Term
| sternum, ribs, costochondral junctions, thoracic vertebrae, and diaphragm |
|
Definition
| the 5 things that make up the thoracic cage |
|
|
Term
| midsternal line, midclavicular line, and anterior axillary line |
|
Definition
| what are the three anterior reference lines? |
|
|
Term
| vertebral line and scapular line |
|
Definition
| what are the two posterior reference lines? |
|
|
Term
| anterior axillary line, midaxillary line, and posterior axillary line |
|
Definition
| three lateral reference lines |
|
|
Term
|
Definition
|
|
Term
|
Definition
| the middle section of the thoracic cavity that contains the esophagus, trachea, heart, and great vessels |
|
|
Term
apex- highest point, 3-4 cm above the inner 3rd of the clavicle
base- lowest point, rests on the diaphragm at 6th rib in the midclavicular line
laterally- from apex of axilla to 7th or 8th rib
posteriorly- down to T10, T12 |
|
Definition
|
|
Term
|
Definition
| which lung is shorter and has three lobes |
|
|
Term
|
Definition
| which lung has a horizontal fissure and a right oblique fissure |
|
|
Term
|
Definition
| which lung is more narrow and has two lobes? |
|
|
Term
|
Definition
| which lung has a left oblique fissure? |
|
|
Term
|
Definition
| what does the left oblique fissure divide? |
|
|
Term
| left lower lobe and left upper lobe |
|
Definition
| in the left lung, what are the lobes called? |
|
|
Term
| right upper lobe, right middle lobe, and right lower lobe |
|
Definition
| in the right lung, what are the lobes called? |
|
|
Term
|
Definition
| what does the horizontal fissure in the right lobe divide? |
|
|
Term
|
Definition
| in the right lobe, what does the right oblique fissure divide? |
|
|
Term
|
Definition
| lines the outside of the lungs |
|
|
Term
|
Definition
| lines the inside of the chest wall and diaphragm |
|
|
Term
| costodiaphragmatic recess |
|
Definition
| located below the lungs, comprises lung expansion when abnormally filled with air or fluid |
|
|
Term
| visceral, parietal, costodiaphragmatic |
|
Definition
| the three thoracic pleurae |
|
|
Term
|
Definition
| anterior to esophagus, begins at cricoid cartilage, bifurcates below sternal angle at T4 and T5 into the right and left bronchi, and the right bronchi is shorter, wider, and vertical |
|
|
Term
| supply oxygen to the body for energy, remove carbon dioxide, maintain homeostasis of arterial blood, and maintain heat exchange |
|
Definition
| what are the major functions of respiratory system? |
|
|
Term
|
Definition
| involuntary control of respirations |
|
|
Term
|
Definition
| increase carbon dioxide in the blood; normal stimulus to breathe |
|
|
Term
|
Definition
| decrease of oxygen in the blood |
|
|
Term
|
Definition
| increase chest size, diaphragm contracts, descends, and flattens |
|
|
Term
|
Definition
| chest recoils, diaphragm relaxes |
|
|
Term
|
Definition
| what disease is more prevalent in cross-cultural care? |
|
|
Term
| size in the thoracic cavity |
|
Definition
| what influences pulmonary function? |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| what should be less than 90 degrees? |
|
|
Term
|
Definition
| this is where the trachea bifurcates into left and right bronchi |
|
|
Term
|
Definition
|
|
Term
|
Definition
| when does the scapula end |
|
|
Term
|
Definition
| this sound is heard whenever there is airway obstruction |
|
|
Term
|
Definition
| this sound occurs with secretions in the chest |
|
|
Term
high-pitched wheezing sound
|
|
Definition
|
|
Term
| stridor (ex. child with croup) |
|
Definition
| this sound is heard when there is significant inflammation in the UPPER airway |
|
|
Term
|
Definition
| atelectic crackles are what? |
|
|
Term
| louder (ex. emphesema, COPD) |
|
Definition
| if there is more air in the lungs, when you percuss the sound will be... |
|
|
Term
| in the intercostal spaces... not on top of the ribs |
|
Definition
| where do you percuss on the chest? |
|
|
Term
|
Definition
| in COPD patients, neck muscles are... |
|
|
Term
|
Definition
| COPD patients often sit in what position? |
|
|
Term
|
Definition
| what are two examples of skeletal deformities of the spinous processes? |
|
|
Term
| with barrel chest (ex. emphysema) |
|
Definition
| when is the AP diameter equal? |
|
|
Term
