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health assessment 2d
thorax and lungs
| Question | Answer |
|---|---|
| normal adult | throax elliptical shape w/ AP: TD 1:2 or 5:7 |
| barrel chest | AP not TD, ribs are horizontal -normal aging + chronic emphysema + asthmas as a rsult of hyperinflation of lungs |
| pectus excavatum | sunken sternum + adjacent cartilages -depression @ 2nd intercostal -noticable on inspiration -congential |
| pectus carinatum | foward protruison of stenum w/ribs sloping back at either side + vertical depression -minor deformity requires no treatment -severe surgery |
| scoliosis | s-shaped curvature of thoracic + lumbar spine -unequal shoulder + scapula height, hip levels, rib interspaces flarred ->45 severe, deviation -reduce lung volume, |
| kyphosis | exaggerated posterior curve of throaci spine (humpback) hyperextension of head to maintaing level of vision -aging, postmenopauls osteoportic women, common b4 menopause -related to phyiscal fitness |
| normal respiration patterns | rate- 10 to 20 depth- 500 to 800 pattern-even depth- air moving in + out with each respiration ratio of pulse to resp. is fairly constant (4:1) both values increase as a normal response to exercise, fear, or fever |
| sigh | occassional sighs puctuate the normal breathing pattern and purposeful to expand alveoli -freq sighs may indicate emotional dysfunction; may leasd to hyperventilation + dizzines |
| tachypnea | rapid shallow breathing -increased rate >24 normal response: fever, fear, exerciase rate increases w. resp insufficency, pnuemonia, alkalosis, pleurisy, + lesions in the pons |
| hyperventialation | increase in rate + depth normal: extreme exertion, fear, or anxiety -diabetic keotoacidosis, hepatic coma, salicylate overdoese |
| bradypnea | slow breathing decreased but reg rate (<10) |
| hypoventilation | irregular shallow pattern caused by an overdoese of narcotics or anestheitcs -prolonged bed rest or conscious splinting of chest to avoid resp. pain |
| cheyen stokes respiration | cycle with gradually wax and wane in regualr pattern, increasing in rate + depth + then decreasing -breathing pd lasts 30-40 sexs, with pd of apnea (20 secs) alternating -cause: HF, RF, meingitis, drug overdoes -normally: infants and aging during sleep |
| biot's respiration | irregular Cheyne-Stokes -normal resp (3-4) is followed by pd of apnea -cycle variable, lasting from 10 sec - 1 min -head trauma, brain abscess, heat stroke, spinal meingitis, encephalitys |
| chronic obstructive breathing | normal inspiration + prolonged expiration to overcom increased airway resistance -normal inspiration, prolonged expiration, air trapiing |
| increased tactile fremitus | occurs w/conditions that increase density of lung tissue, thereby making a better conducting medium for vibration increased fremitus: patent bronchus, + consolidation must extend to ung surface |
| decreased tactile fremitus | occurs wen anything obstructs transmission of vibrations -decreasd fremitus: any barrier that gets in the way of sound + palpating hand |
| rhoncal fremitus | -vibration felt when inhaled air passes through thick secretions in larger bronchi -decrease with coughing |
| pleural friction fremitus | produced wen inflammation of the parietal or visceral pleura causes a decrease in norm lubritcating fluid. Then opposing surfaces make a coars grating sound wen rubbed together durign breathing -best ausc, but palpable+ feels like 2 pieces of leather |
| discontinous sound | discrete, crackling counds |
| crackles-fine | -discontinous, high pitched, short crackling, popping sounds heard during inspiration |
| crackles-coarse (coarse rales) | discntinous, loud, low-pitched, bubbling + gurgling sounds that stat in early inspiration |
| atelectatic crackles (atelectatic rales) | discontinous, sounds like fine crackles, disapper after 1st few breathes; heard in axillae +bases |
| pleural friction rub | discontinous, superifical, coarse + low-pithced; grating quality; sound is inspiratory + expiratory |
| continous sounds | connected, musical sounds |
| wheeze-high-pithced | continous, high-pitched, musical squeaking; predominate in expiration |
| wheeze-low-pitched (sonorous ronchi) | continours, low-pitched, monophoic, musical snoring, moaning, heard throughout cyce |
| stridor | continous, high-pitched, monophonic, inspiratory, crowing sound, louder in neck than over chest wall |
| bronchophony | normal: soft, muffled, indistinct abn: clear "99", distinct, sound close |
| egophony | normal: "eee" abn: "aaa" |
| whisped pectoriloquy | normal: fiant, muffled, inaudible abn: clear, distinct, whispering into stethoscope |
Created by:
xnyzlatinangelx
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