patient most likely has what |
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Definition
|
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Term
| what tissue in the chest has no pain receptors |
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Definition
|
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Term
| If the lung has no pain receptors than how come people feel pain |
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Definition
| from irritation to parietal layer surrounding the lung. |
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Term
| the cartilage that attaches the ribs to the sternum are known as? They can be inflammed and cause pain related to? |
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Definition
| Costochondrial junction: can be inflammed inpatients due to inflammation (costochondritis) usually related to trauma, heavy weight carrying or pressure over that areas, |
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Term
| a person who has "trouble getting air in" has dyspnea which is most likely related to ? |
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Definition
|
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Term
| what are the different duration categories of a cough |
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Definition
1. Acute < 3 weeks
2. Subacute 3-8 weeks
3. Chronic > 8 weeks. |
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Term
| what medication can cause coughing? If so what medicaiton would you switch patient to |
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Definition
| ACE Inhibitors cause coughing and you should switch patient to ARB so that patient is compliant |
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Term
| what type of kids can cough up blood and it is not abnormal |
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Definition
|
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Term
| Asymmetrical expansion of the lung may indicate what |
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Definition
|
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Term
| retraction of the lung may indicate? |
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Definition
1. bad asthma
2. COPD
3. bad upper airway obstruction |
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Term
| impaired movement of one side of both of the lung may indicate |
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Definition
|
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Term
| What are Sx of residual NMB |
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Definition
1. abdominal rocking
2. can't take a deep breath |
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Term
| when does the skin over the tracheal notch get sucked down? |
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Definition
| when there's an obstruction or resistance in the airway. The thorax attempts to pull harder (more negative) to get airflow to alveoli and this results in a suctioning effect on the skin over the tracheal notch (supra spinal) also known as a supraspinal retraction |
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Term
| What is tactile fremitus? |
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Definition
| palpable vibrations transmitted through the bronchopulmonary tree to the chest wall when the patient is speaking |
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Term
| To test for chest expansion you would position your hands how on the anterior and posterior surfaces |
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Definition
Anterior: align thumb parrallel to the costal margins and fingers on the lateral ribs
Posterior: thumbs align on 10th rib. |
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Term
| what part of your hand do you use to test for tactile fremitus |
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Definition
| ball of hand or ulnar surface |
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Term
| percussion is good to detect tissues characteristics up to what depth |
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Definition
|
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Term
| whats the name for the sound upon percussion will be high (musical) |
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Definition
|
|
Term
| what type of sound upon percussion will be tympanic |
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Definition
| gastric bubble of puffed cheek |
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Term
| List the five percussion notes in medicine |
|
Definition
1. Flat
2. Dull
3. Resonant
4. Hyperresonant
5. Tympanic |
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Term
| Lungs when percussed, should sound like? |
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Definition
|
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Term
| describe resonant: intensity, pitch, duration |
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Definition
| L=LUNG are L=loud intensity, L=low pitch, L=long duration |
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Term
| dullness over the lung indicates what physiological process |
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Definition
| fluid or solid tissue replacing air in the lung |
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Term
| COPD patients will have what associated percussion note |
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Definition
|
|
Term
| A pneumothorax is associated with what percussion onte |
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Definition
| hyperresonance due to lung tissue being pulled away from the expanding air filled pleural cavity. The result is loud intensity sound as a result of hte air in the pelural space |
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Term
| the suprasternal notch is an important landmark for the following things |
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Definition
1. level of the right atrium
2. bifurcation of the bronchi
3. thoracic duct crosses over
4. lower border of T4
5. 2nd rib joins exactly at it. So 2nd intercostal space is below it. |
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Term
| what area of the thorax can you see all of the lobes in the right lung? |
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Definition
|
|
Term
| Bronchovesicular represent |
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Definition
| Bronchovesicular transition b/w bronchi and parenchyma |
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Term
| air sounding like its blowing through a tube are what kind of breath sound |
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Definition
|
|
Term
| this type of deformed chest is often associated with murmurs |
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Definition
|
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Term
| what is the name for the chest that is anteriorly displaced sternum and depressed costal cartilages |
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Definition
|
|
Term
| what sided heart failure can cause cough |
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Definition
|
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Term
| an acute cough is related to? |
|
Definition
| URI, Asthma or aspirated foreign body |
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Term
| What can cause a sub-acute cough |
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Definition
|
|
Term
| What can cause an chronic cough |
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Definition
| GERD, Chornic bronchitis, bronchiticitis (damage to the bronchioles over time with dilation and scarring) , ACE inhibitos |
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|
Term
| impaired movement on one side or both can be caused by |
|
Definition