| cough? shortness of breath? chest pain with breathing? history of respiratory infections? smoking history? environmental exposure? self-care behavior? |
|
Definition
| what are the health history questions to ask when assessing the thorax? |
|
|
Term
1. shape and configuration (spinous processes, thoracic symmetry, and AP diameter)
2. neck and trapezius muscles
3. position
4. skin color and condition |
|
Definition
| when inspecting the posterior chest what do you look at? |
|
|
Term
|
Definition
| where do you test for symmetrical chest expansion? |
|
|
Term
|
Definition
| what happens to the vibrations when something obstructs transmission of vibrations, ex. emphysema, obstructed bronchus? |
|
|
Term
|
Definition
| what happens when the vibrations are over areas of consolidation ex. pneumonia |
|
|
Term
|
Definition
| palpate in five places, ask the patient to say "99", vibrations should be equal on both sides |
|
|
Term
| relative location of bronchi to chest wall, thickness of chest wall, and pitch and intensity |
|
Definition
| factors that affect intensity of tactile fremitus include... |
|
|
Term
| resonance, hyperresonance, dull |
|
Definition
| 3 types of percussion notes |
|
|
Term
|
Definition
| how many places do you percuss on the back? |
|
|
Term
|
Definition
| normal lung, air-filled, low-pitched, clear, hollow sound |
|
|
Term
|
Definition
| lower-pitched, booming sound, has too much air is present, ex. emphysema and pneumothorax |
|
|
Term
|
Definition
| soft, muffled thud, signal abnormal density in lungs, ex. pneumonia, pleural effusion, or tumor |
|
|
Term
| vesicular, bronchial, bronchovesicular |
|
Definition
| characteristics of normal breath sounds |
|
|
Term
|
Definition
| low, soft pitch heart over the peripheral lung fields |
|
|
Term
|
Definition
| loud, high pitch heard in the trachea and larynx (heard on the anterior chest best) |
|
|
Term
|
Definition
| moderate pitch heard over major bronchi where fewer alveoli are located |
|
|
Term
|
Definition
| added sounds not normally heard in the lungs |
|
|
Term
| crackles, wheezes, rhonchi, stridor |
|
Definition
| examples of adventitious sounds |
|
|
Term
|
Definition
| these type of lungs do not make as much noise |
|
|
Term
1. obstruction
2. emphysema patients (loss elasticity, decreased force of inspired air, hyperinflated lungs do not make as much noise)
3. silent chest |
|
Definition
| 3 things that can cause decreased breath sounds |
|
|
Term
| consolidation (ex. pneumonia) and compression (ex. pleural effusion) |
|
Definition
|
|
Term
|
Definition
| increase in both rate and depth, blows off CO2 |
|
|
Term
|
Definition
| irregular slow shallow pattern, retains CO2 |
|
|
Term
| Cheyne-Stokes Respiration |
|
Definition
| breathing patterns fluctuates from regular, to rapid and shallow, to periods of apnea (ex. drug OD, increased ICP, meningitis) |
|
|
Term
| enhances voice sounds when auscultating the posterior chest |
|
Definition
| what does compression and consolidation of lung tissue do? |
|
|
Term
dull- heart and liver
tympanic- gastric space
hyperresonance- hyperinflated lungs
flat- bone |
|
Definition
| what organ has a dull note, what has a tympanic note, hyperresonance, flat note? |
|
|
Term
|
Definition
| number of seconds it takes to exhale from total capacity to residual volume |
|
|
Term
|
Definition
| measures air flow obstruction, ask person to inhale deepest breath possible and then blow it all out hard, as quick as possible with mouth open, listen over the sternum |
|
|
Term
|
Definition
|
|
Term
|
Definition
| varies depending on hemoglobin level, acid-base balance, and ventilatory status |
|
|
Term
|
Definition
|
|
Term
|
Definition
| infection of parenchyma, leaving alveoli filled bacteria and fluid instead of air, results to decrease surface area, which causes hypoxia |
|
|
Term
|
Definition
| adventitious sound associated with pneumonia |
|
|
Term
|
Definition
| adventitious sounds associated with bronchitis |
|
|
Term
| atelectasis and emphysema |
|
Definition
| 2 respiratory conditions that don't have adventitious sounds associated with them |
|
|
Term
|
Definition
| destruction of pulmonary CT (connective tissue) that leads to permanent enlargement of air sacs to bronchioles and rupture of interalveolar walls, which results in hyperinflated lungs. |
|
|
Term
|
Definition
| emphysema percussion will sound.. |
