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263 CH19
263 EXAM 2
| Term | Definition |
|---|---|
| thorax | portion of the body extending from the base of the neck superiorly to the diaphragm inferiorly |
| lower respiratory system | lungs, distal portion of the trachea and bronchi |
| thoracic cage | outer structure of the thorax, sternum, 12 ribs, 12 thoracic vertebrae, muscles and cartilage |
| manubrium | connect laterally with clavicle and first 2 pairs of ribs |
| sternum | breastbone, center of chest, 3 parts |
| pectus carinatum | forward protrusion of sternum causing adjacent ribs to slope back |
| sunken sternum | funnel chest |
| suprasternal notch | U shaped indentation superior border of manubrium |
| sternal angle | angle of louis, location of second pair of ribs |
| mid axillary line | runs from apex of axillae to the 12th rib |
| costal angle | less than 90 degrees, meeting at xiphoid process |
| costal angle COPD patients | trapped air, barrel chest |
| first 7 ribs | articulate with sternum by way of coastal cartridges |
| xiphoid process | smallest region of sternum, functions as muscular attachment |
| medastinum | between lungs and above diaphragm, trachea, bronchi, esophagus, heart, great vessels |
| midsternal line | middle of chest |
| trachea | C shaped rings of hyaline cartilage, maintain shape and prevent collapse during respiration |
| bronchi | bifurcates into right and left bronchi, in oblique position of mediastinum, enter lungs at hilum |
| right main bronchus | shorter/ more vertical, make aspirated objects more likely to enter right lung |
| trachea and bronchi | lined by mucus membranes that contain cili, dead space |
| dead space | air is transported but no gas exchange |
| thoracic duct | lumbar, superficial inguinal, superficial popliteal nodes drain into |
| pleural membranes | line lungs, parietal and visceral |
| apex | above clavicle |
| base | level of diaphragm |
| adventitious sounds | related to atelectasis, pulmonary edema (inside lungs), heard at bases |
| pulmonary edema | pink, frothy sputum |
| pleural effusion | fluid collects outside lungs |
| right lung | 3 lobes, near heart |
| left lung | 2 lobes |
| parietal pleura | lines the chest cavity |
| visceral pleura | covers external surface |
| pleural space | lies between pleural layers, decreases friction as breathing |
| severe dehydration | reduces volume of pleural fluid, results in increased transmission of lung sounds and possible friction rub |
| midclavicular line | midway through clavicle on either side |
| vertebral line | along spine in middle of back |
| midaxillary line | middle of armpit down to the 12th rib |
| hypercapnia | strongest stimulus to breathe (CO2) |
| bradypnea | less than 10 per minute, can be medication induced, coma |
| hypoventilation | decreased breathing rate, irregular pattern |
| kussamul breathing | rapid, deep, associated with diabetic keto acidosis |
| cheyne stokes | increased intracranial pressure and congestive heart failure, deep and rapid breathing, periods of apnea, drug OD |
| chronic bronchitis | labored and noisy, occasional coughing (resonance) |
| continuous cough | infection |
| early morning cough | chronic bronchial inflammation |
| late cough | exposure to irritants |
| wheezing | narrowing of airways due to spasm or obstruction, asthma, CHF, excessive secretions |
| nonproductive cough | upper respiratory irritants and early CHF |
| white mucus | colds, viral infections, bronchitis |
| yellow/ green mucus | bacterial infections |
| brown/ black mucus | indicates blood in the sputum, seen in respiratory conditions |
| rust sputum | tuberculosis, pneumococcal pneumonia |
| DRIVE4COPD | determines risk for difficulty of breathing |
| starting point for posterior assesment | 12th rib |
| ineffective airway clearance | use of accessory muscles, deep, wet cough, cannot lie flat |
| crepitus | rice crispy sounds |
| tactile fremitus abnormal | consolidated or bronchial obstruction |
| pursed lip breathing | asthma, CHF, emphysema, response to help slow down expiration and keep alveoli open |
| tripod position | clients leaning forward, seen with COPD |
