Thorax and Lung Assessment Flashcards

Flashcards for reviewing key concepts in thorax and lung assessment, based on lecture notes.

Components of the Thoracic Cage

Sternum, clavicle, scapulae, 12 vertebrae, 12 pairs of ribs

Three Main Compartments of the Thorax

Airways, blood vessels, interstitinum

Contents of the Mediastinum

Heart, great vessels, lymph nodes, nerves, fat

Arterial Blood Supply to the Thorax

Thoracic aorta, subclavian, brachial, axillary

Reference Lines of the Axillary Region

Anterior axillary line, posterior axillary lines, midaxillary lines

Anterior Thorax Reference Lines

Midsternal line, midclavicular lines, anterior axillary lines

Posterior Thorax Reference Lines

Vertebral line, midscapular lines

Mechanics of Respiration

Automatic process initiated by pons and medulla

Main Trigger for Respiration

Increased CO2 levels

Process of Inspiration

Diaphragm contracts and flattens, thorax and lungs elongate, external intercostal muscles open ribs

Process of Expiration

Diaphragm, internal intercostal muscles, abdominal muscles relax, pressure in lungs > atmosphere

Respiratory Changes in Older Adults

Respiratory strength declines, lungs lose elasticity, decreased flexibility in rib cartilage, bone density decreases

Results of COPD

Irritation, swelling, and impaired gas exchange

Airway Obstruction Causes

Throat swelling, anaphylactic shock, foreign object, trauma, epiglottitis

Signs of Breathing Difficulty

Shortness of breath, fast or slow respiratory rate, low PaO2 %, labored breathing

Circulation Issues

High or low blood pressure, fast or slow heart rate, poor coloring

ABC Priority Assessment

Airway, breathing, circulation

Immediate Assessments for Acute Shortness of Breath

Assess airway, respiratory and heart rate, BP, oxygen saturation, auscultate lungs

Subjective Data Risk Factors

Past medical history, lifestyle, occupational history, environmental exposures, medications, family history

Common Respiratory Symptoms

Chest pain, dyspnea, orthopnea, cough, sputum, wheezing

Basic and Advanced Assessment Techniques

Inspection of client and chest, palpation and percussion of chest, auscultation of lungs

Comprehensive Physical Examination Steps

General appearance, posterior and anterior chest inspection, palpation, percussion, auscultation

Analyzing Diagnostic Testing

Analyze lab data, radiography, pulmonary function tests

Priority Assessment for Acute Shortness of Breath

Auscultate lungs

Signs of Breathing Difficulty by Looking

Respiratory rate, shallow breathing, accessory muscle use, intercostal retractions, tripod position, cyanosis

Instructions for Auscultating Lung Sounds

Breathe through mouth, deeper than usual; use flat diaphragm of stethoscope

Three Types of Normal Breath Sounds

Bronchial, bronchovesicular, vesicular

Explanation of Crackles

High pitched, popping sound caused by air being forced through an airway

Explanation of Wheezing

High-pitched continuous musical sound due to airway obstruction

Explanation of Rhonchi

Deep, low-pitched rumbling sound caused by respiratory secretions

What is Tactile Fremitus?

Tactile refers to the hands, Fremitus is a palpable vibration

How Tactile Fremitus Works

Sounds transmitted through bronchi and lung tissue to the chest wall

How to Assess Tactile Fremitus

Use palmar base of fingers or ulnar edge of hand; patient repeats 'ninety-nine'

What Increases Tactile Fremitus?

Conditions that increase density of lung tissue

Examples of Conditions That Increase Tactile Fremitus

Fluid or pneumonia

Normal SpO2 for Healthy Person

Above 92% (COPD 88-92%)

Conditions Affecting PaO2 % Reading

Temperature of fingers, nail polish, anemia, acid-base imbalances, ventilatory status

Action to Take if Pulse Ox Reading Seems Off

Switch fingers and try again

Anterior Thorax: Sternum Components

Suprasternal notch, manubrium, sternal angle, body, xiphisternal junction, xiphoid process

Arterial Blood Supply to the Thorax:

Thoracic aorta, subclavian, brachial, axillary

Emphysema

CO2 retention which leads to a barrel chest

Key lines of the Axillary region

Anterior, posterior, and midaxillary lines

Expiration Process:

Diaphragm, internal intercostal muscles, abdominal muscles relax

Increased anxiety leads to:

Increased dyspnea, cyanosis, confusion, LOC

Steps for anterior chest examination:

Inspect, palpate, percuss, auscultate

Disorders associated with crackles:

Pneumonia, pulmonary edema, ARDS, heart failure

What conducts sound better?

Uniformly dense areas

What can cause an upper airway obstruction?

Epiglottitis

What causes a Pleural Friction rub?

Pleuritis

What causes Rhonchi?

Bronchitis

Disorder associated with wheezing:

Asthma