|
|
Term
| atelectasis and pneumonia |
|
Definition
| which two respiratory conditions would have dull percussion? |
|
|
Term
| the whole area across chest wall |
|
Definition
|
|
Term
|
Definition
| these 2 respiratory conditions would have resonant percussion |
|
|
Term
|
Definition
| the heart goes from which intercostal space to which intercostal space? |
|
|
Term
| pulmonary artery, pulmonary veins, aorta, and superior and inferior vena cava |
|
Definition
|
|
Term
| left to body, right to lungs |
|
Definition
| where do the left and right sides of the heart pump blood? |
|
|
Term
| the AV valves open, allowing the ventricles to fill with blood |
|
Definition
| what happens to which valves during diastole |
|
|
Term
|
Definition
| the valves between the ventricles and the arteris |
|
|
Term
| pulmonic on the right and aortic on the left. they open during systole to allow blood to be ejected from the heart |
|
Definition
| what are the two SL valves |
|
|
Term
1. pericardium- tough double-walled sac that surrounds and protects the heart
2. myocardium- the muscular wall of the heart; it does the pumping
3. endocardium- the thin layer of endothelial tissue that lines the inner surface of the heart chambers and valves |
|
Definition
| the layers of the heart wall |
|
|
Term
|
Definition
| the middle third of the thoracic cage |
|
|
Term
open- during beginning of systole (S1)
close- during end of systole (S2) |
|
Definition
| the valves open during what and close during what |
|
|
Term
| tricuspid (right side) and mitral/bicuspid (left side) |
|
Definition
| the two atrioventricular valves |
|
|
Term
|
Definition
| where is S2 best heard at? |
|
|
Term
|
Definition
| where is S1 best heart at? |
|
|
Term
| when the mitral and tricuspid valves swing shut |
|
Definition
|
|
Term
| when the semilunar valves close |
|
Definition
| S2 (second heart sound) occurs... |
|
|
Term
|
Definition
| which side of the heart has less pressure |
|
|
Term
| SA node (it has an intrinsic rhythm) |
|
Definition
|
|
Term
|
Definition
| when do extra heart sounds occur if they are present? |
|
|
Term
| third heart sound. it occurs immediately after S2 |
|
Definition
| this sound occurs with heart failure, volume overload |
|
|
Term
|
Definition
| the ventricles become resistant and noncompliant. heard just before S1 |
|
|
Term
1. frequency- heart sounds are described as high pitched or low pitched
2. intensity- loud or soft
3. duration- very short for heart sounds; silent periods are longer
4. timing- systole or diastole |
|
Definition
| 4 characteristics of sound (how they are described) |
|
|
Term
|
Definition
| equals the volume of blood in each systole (stroke volume) times the number of beats per minute (rate) |
|
|
Term
|
Definition
| what two things affect the heart's ability to increase cardiac output |
|
|
Term
|
Definition
| the venous return that builds during diastole. it is the length to which the ventricular muscle is stretched at the end of diastole just before contraction |
|
|
Term
|
Definition
| the opposing pressure the ventricle must generate to open the aortic valve against the higher aortic pressure. it is the resistance against which the ventricle must pump its blood |
|
|
Term
|
Definition
| what is normal cardiac output? |
|
|
Term
|
Definition
| how many times does the SA node beat per minute? |
|
|
Term
|
Definition
| indicator of volume status of blood in heart |
|
|
Term
| the efficiency of cardiac function |
|
Definition
| the carotid artery and jugular veins reflect what? |
|
|
Term
| SA node--> AV node--> bundle of his--> R and L bundle branches |
|
Definition
|
|
Term
|
Definition
| pressure that LV has to pump against to get blood to the body |
|
|
Term
|
Definition
| the artery located in the groove between the trachea and the sternomastoid muscle, medial to and alongside that muscle |
|
|
Term
|
Definition
| these empty unoxygenated blood directly into the superior vena cava. they give info about activity on the right side of the heart |
|
|
Term
|
Definition
| name the two jugular veins |
|
|
Term
|
Definition
| this vein is larger and lies deep and medial to the sternomastoid muscle |
|
|
Term
|
Definition
| this vein is more superficial; it lies lateral to the sternomastoid muscle, above the clavicle |
|
|
Term
S4- tennessee
