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Thorax and Lungs
Fund. Test 2
Terms in this set (77)
= bony structure with conical shape, narrower at top
thoracic cage is defined by
sternum, ribs, and thoracic vertebrae.
a musculotendinous septm is floor , and separates the thoracic cavity from the abdomen.
Ribs 1-7 attach to
sternum via costal cartilages.
Ribs 8-10 attach to
the costal cartilage above, while ribs 11 and 12 are floating.
what are the anterior thoracic landmarks
suprasternal notch, sternum, manubriosternal angle, costal angle
Hollow U shaped depression just above sternum between clavicals
Breastbone. Has 3 parts
what are the 3 parts of the sternum
manubrium, body, xiphoid process
Manubriosternal Angle: Sometimes referred to as
sterna angle. or Angle of Louis.
angle of louis marks site of
tracheal bifurcation into right and left main bronchi
the angle is where what of the heart lies
upper border of atria
. Articulation of manubrium and body of sternum
angle formed where costal margins meet xiphod process.
what are the posterior thoracic landmarks
vertebra prominens, spinous processes, inferior border of scapula, twelfth rib
why is it harder to count ribs on the back
muscles, soft tissue, and spinal column
C7. Have client flex head and feel for the most prominent bony spur protrucing at the base of the neck. If you have two bony prominens you have C7 and T1
Bony process of the thoracic vertebrae
Inferior Border of Scapula: Located where
symmetrically in each hemithorax. Lower tip is at 7th or 8th rib
Twelfth Rib: is where
Midway between spine and clients side
reference lines are used for what
to pinpoint findings vertically on the chest
reference lines for anterior chest
a. Midsternal Line: Runs vertically down sternum
b. Midclavicular Line- Bisects the center of each clavicle
c. Anterior Axillary line: Runs from axilla on each side
reference lines for posterior chest
a. Vertebral Line: Mid spinal line. Runs down vertebral column
b. Scapular Line: Corresponds with midclavicular line on anterior chest
reference lines for lateral chest
a. Anterior axillary
b. Posterior Axillary
what is the middle section of the thoracic cavity
the mediastinum contains
the esophagus, trachea, heart, and great vessels.
what are on either side of the mediastinum and what do they contain
right and left pleural cavities. contain lungs
what are the lung borders
apex and base
apex is located where
: highest point of lung tissue. 3-4 cm above the inner third of clavicles
base is located where
lowest border of lung tissue. Rests on diaphragm. Anterior location at 6th rib in midclavicular line. Laterally at 7th or 8th rib. Posterior location at T 10.
compare the right lung to the left lung
Right lung is shorter than left lung because of underlying liver. Left lung is narrower than right because of heart
describe the lobes
are stacked in diagonal sloping segments and separated by fissures.
describe anterior lobes
Oblique fissure crosses the 5th rib. Right lung contain horizontal fissure that divides the RUL and RML.
describe posterior lobes
Posterior chest is almost all lower lobe. The LUL and RUL is only a narrow band than extends from apices at T1 down to T3 or T4.
describe lateral lobes
Extends from apex of axilla down to 7th or 8 rib. RUL extends from apex of axilla down to 5th rib midaxillary line and 6th rib at midclavicular line. RML extends from horizontal fissure to 6th rib midclavicular line. RLL 5th to 8th ribs midaxillary line
LUL and LLL look like 2 triangles stacked together at their base.
description of pleurae
thin, slippery and forms an envelope between the lungs and chest wall
what are the different kinds of pleurae
visceral and parietal
Lines the outside of lungs and dips down into lung fissures
Inside chest wall and diaphragm
Inside the envelope, pleural cavity is a potential space filled with a few milliliters of lubricating fluid. Pleurisy
location and characteristics of trachea
lies anterior to esophagus. About 10-11 cm long in adults. Begins at cricoids cartilage in neck and bifurcates just below sterna angle into right and left main bronchi.
function of trachea
transports gas between environment and lung parenchyma
description of bronchi
Transports gases between environment and lung parenchyma. Together constitute dead space (air in lungs not available for gaseous exchange. Protects alveoli from small particulate matter that is in inhaled air. Lined with goblet cells that secrete mucus to entrap particles. Lined with cilia that sweep particles upward so they can be swallowed or expelled
Functional respiratory unit.
acinus consist of
bronchioles, alveolar ducts, alveolar sacs, and alveoli.
function of acinus
Gas exchanges across the respiratory membrane in the alveolar duct and alveoli.
alveoli are located where
clustered like grapes around each alveolar duct
functions of the respiratory system
1. Supply oxygen to body for energy production
2. Remove carbon dioxide as waste product of energy reactions
3. Maintain homeostasis (acid-base balance)of arterial blood
4. Maintain heat exchange (more important in animals than humans) Panting dog
control of respirations: normally breathing patterns do what
changes without our awareness in respond to cellular demands.
