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50 Cards in this Set
- Front
- Back
What is the upper airway composed of?
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Nose, mouth, laryngopharynx, larynx
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What is the lower airway composed of?
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trachea, bronchi, bronchioles, alveoli
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Which lung has 3 lobes, 2?
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right, left
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What do you observe for when assessing respiratory system?
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Deformities, Slope of ribs, Abnormal retraction or bulging, Local lag or impairment of respiratory movement, Rate, Rhythm
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What is characterized by a rounded chest appearance seen in infants and COPD patients?
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Barrel Chest
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What is it called when the sternum projects forward and the chest looks like that of a chicken or pigeon? Seen in Atrial or Ventricular defects that may cause pulmonary HTN.
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Pectus carinatum
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What is the disorder when the sternum points posteriorly and may cause abnormal pressure on the heart which could affect function. May cause respiratory failure.
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Pectus excavatum
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An exaggerated curvature of the thoracic vertebrae. Happens to women. Adequate exercise decreases it.
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Kyphosis
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A lateral curvature of the thoracic and lumbar spine. Unequal shoulder and scapulae height.
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Scoliosis
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An exaggerated curvature of the lumbar vertebrae
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Lordosis
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Ribs normal slope
Horizontal rib slope seen in what patients. |
45 degree angle
Emphysema |
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What does abnormal retraction or bulging indicate?
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Asthma, emphysema, pleural effusion, tension pneumothorax
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What does unilateral local lag indicate?
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Respiratory movement impairment
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Whats the normal respiratory rate?
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12-20
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> 20 respiratory rate
seen when? |
tachypnea
fever, pain, anxiety, anemia, pneumonia, pleurisy, lesion in pons |
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< 12 Respiratory rate
seen when? |
bradypnea
Increased ICP, diabetic coma, opiate OD, brain tumor |
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total absence of breathing
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apnea
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increased depth of respirations that can result from exercise or DKA
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hyperpnea
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increase in rate and depth of respirations, blowing off co2 and taking in less o2.
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hyperventilation
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a gradual increase in respirations with rate and depth, then a decrease over a cycle of 30-45 seconds. Periods of apnea will alternate. CHF, RF, OD and end of life
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Cheyne-Stokes
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like cheyne-stokes but same depth of breathing
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Bitos
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Panting labored respiration with increased rate and depth
occurs in acidodic patients |
Kussmaul's respirations
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What part of your hand do you use to palpate for tenderness?
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Finger pads of dominant hand
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What indicates subcutaneous air under the skin?
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Crepitus
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What test is done this way:
o Performed to assess range and symmetry of respiratory movement. Place your thumbs at the level of and parallel to the tenth ribs. Your hands should be grasping the lateral rib cage. As you position your hands, slide them medially to raise loose skin folds between the thumbs and spine. Ask the person to inhale deeply as you note the chest move upward and outward. Watch for excursion of the thumbs (they should move outward as the person inhales and move inward when the person exhales). A picture with a more detailed description is provided in your Jarvis textbook. Unequal chest expansion can result from pleural effusion , rib fractures, pneumothorax, and tumors. |
Respiratory Excursion
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What is the test that occurs this way:
Have the patient fold their arms across their chest. This will shift the scapulae out of the way. Ask the person to repeat the words, ninety- nine or one-one-one, every time you touch the posterior chest using the palmar surface of your dominant hand. Jarvis textbook shows a picture of hand placement for the posterior chest. Your dominant hand is preferrable because this omits any discrepancies in the findings if there is a difference in the sensitivities of the examiner's hands. The examiner moves back and forth from one side of the posterior chest to the other covering first the upper lobes of the lungs to the lower lobes |
Vocal or tactile fremitus
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Where should vibrations be the strongest at with fremitus?
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tracheal bifrication and major bronchus
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When will you have decreased fremitus?
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Obstructed bronchus, COPD, pleural thickening, pneumothorax, emphysema, pleural effusion
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When will you have increased fremitus?
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mass, consolidated area such as in pneumonia
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What is the normal resonant sound?
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Loud and low pitched
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Lung tumors, pneumonia, pleural effusion, and atelectasis will elecit what kind of sound?
Percussing the chest |
Dull
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Emphysema or pneumothorax will elecit what kind of sound
Percussing the chest |
hyperresonant
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What's the normal range for diaphragmatic excursion for men and women
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Women 3-5cm
men 5-7cm |
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What are normal breath sounds?
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Bronchial, Vesicular, Bronchiovesicular
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What are soft, low pitched rustling sounds over the periphery of the lungs? Occurs in inspiration. Most predominant breath sound.
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Vesicular
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What are high pitched tubular sounds located over the trachea and major bronchi. Louder and longer during expiration
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Bronchial
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What are moderately pitched breath sounds?
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Bronchiovesicular
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What breath sounds are heard posteriorly?
Anteriorly? |
Bronchiovesicular, Vesicular
Bronchiovesicular, Vesicular, Bronchial |
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What are noises created when air is traveling through vessels containing abnormal moisture?
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Crackles
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What are soft and high pitched noises that sound like two hairs being rubbed together?
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Fine Crackles
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What are coarse rattling sounds more like a snore, moan, or groan caused by narrowed or constricted large airways. More pronounced on expiration.
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Rhonchi
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What are high pitches sounds produced by air passing through a narrowed passageway in the small airways.
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Wheezes
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Crackling, grating sounds produced when two roughened or inflamed pleural spaces rub across each other during respiration. Heard on both inspiration and expiration. Painful.
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Friction rub
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loud, high pitched crowing sound heard usually without a stethescope during inspiration. Caused by an upper airway obstruction. Requires immediate attention.
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Stridor
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Anxiety, dyspnea, stridor, wheezes, decreased or absent breath sounds, use of accessory muscles, inability to speak (complete obstruction), cyanosis, and seesaw movement of chest.
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Upper airway obstruction
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Person to say, "ninety-nine" while you auscultate the posterior chest. Normally, the sound should be muffled and indistinct. If the sound is clear, it is called
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bronchophony
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Instruct the person to say, "ee" while you auscultate the posterior chest. Normally, the sound should be muffled and indistinct. If the sound is heard as "ay", it is
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egophany
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Instruct the person to whisper "ninety-nine" while you auscultate. The sound should be very faint and indistinct. If the sound is louder and clear, it is called
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whispered pectoriloqy
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What do you examine the anterior chest for?
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Shape, Width of costal angle, Abnormal retraction or bulging, use of accessory muscles, local lag or impairment, Measure Anteroposterior (AP) to lateral diameter - should be 1:2
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When will you observe an increase in AP diameter?
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Older adults, barrel chest, pectus carinatum (pigeon chest)
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