S3- kentucky |
|
Definition
| what word does S4 sound like? and S3? |
|
|
Term
|
Definition
| what two things are more prevalent for African Americans? |
|
|
Term
| shortness of breath that occurs when sleeping |
|
Definition
|
|
Term
| difficulty breathing when laying down |
|
Definition
|
|
Term
| lie back and turn head slightly away from you |
|
Definition
| to assess the jugular veins what do you need to tell the patient to do? |
|
|
Term
| palpate and look for a symmetric pulse. grade the pulse on a scale of 1-3. and auscultate for a bruit- listen in 3 spots on each side |
|
Definition
| how do you assess the carotid arteries? |
|
|
Term
|
Definition
|
|
Term
|
Definition
| which heart sound is louder at the apex? |
|
|
Term
|
Definition
| which heart sound coincides with carotid artery pulse? |
|
|
Term
|
Definition
| S1 coincides with what wave on an electrocardiogram? |
|
|
Term
| aortic, pulmonic, erb's point, tricuspid, mitral |
|
Definition
| what are the five auscultatory areas? |
|
|
Term
|
Definition
where is the aortic valve area
|
|
|
Term
|
Definition
| where is the pulmonic valve area |
|
|
Term
| left lower sternal border |
|
Definition
| where is the tricuspid valve area |
|
|
Term
| the fifth interspace at around left midclavicular line (nipple line) |
|
Definition
| where is the mitral valve area |
|
|
Term
|
Definition
| how long do you listen to the apical impulse? |
|
|
Term
|
Definition
| the rhythm varies with the person's breathing, increasing at the peak of the inspiration and slowing with expiration. it occurs normally in young adults and children |
|
|
Term
|
Definition
| signals a weak contraction of the ventricles; it occurs with atrial fibrillation, premature beats, and heart failure |
|
|
Term
|
Definition
| when you notice any irregularity, check for _____ _______ by auscultating the special beat while simultaneously palpating the radial pulse |
|
|
Term
|
Definition
| if homan's sign is positive (pain), then what is that possibly indicative of? |
|
|
Term
|
Definition
| where do you palpate the temporal artery? |
|
|
Term
| brachial (major artery supplying blood to the arm), radial (thumb side), and ulnar (pinky side) |
|
Definition
| what are the three arteries of the arm? |
|
|
Term
|
Definition
|
|
Term
| femoral (major one- inguinal pulse site), popliteal (pulse site behind the knee), dorsalis pedis (top of foot), and posterior tibial (inside of ankle) |
|
Definition
| what are the 4 arteries in the leg? |
|
|
Term
|
Definition
| the two types of deep veins |
|
|
Term
| great saphenous and small saphenous (sometimes used for open heart surgery) |
|
Definition
| the two types of superficial veins |
|
|
Term
| deep (femoral and popliteal), superficial (great and small saphenous), and perforators (connecting veins) |
|
Definition
| what are the 3 types of veins in the leg? |
|
|
Term
1. contracting skeletal muscles
2. breathing
3. valves |
|
Definition
| what are the three mechanisms of venous flow? |
|
|
Term
|
Definition
| retrieve excess fluid from the tissue spaces and return it to the bloodstream |
|
|
Term
| right lymphatic duct and thoracic duct |
|
Definition
|
|
Term
| the right subclavian vein |
|
Definition
| what does the right lymphatic duct empty into? |
|
|
Term
|
Definition
| drains right side of head and neck, right arm, right side of thorax, right lung and pleura, right side of the heart, right upper section of the liver |
|
|
Term
|
Definition
| drains the rest of the body and empties into the left subclavian vein |
|
|
Term
| spleen, tonsils, and thymus |
|
Definition
| what are the organs that aid the lymphatic system? |
|
|
Term
1. to conserve fluid and plasma proteins that leak out of the capillaries
2. to form a major part of the immune system that defends the body against disease
3. to absorb lipids from the intestinal tract |
|
Definition
| what are the functions of the lymphatic system? |
|
|
Term
| cervical, axillary, epitrochlear (middle of arm), and inguinal |
|
Definition
| what are the four superficial groups of lymph nodes? |
|
|
Term
|
Definition
| the storage site for RBCs |
|
|
Term
|
Definition
| this functions more in a child |
|
|
Term
|
Definition
| what medication increases the risk of a DVT? |
|
|
Term
|
Definition
| how long should capillary refill take? |
|
|
Term
