Guided Questions Module 3 6700 Module 3

Suprasternal notch

U-shaped dip at the top of the sternum (manubrium).

Angle of Louis

Junction of the manubrium and body of the sternum, typically at the level of the second rib.

Point of maximal impulse (PMI)

Located at the 5th intercostal space at the midclavicular line, where the apex of the heart contacts the chest wall.

Aortic placement

Right 2nd intercostal space near the sternum for auscultation.

Pulmonic placement

Left 2nd intercostal space near the sternum for auscultation.

Tricuspid placement

Lower left sternal border at the 4th intercostal space for auscultation.

Mitral placement

Left 5th intercostal space, midclavicular line, also where PMI is found.

Right lung lobes

Comprises three lobes:upper, middle, and lower.

Left lung lobes

Comprises two lobes:upper and lower, due to heart space.

Apex of the lung

Slightly higher than the clavicle.

Base of the lungs

Located around the 6th rib anteriorly and the 10th rib posteriorly.

Pleurae

Thin membranes lining the lungs and chest cavity, creating a pleural space to reduce friction.

Trachea

Conducts air from the larynx into the bronchi.

Bronchi

Main airways branching from the trachea into the lungs.

Alveoli

Small air sacs where gas exchange occurs��oxygen enters blood, carbon dioxide is removed.

Tidal volume during pregnancy

Increased due to hormonal changes and diaphragm elevation.

Physiologic dyspnea

Shortness of breath during pregnancy due to increased oxygen consumption.

Risk factors for asthma

Genetics, allergens, pollutants, smoking, obesity, respiratory infections, occupational hazards.

Important questions for SOB

Onset, activity during onset, constant or intermittent, alleviating or aggravating factors, associated symptoms, history of respiratory conditions.

Fremitus

Vibration felt on the chest during speech or breathing, indicating lung tissue changes.

Resonance

Normal sound during lung percussion, indicating air-filled lung tissue.

Crepitus

Crackling sound under the skin, indicating air in subcutaneous tissues.

Hyperresonance

Loud, low-pitched sound during percussion, indicating excess air in the lungs.

Bronchial sounds

Loud, high-pitched sounds over the trachea; longer expiratory phase.

Bronchovesicular sounds

Medium-pitched sounds over major bronchi; equal inspiratory and expiratory phases.

Vesicular sounds

Soft, low-pitched sounds over lung fields; longer inspiratory phase.

Strategies for respiratory assessment in children

Use distractions, observe breathing patterns, ensure calmness, use smaller stethoscope diaphragm.

Auscultation findings for atelectasis

Decreased or absent breath sounds.

Auscultation findings for lobar pneumonia

Crackles and bronchial breath sounds over consolidation area.

Auscultation findings for acute bronchitis

Rhonchi and wheezing.

Auscultation findings for pneumothorax

Absent breath sounds on affected side.

Auscultation findings for heart failure

Crackles at lung bases due to fluid accumulation.

Neurologic signs of respiratory distress

Confusion, agitation, restlessness, lethargy, loss of consciousness.

Cardiovascular signs of respiratory distress

Tachycardia, cyanosis, cool extremities, hypotension, shock.

Hypoxia

Deficiency of oxygen reaching tissues.

Hypoxemia

Low levels of oxygen in the blood.

Blood flow through the heart

Right atrium → tricuspid valve → right ventricle → pulmonary valve → pulmonary arteries → lungs → pulmonary veins → left atrium → mitral valve → left ventricle → aortic valve → aorta → body.

Diastole

Phase of cardiac cycle when heart relaxes and chambers fill with blood.

Systole

Phase when heart contracts and pumps blood out of chambers.

Heart sounds S1

"Lub" sound from closure of mitral and tricuspid valves.

Heart sounds S2

"Dub" sound from closure of aortic and pulmonic valves.

Heart sounds S3

Indicates heart failure, heard after S2.

Heart sounds S4

Indicates stiff ventricle, heard before S1.

ECG P wave

Represents atrial depolarization.

ECG PR interval

Time between atrial depolarization and start of