Involuntary control of respirations is mediated by
respiratory center in pons and medulla (brainstem)
b. Normal stimulus to breath is an
increased carbon dioxide level in blood (hypercapnia)
c. Back up stimulus to breath is
decrease of oxygen in blood (hypoxemia)
which is more effective? hypoxemia or hypercapnia
Chest size increases with
with inspiration when air rushes into lungs
chest size decreases with
because of upward or downward movement of diaphragm
Vertical diameter lengthens or shortens
because of rib movement (AP to lateral diameter, and thoracic chest expansion)
2. AP diameter increases or decreases
Accessory Muscles: are
Not used with normal respirations. Used with forced inspirations after exercise. Also used when pathological condition exist (respiratory distress). Accessory muscles include neck muscles (sternomastoid, scalene, trapezii).
aging adult changes
Costal cartilages calcify and produce less mobile thorax. Thoracic expansion decreases.
2. Respiratory muscle strength declines after 50 y/o and continues to decrease in the 70s. Decreased vital capacity or amount of air that older can expel from lungs Leads to increased residual volume
3. Histological changes include a gradual loss of intra alveolar septa and a decrease in number of alveoli. Less surface area is available for gas exchange.
aging adults are at greater risk for
postoperative pulmonary complication atelectasis and infection.
Also, greater risk because of decreased ability to cough, and loss of protective airway reflexes, and increased secretions.
Disproportionately large number of TB cases reported among
TB rates in foreign born persons in US is
More than half of TB cases in US are in persons from
with the rest of people from
Philippines, Vietnam, India and China.
Asthma attach higher among
least likely to report to urgent care for asthma
Non Hispanics, white and Asian
Size of the thoracic cavity, cultural difference, seems to influence
. In descending order from largest to smallest thoracic cavity
Whites, blacks, Asian, American Indians.
a cough can be what
acute (sudden onset lasting less than 3 weeks) or chronic (lasting longer than 3 weeks)
causes of acute cough
are viral infections, allergic rhinitis, acute asthma, acute bacterial sinusitis, or environmental irritants.
causes of chronic cough
postnasal drip, gastroesophageal reflux disease (GERD), asthma, chronic bronchitis, bronchiectasis, cystic fibrosis, chronic interstitial lung disease, and smoking.
if cough is productive you need to ask
How much sputum do you cough up? What does the sputum look like? Color, consistency, odor.***
what conditions can cause SOB
pneumonia may cause sudden onset of SOB, other conditions such as chronic heart failure may be more gradual onset.
chest pain with breathing usually caused by
respiratory disease is usually associated with chest wall or parietal pleura.
what may be indication of pleural lining irritation
A sharp, abrupt pain associated with breathing
DESCRIBE ABNORMAL FINDINGS ASSOCIATED WITH ASSESSMENT OF THE RESPIRATORY SYSTEM
1. Asymmetry or unequal muscle development - inspection
2. AP to Lateral diameter
3. Thoracic expansion
4. Tripod position
5. Clubbing of nails
6. Breathing patterns:
7. Adventitious Lung Sounds
Breathing patterns: include
a. Bradypnea = rate less than 12 breaths per minute
b. Tachypnea = rate greater than 20 breaths per minute (fever, fear, activity
c. Hyperventilation = Increased rate and depth of respiration
d. Kussmaul = hyperventilation occurs with ketoacidosis (diabetes mellitus)
e. Biot = irregularly interspersed periods of apnea in a disorganized and irregular pattern, rate, or depth. Associated with increased ICP, respiratory distress, or damage to medulla
f. Cheyne Stokes = intervals of apnea interspersed with a deep rapid breathing pattern. Associated with severe illness, drain damage, or drug overdose
Adventitious Lung Sounds include
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