|
Definition
| this test is used to evaluate the adequacy of collateral circulation prior to cannulating the radial artery. (this is the test we did in class where you depress the radial and ulnar arteries and the person opens and closes their fist.. when you take off the pressure, the blood should return. if it doesn't, then the ulnar artery is occluded) |
|
|
Term
|
Definition
| removal of lymph nodes with breast surgery, or damage to lymph nodes and channels with radiation therapy for breast cancer; can impede drainage of lymph |
|
|
Term
| viewing the finger from the side (used to detect early clubbing) |
|
Definition
| what is the profile sign? |
|
|
Term
| if they are hard and fixed |
|
Definition
| what are characteristics of lymph nodes that are worrysome? |
|
|
Term
|
Definition
| anterior chest wall between the second and sixth ribs |
|
|
Term
|
Definition
| center of the breast; rough, round, protuberant |
|
|
Term
|
Definition
| surrounds the nipple; small elevated sebaceous glands |
|
|
Term
|
Definition
| these become contracted when there is a malignancy there- creates dimples |
|
|
Term
|
Definition
| when examining the woman's axillae, how should she be positioned? |
|
|
Term
| enlargement of breast tissue in men. usually happens in puberty. it's temporary and it's usually one-sided |
|
Definition
|
|
Term
|
Definition
| a firm transverse ridge of compressed tissue in the lower quadrants |
|
|
Term
| swelling in the lymph system |
|
Definition
|
|
Term
1. solid- liver, kidneys, etc.
2. hollow- the shape depends on the contents (bladder, stomach, colon, etc.) |
|
Definition
| what are the two types of viscera? |
|
|
Term
| no bowel movement for three days |
|
Definition
what constitutes constipation?
|
|
|
Term
|
Definition
|
|
Term
normal- flat, rounded
abnormal- scaphoid, protuberant |
|
Definition
| describe normal and abnormal contour of abdomen |
|
|
Term
abdomen is large and firm, rounded
(ex. bowel obstruction) |
|
Definition
|
|
Term
| abdomen shape of patient who is anorexic, wasted |
|
Definition
|
|
Term
hyperactive- loud, high-pitched, rushing, tinkling sounds that signal increased motility
hypoactive or absent- follow abdominal surgery or with inflammation of the peritoneum |
|
Definition
| two distinct patterns of abnormal bowel sounds |
|
|
Term
|
Definition
| to declare an abdomen has having absent bowel sounds, how long do you have to listen for? |
|
|
Term
| legal document, communication and care planning, quality assurance, financial reimbursement, education, and research |
|
Definition
| what are some patient medical record purposes? |
|
|
Term
| confidential (never leave a computer unattended), accurate and complete, organized, timely (time of entry must reflect the time that you did it), and concise |
|
Definition
| what are the principles of documentation? |
|
|
Term
| narrative, SOAP (IE), PIE, focus, and charting by exception |
|
Definition
| 5 kinds of documentation formats |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| if nothing is wrong, just click on to the next section without writing anything. |
|
Definition
|
|
Term
| problem, intervention, evaluation |
|
Definition
|
|
Term
| subjective, objective, assessment, plan, intervention, evaluation |
|
Definition
| what does SOAP (IE) stand for? |
|
|
Term
|
Definition
| incorporates plan of care, includes outcomes which increase quality assurance, less redundancy, easily adapted to computer charting |
|
|
Term
|
Definition
| hot topic with joint commission. ensures quality |
|
|
Term
|
Definition
| occurs when care for a patient is transferred from one health provider to another. receiving staff must have up-to-date assessment data |
|
|
Term
| use a standardized format- SBAR, communicate face to face with current and historical data, ensure limited interruptions, use "read-back" policies, and use written documentation to supplement handoff |
|
Definition
| what are some strategies for effective handoff? |
|
|
Term
S- situation, state concisely why you are communicating
B- background, describe circumstances that lead up to the situation
A- assessment, give objective/subjective data pertinent to the situation
R- recommendation, make suggestions for what needs to be done to manage the patient |
|
Definition
| what does SBAR stand for and mean? |
|
|
