Term
| Analyze objective data collection for the thorax and lungs |
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Definition
| Inspect posterior chest- note the shape and configuration of the chest wall. The spinous process should appear in a straight line. The thorax is symmetric. Assess skin color and condition. Confirm symmetric Chest expansion with palpation. Assess tactile fremitus. Symmetry is most important; vibrations should feel the same in the corresponding area on each side. Avoid palpating over scapula. Percuss the posterior chest. Inspect anterior chest. Assess facial expression, LOC and color and condition. |
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Term
| Lung anatomy; How many lobes on each lung? |
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Definition
| The right lung has three lobes and the left lung has two lobes. The left upper lobe has the cardiac notch where the heart sits. The thoracic cage consists of the sternum, 12 pairs of ribs, 12 thoracic vertebrae, and the diaphragm; which forms the floor separating the thoracic cavity from the abdomen. Anatomical landmarks that are important are the midclavicular line (MCL) and the mid axillary line (MAL). The first seven ribs attach directly to the sternum via costal cartilages, 8,9,10 attach to costal cartilage above and 11 and 12 are floating ribs. Suprasternal notch is u shaped depression just above the sternum, between clavicles. Sternum is the breastbone (three parts- manubrium, body and diploid). The angle of Louis is useful to start counting ribs. |
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Term
| Four major functions of respiratory system |
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Definition
| Supplies o2 to the body for energy production, removes co2 as a waste product of energy reactions, maintains homeostasis (acid base balance) in arterial blood and maintains heat exchange. pg 409 |
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Term
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Definition
| air rushes into the lungs as the chest size increases (inspiration) and is expelled from lungs as the chest reviled (expirations). During inspiration contraction of the bell shaped diaphragm causes it to defend and flatten. This lengthens vertical diameter. Expiration is passive, as the diaphragm relaxes. Elastic forces within the lung, chest cage and abdomen cause it to dome up. |
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Term
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Definition
| cough, SOB, chest pain with breathing, hx respiratory infections, smoking, environmental exposure |
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Term
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Definition
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Term
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Definition
| Asthma is 8.4% in children ages ,18 years, making it the most common chronic disease in childhood. The highest burden of asthma is among those living at or below the federal poverty level. |
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Term
Describe the pathological
changes that occur in the lungs with aging process
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Definition
Respiratory muscle strength declines after age 50 years and continues to decrease into the 70s. A more significant change e is the decrease in elastic properties within the lungs, making them less distensible and lessening their tendency to collapse and recoil. In all the aging lung is a more rigid structure that is harder to inflate. This is due an increase in small airway closure, which yields a decreased vital capacity (the maximum amount of air that a person can expel from the lungs after first filling the lungs to maximum) and increased residual volume (the amount of air remaining in the lungs even after the most forceful expiration. With aging, the gradual loss of inter alveolar septa and fewer alveoli) also occurs therefore less surface area is available for gas exchange. In addition, the lung bases become less ventilated as a result of closing off several airways. This increased the risk for dyspnea with exertion.
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Term
| Abnormal findings of thorax and lungs |
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Definition
Acute cough that lasts less than 2 or 3 weeks, chronic cough last over 2 months. Timing of the cough- continuous throughout day (infection), afternoon/evening (irritant), night (postnasal drip, sinusitis), early morning (chronic bronchial inflammation of smokers). Chronic bronchitis has history of productive cough for 3 months of the year for 2 years in a row.
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Term
| Abnormal findings of thorax and lungs |
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Definition
| Hemoptysis- coughing up blood. Some other conditions- white or clear mucoid- colds, bronchitis- viral infections, yellow or green-bacterial infections, rust colored- tb or pneumococcal pneumonia, pink or frothy- pulmonary edema, some sympathomimetic medications have a side effect. |
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Term
| Abnormal findings of thorax and lungs |
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Definition
| Mycoplasma- hacking, early heart failure- dry, croup- barking, colds, bronchitis, pneumonia- congested. |
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Term
| Abnormal findings of thorax and lungs |
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Definition
| Orthopnea is difficulty breathing when supine. paroxysmal nocturnal dyspnea is awakening from sleep with SOB and needing to be upright- diaphoresis, cyanosis signal hypoxia. |
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Term
| Abnormal findings of thorax and lungs |
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Definition
| Asthma attacks often feel like tightening of chest- allergen, extreme cold, anxiety. |
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Term
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Definition
| Incidence of sarcoidosis is highest in African Americans and cystic fibrosis is highest incidence in Caucasians 1/29 carriers |
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Term
| Characteristics of complaints |
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Definition
| Quality, quantity, associated manifestations, aggravating factors, alleviating factors, setting, timing. PQRSTU |
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Term
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Definition
Adults >10
eupnea 12-20
tachypnea >20
BRADPNEA <12
apnea no respire for 10 or more seconds
children 3-9 years
tachypnea >30
6 mos-1 year
tachypnea > 40
newborn >60 |
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Term
Respiration Pattern
SHOULD BE REGULAR AND EVEN |
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Definition
Cheyne stokes- periods of apnea (20 seconds),breathing period lasts 30-40 seconds
ataxic- periods of apnea- however irregular. Breaths will be 3-4 with apnea @ 10 seconds to a minute
Kussmauls- hyperventilation
agonal- irregular and inadequate pattern of breathing- imminent death |
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Term
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Definition
| CYANOSIS is usually related to tissue hypoxia |
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Term
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Definition
| palpable vibration. Sounds generated from larynx are transmitted through patent bronchi and the lung parenchyma to the chest wall. use palmar base and have the pt repeat words ninety nine or blue moon. Decreased fremetus occurs with obstructed bronchus, pleural effusion or thickening, pneumothorax or emphysema. Increased fremitus occurs with compression of consolidation of lung tissue (lobar pneumonia). This is present when bronchus is patent .Rhonchial remits is pliable with thick bronchial secretions. Pleural friction remits is pliable with inflammation of the pleura. |
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Term
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Definition
| course, crackling sensation over skin. Emphysema- air is trapped in sub tissue like after open thoracic injury or surgery. |
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Term
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Definition
| One side with prominent dullness or marked hyper resonance indicates underlying disease Hyperresonance is a lower pitched, booming sound found when too much air is present like with its who have emphysema or pneumothorax. |
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Term
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Definition
| (soft, muffled thud) signals abnormal density in lungs. |
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Term
| Tactile fremitus increase |
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Definition
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Term
| Tactile fremitus decrease |
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Definition
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Term
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Definition
Fine crackles are more high pitched popping sound while coarse are more low pitched. You may have fine crackles that disappear with a series of deep breaths from atelectasis. Usually heard in the bases and the axillae…at the bottom of the lobes. Wheezes can be high pitched or low pitched. Low pitched are referred to as sonorous or rhoncherous and may clear with coughing because often they are caused from the pooled secretions in the airways.
Pleural friction rubs are coarse, low pitched grating sounds. Stridor, this is high pitched and associated with impending complete obstruction, usually in children and may be life threatening. |
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Term
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Definition
Rib angle- 45 degrees
thoracic expansion 3-5cm or 1 1/4 to 2 inch
tactile fremitus- moderate
tracheal position-midline
percussion-resonance
breath sounds-vesicular in periphery
voice sounds-muffled |
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