| hyperresonance | trapped air (emphysema or pneumothorax), hyper-inflated lungs |
| pneumonia | louder, fluid in the lungs conducts sound, increased fremitus |
| pleural effusion | visceral pleura absorbs sound, acts as a blockade of sound |
| pneumothorax | sound is contained, decreased tactile fremitus |
| breath sounds decrease | air flow decreased/ transmission of sound is poor |
| egophony | repeat letter e, sounds like a over area of consolidation |
| bronchophony | patient sats 99 while listening to chest wall |
| pectoriloquy | client whispers 1, 2, 3, heard faintly (abnormal = clear) |
| auscultate posterior | apex of lungs at C7, intensity, pitch, quality |
| bronchovesicular | moderate pitch, moderate amplitude |
| vesicular | low pitch, soft amplitude, heard throughout inspiration, 2/3 expiration |
| pneumonia sounds | course crackles, low pitch, bubbling, moist sounds |
| pleural friction | low pitched, dry, grating sound |
| sibilant lung sounds | high pitched heard during expiration |
| anterior inspection | position of sternum, sternal retractions, slope of ribs, quality and pattern of respirations, intercostal spaces, use of accessory muscles |
| anterior palpation | tenderness, sensation, crepitus, surface masses or lesions, chest expansion |
| pneumonia percussion sound | dull |
| pleuritis | friction rub, seen in older adults |
| older adults ability to cough | weaker muscles and increased rigidity of thoracic wall |
| older adults dyspnea | loss of lung elasticity, fewer functioning capillaries, loss of lung resiliency |
| kyphosis | loss of lung resiliency and loss of accessory musculature |
| calcification of costal cartiladge | loss of accessory musculature, thoracic expansion may decrease |
| tenderness at costochondral junction | seen in fractures, in areas of extreme congestion, crepitus may be palpated |
| focused thoracic assesment | percuss for diaphragmatic excursion, auscultate voice sounds |
| vertical expansion | contraction of diaphragm |
| horizontal expansion | intercostal muscles lift the sternum and elevate the ribs, increased anteroposterior diameter |
| bronchovesicular breath sounds | 1st/ 2nd intercostal space anterior, posterior between scapulae, medium pitch |
| vesicular breath sounds | low pitch, breezy quality, soft amplitude, located over peripheral lung fields |
| COPD | causes obstructed airflow from the lungs, emphysema and chronic bronchitis main conditions, increase posterior to transverse diameter |
| airless lung | increase of voice transmission auscultated |
| bronchial lung sounds | expiration is longer than inspiration, sound is louder and higher in pitch with a short silence in between |
| pleural effusion sound | flat |
| health lung tissue sound | resonance |
| gastric air bubble sound | tympany |
| fine crackles | fluid in alveoli, high pitch, doesn't clear with cough, bronchitis, asthma, emphysema |
| coarse crackles | popping sounds, velcro, extra fluid in lungs, pneumonia, pulmonary edema, pulmonary fibrosis |
| wheezes | continuous musical sounds, airway obstruction |
| thoracic inspection | client's lateral diameter is larger than anteroposterior diameter |
| biot's respirations | seen with brain damage, irregular depth/ rate, periods of apnea |
| hypoventilation | seen with narcotic OD |
| diaphragmatic excursion | client breathes deep and hold breath |
| dullness | heard when fluid or tissue occupies pleural space |
| trachea bifurcates | sternal angle |
| scoliosis | lateral deviation of spinous process |
| continuous cough | acute infection |
| sinusitis | nasal drip, nighttime |
| guide for vertical locations on chest | sternal angle |
| normal lung position | anterior - lower border crosses 6th rib at mid clavicular line |
| right middle lobe | anterior 4th intercostal space |
| bronchial breath sounds | anterior only, over tracheal area, high pitch, inspiration shorter than expiration |
| stridor | heard on inspiration, obstructed airway, high pitch whistle |
| rhonchi | whistle |
| late inspiratory crackles | heart failure |
| early inspiratory crackles | COPD, asthma |
Created by:
ahommel
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