1. phrenic nerve
2. pleural disease |
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Term
| if crackles or rhonchi clear after a cough then it was most likely related to? 2x |
|
Definition
1. bronchitis
2. atelectasis |
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Term
| when would you assess transmitted voices? |
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Definition
| You would assess transmitted voices when you hear abnormal bronchial or bronchovesicular sounds in the wrong areas so that you can better pin point it. |
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|
Term
|
Definition
| Say "ee" and in a normal person you will hear a muffled eeee. If PNA present then you hear aaa |
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Term
|
Definition
| say 99. Normal you will hear indiscernable sounds. |
|
|
Term
| normal whispered pectorioquy |
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Definition
| whisper 99, you should be able to hear faintly or not at all. |
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|
Term
| late inspiratory crackles are often associated with? |
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Definition
|
|
Term
| what type of breath sounds do you hear over areas of consolidation or edema |
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Definition
| bronchial breath sounds over affected area |
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|
Term
| trachea goes which direction withc atelectasis compareed to pneumo compared to effusion |
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Definition
| Towards atelectasis. But away from pneumo and away from effusion. |
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Term
| you may hear a friction rub during what lung pathology |
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Definition
|
|
Term
| trachea bifurcated into l and r main stems at what landmark |
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Definition
|
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Term
| The oblique fissure on both sides runs from ___ down and around the chest to the ____ rib |
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Definition
| Oblique fissure runs from T3 spinous process obliquely down and around to the 6th rib at the midcalvicular line. |
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|
Term
| two most common causes of chest pain in children are |
|
Definition
1. anxiety
2. costochondritis (trauma, heavy lifting) |
|
|
Term
| defintinion for shortness of breath |
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Definition
| is a painless, but unconfortable awareness of breathing that is inappropriate to the level exertion. |
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|
Term
| Wheezes occur in what kind of airways |
|
Definition
| in airways with partial obstruction from secretions and tissue inflammation in asthma or from a foreign body |
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|
Term
| Most common cause of an acute cough |
|
Definition
| upper respiratory infections |
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|
Term
| purulent sputum is what colors |
|
Definition
|
|
Term
| large volumes of purulent sputum are present in |
|
Definition
| bronchiectasis or lung abcess |
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|
Term
| Asymmetric expansion in chest signifies |
|
Definition
|
|
Term
| asymmetric decrease in fremitus is present in |
|
Definition
1. thick chest wall
2. obstructed brnochus
3. COPD
4. Pleural changes form effusions, fibrosis, air, or tumor |
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|
Term
| Asymmetric INCREASE fremitus occurs in |
|
Definition
| 1. unilateral pneumonia due to consolidated tissue |
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|
Term
| A healthy lung should sound like what on percussion |
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Definition
| loud, low, long, healthy lung |
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|
Term
| A very flat sound over lung tissue most likely is |
|
Definition
|
|
Term
| a very dull sound over lung tissue is most likely |
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Definition
|
|
Term
| Hyperresonant over normal tissue is most likely |
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Definition
|
|
Term
| Tympanic over lung fields is most likely |
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Definition
|
|
Term
| Dullness replaces resonance when? |
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Definition
| When fluid or solid tissue replaces air contianing lungor occupies the pleural space beneath your percussing fingers |
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|
Term
| A pneumo will most likley be characterized as what on percussion |
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Definition
| Hyperresonant or tympanic but unilateral |
|
|
Term
| normal distance from the expired lung space posterior to the distance the diagphram occupies on inspiration is |
|
Definition
|
|
Term
| a silent gap in between breath sounds suggest you are hearing what kind of breath sounds |
|
Definition
|
|
Term
| clearing of crackles, wheezes, or rhonchi after coughing or position change suggests |
|
Definition
| sinspissated secretions seen in bronchitis or atelectasis |
|
|
Term
| what adventisous breath sounds are continuous and which are discontinuous |
|
Definition
| discontinuous are crackles and continuous are wheezes and rhonchi. |
|
|
Term
| what breath sound suggests narrowed airways |
|
Definition
|
|
Term
| what breath sounds suggests secretions in large airways |
|
Definition
|
|
Term
| normal dullness is found over the heart in what interspaces |
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Definition
| from the third to fifth interspaces |
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Term
| What is forced expiratory time. patients older than 60 years with a forced expiratory time of ??? are twice as likely to have COD |
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Definition
| This test assesses the expiratory phase of breathing, in obstructive disease sthis is slowed. forced expiratory time of 6-8 seconds |
|
|
Term
| common complaint of dissecting aortic aneurysm |
|
Definition
| ripping, tearing, very severe |
|
|
Term
| pericarditis and pleuritic pain both have similar complaints but in their specific areas |
|
Definition
| sharp, knifelike severe pain, persistent, worsens on movement heavy breathing, |
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|
Term
| what is chronic bronchitis |
|
Definition
| excessvie mucus production in bronchi, followed by chronic obstruction of airways. |
|
|
Term
| reversible, bronchial hyperresponsiveness involving release of inflammatory mediators, increased airway secretions, and bronchoconstriction |
|
Definition
|
|
Term
| GERD gives what length of a cough |
|
Definition
|
|
Term
| what is the difference between funnel chest and pigeon chest |
|
Definition
| funnel chest: depression in lower sternum, pigeon chest sternum is completely displaced anteriorly and therefore the AP diameter is enlarged. |
|
|
Term
| late inspiratory crackles associated with 2x |
|
Definition
1. interstitial lung disease
2. heart failure |
|
|
Term
| early inspiratory crackles are associated with |
|
Definition
| asthma, or chornic bronchitis |
|
|
Term
|
Definition
| when the large bronchi are so constricted or narrowed you no longer makes rhonchi or wheezing sounds and this is VERY BAD |
|
|
Term
| persistent LOCALIZED Wheezing suggests |
|
Definition
| partial obstruction of a bronchus perhaps from a tumor or foreign body |
|
|
Term
| a series of precordial crackles synchronous with the heart beats is |
|
Definition
| a mediastinal crunch (HAMMAN's Sign) |
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