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Chapter 18- Thorax and Lungs
Terms in this set (59)
Reference line that bisects the center of each clavicle at a point halfway between the palpated sternoclaviclar and acromioclavicular joints. Between anterior axillary line and midsternal line
Reference line that is straight down the middle of the back
Reference line that is straight down the chest
Reference line that extends through the inferior angle of the scapula when the arms are at the sides of the body. On the back from the shoulder blade down. Between the posterior axillary line and vertebral line.
Reference line that extends down from the anterior axillary fold where the pectoralis major muscle inserts. The outer most line, beside the armpit
Reference line that continues down the back from the armpit
Reference line that runs down from the apex of the axilla and lies parallel to the anterior and posterior axillary lines
Lung has three lobes
Lung has two lobes
Lung is shorter than the other because of underlying liver
Lung is narrower because of heart bulging
Coughing up blood
Difficulty breathing when supine. Patient will need two pillows to achieve comfort
Paroxysmal nocturnal dyspnea
Patient states, "awakening from sleep with dyspnea"
During this part of assessment, you assess quality of respirations
Equal anteroposterior-to-transverse diameter and that ribs are horizontal instead of normal aging. A result of hyperinflation of lungs caused by chronic emphysema and asthma.
A lateral S-shaped curvature of the thoracic and lumbar spine, usually with involved vertebrae rotation. Unequal shoulder and scapular height and unequal hip levels, rib interspaces flared on convex side.
An exaggerated posterior curvature of the thoracic spin that causes significant back pain and limited mobility
Exhibits rapid and shallow respirations. <24 per minute
Slow breathing. >10 per minute
Periods of deep breathing alternating with periods of apnea. End of life breathing
Similar to Cheyne-Strokes, except that the patients breathing is irregular
Chronic obstructive breathing
Normal respiration and prolonged expiration to overcome increased airway resistance
Slow, shallow breathing
Causes carbon dioxide to build up in blood
Rapid, deep breathing
A palpable vibration. Use either palmar base of fingers or ulnar edge of one hand
Normal- muffled voice sounds and symmetrical tactile
Increased tactile fremitus
Occurs with compression or consolidation of lung tissues. Example- pneumonia
Decreased tactile fremitus
Occurs when anything obstructs transmission of vibrations. Example- Obstructed bronchus and pneumothorax
Vibration felt when inhaled air passes through thick secretions
Pleural friction fremitus
Produced when inflammation of the parietal or visceral pleura causes a decreased in the normal lubricating fluid, then the opposing surfaces make a course gaiting sound when rubbed together during breathing. Sound is best detected through auscultation.
A course, cracking sensation palpable over the skin surface. Occurs in subcutaneous emphysema, when air escapes from the lung and enters the subcutaneous tissue as after an open thoracic injury or surgery
Breath sound heard over trachea. Expiration longer than inspiration. Also called tracheal or tubular
Breath sound heard over main-stem. Inspiratory phase equals expiratory phase
Breath sound that are soft and breezy. Inspiration longer than expiration. Decreased breath sounds.
Discontinuous, high-pitched, short crackling, popping sounds heard during inspiration. Not cleared by coughing. Sounds like strands of hair rolling between fingers.
Late inspiratory crackles, early inspiratory crackles, and posturally inducted crackles
Loud, low-pitched, bubbling and gurgling sounds that start in early inspiration. May present in expiration. Decreases with coughing.
Pulmonary edema, pneumonia, pulmonary fibrosis, and the terminally ill who have a depressed cough reflex
Sounds like fine crackles, but does not last. It disappears after that first few breaths. Associated in aging adults, bedridden, or just aroused from sleep
Pleural friction rub
Sound made when pleurae become inflamed and rub together during respiration. The sound is superficial, coarse, and low-pitched, as if two pieces of leather are being rubbed together. Associated with pleuritis
High-pitched, musical squeaking sounds. Predominate in expiration, but may occur in both expiration and inspiration. Associated with asthma or chronic emphysema
Low pitched wheeze. Course rattling. Continuous sounds. Monophonic single note. Snoring, moaning sounds. Associated with bronchus obstruction from airway tumor
High-pitched, monophonic. Inspiratory, crowing sound. Sounds are louder in the neck than over the chest wall. Associated with croup, acute epiglottis in children, and foreign body inhalation.
Predominate in health lung tissue in the adult
Low-pitched, clear, hollow sound. When too much air is present. Emphysema or pneumothorax
Note soft, muffled thud. Signals an abnormal density in the lungs. Pneumonia, plural effusion, atelectasis, or tumor
Collapsed shrunken section of alveoli or an entire lung as a result of airway obstruction, bronchus is completely blocked, the alveolar air beyond it is gradually absorbed by the pulmonary capillaries, and the alveolar walls cave in, compression on the lung, and lack of surfactant.
Infection in lung parenchyma leaves alveolar membrane edematous and porous, so red blood cells and white blood cels pass from blood to alveoli.
Proliferation of mucus glands in the passageways, resulting in excessive mucus secretion. Inflammation of bronchi with partial obstruction of bronchi by secretions or constrictions.
Caused by destruction of pulmonary connective tissue; characterized by permanent enlargement of air sacs distal to terminal bronchioles and rupture of interalveolar walls
An allergic hypersensitivity to certain inhaled allergens, irritants, microbes, stress, or exercise that produces a complex response characterized by bronchospasm and inflammation, edema in walls of bronchioles, and secretion of highly viscous mucus in airways.
Pleural effusion thickening
Collection of excess fluid in the intrapleural space, with compression of overlying lung tissue
Free air in pleural space causes partial or complete lung collapse. Air in pleural space neutralizes the usual negative pressure present; thus lung collapses
Pump failure with increasing pressure of cardiac overload causes pulmonary congestion or an increased amount of blood present in pulmonary capillaries. Dependent air sacs are deflated.
Inhalation of tubercle bacilli into the alveolar wall starts: initial complex is acute inflammatory response.
Undissolved materials originating in legs or pelvis detach and travel through venous system returning blood to right heart and lodge to occlude pulmonary vessels
Acute respiratory distress syndrome
An acute pulmonary insult damages alveolar capillary membrane, leading to increased permeability of pulmonary edema
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