Unit 5A.11: Chest & Lungs Assessment

Kyphosis

Increased curve of the thoracic spine that results from a loss of lung resiliency and loss of skeletal muscle

Normal

Barrel Chest

Pectus Excavatum (Funnel Chest)

Pectus Carinatum (Pigeon Breast)

1:2

What is the normal ratio of anteroposterior to transverese diameter?

45 degrees

The ribs should slope downward at approximately ___ in relation to the spine.

Trapezius

What muscle should a normal client not use to assist breathing?

12-20 breaths/minute

What is the normal breathing pattern?

Normal

Tachypnea

• More than 24 breaths/minute and shallow

• May be caused by:

  • Fever

  • Anxiety

  • Exercise

  • Respiratory Insufficiency

  • Alkalosis

  • Pneumonia

  • Pleurisy

Bradypnea

• Less than 10 breaths/min and regular

• May be normal in well-conditioned athletes

• Can occur with

  • Medication-induce depression of the respiratory center

  • Diabetic Coma

  • Neurologic Damage

Hyperventilation

• Increased rate and depth

• Usually occurs with

  • Extreme exercise

  • Fear

  • Anxiety

  • Disorders of CNS

  • Salicylate Overdose

  • Severe Anxiety

Kussmaul

• Rapid, deep, labored

• Type of hyperventilation associated with diabetic ketoacidosis

Hypoventilation

• Decreased rate and depth, irregular

• Usually associated with narcotic or anesthetic overdose

Cheyne-Stokes Respiration

• Regular pattern characterized by alternating periods of deep, rapid breathing, followed by periods of apnea

• May result from

  • Severe congestive heart failure

  • Drug overdose

  • Increased intracranial pressure

  • Renal Failure

• May be noted in elderly patients during sleep

Biot’s

• Irregular pattern characterized by varying depth and rate of respirations followed by periods of apnea

• May be seen with

  • Meningitis

  • Severe brain damage

Ataxic

• Significant disorganization with irregular and varying depths of respiration

• More extreme expression of Biot’s respirations indicating respiratory compromise

Air Trapping

• Increasing difficulty in getting breath out

• In chronic obstructive pulmonary disease

Apnea

temporary cessation of breathing, especially during sleep

Apneustic

involves a prolonged inhalation, followed by a pause, and then a very short, inadequate exhalation

linked to injuries or damage in the upper pons region of the brain, which controls breathing

Subcutaneous Emphysema

What is another name for crepitus?

Crepitus

Crackling sensation that occurs when air passes through fluid or exudate

Fremitus

Vibrations of air in the bronchial tubes transmitted to the chest wall

T9 & T10

Where on the posterior chest wall should the hands be placed to assess chest expansion?

5-10 cm

What is the normal measurement for chest expansion?

Hyperresonance

What is the sound elicited in cases of trapped air such as in emphysema or pneumothorax?

T7

Where should percussion for diaphragmatic excursion begin?

3-5 cm

What is the measurement for normal diaphragmatic excursion?

Up to 7-8 cm

What is the measurement for diaphragmatic excursion in well- conditioned clients?

C7

Where should auscultation for breath sounds be started in the posterior chest wall?

Stridor

Harsh, honking wheeze with severe broncholaryngospasm

Pleural Friction Rub

Low-pitched, dry grating sound