Thorax & Lung Assessment: Infant to Aging Adult

What should be ignored during the physical examination of an infant's thorax?

The usual sequence of physical examination.

What enhances palpation of tactile fremitus and auscultation of breath sounds in infants?

Crying.

What is the normal frequency of uncomplicated upper respiratory infections in infants?

4-6 infections per year.

What is acrocyanosis, and when is it typically observed?

A bluish discoloration of the extremities at birth.

What breathing characteristic is common in newborns?

Brief periods of apnea and fine crackles.

What is a common thoracic finding in children under 6 years old?

Barrel chest or rounded thorax.

What are marked sternum and intercostal retractions indicative of?

Possible airway obstruction, atelectasis, pneumonia, or asthma.

What does nasal flaring and tachypnea suggest?

Possible heart failure.

What does asymmetric chest expansion indicate?

Possible hernia or pneumonia.

What does the presence of crackles in older infants suggest?

Possible cystic fibrosis or heart failure.

What does crepitus indicate in a thoracic assessment?

Possible rib or clavicle fracture.

What does the APGAR score measure?

Successful transition to extrauterine life.

When is the APGAR score measured?

At 1 minute and 5 minutes after birth.

What APGAR score indicates good condition in a newborn?

A score of 7-10.

What should be assessed during the inspection phase of a thoracic examination?

Thoracic cage, respirations, skin color and condition, person's position, facial expression, and level of consciousness.

What is the purpose of palpation in a thoracic assessment?

To confirm symmetric expansion, tactile fremitus, and detect lumps or tenderness.

What does percussion over lung fields assess?

The presence of fluid or air in the lungs.

What should be noted during auscultation of breath sounds?

Normal and abnormal breath sounds, and perform tests like bronchophony if abnormal sounds are present.

What thoracic changes occur with aging?

Costal cartilages become calcified, respiratory muscle strength declines, and lung tissue loses elastic properties.

What are the volume changes in the lungs as a person ages?

Decreased vital capacity and increased residual volume.

What clinical implications arise from aging-related lung changes?

Increased risks for dyspnea with exertion and postoperative pulmonary complications.

What are normal breath sounds heard over the trachea?

Tracheal sounds, which are very loud and high-pitched.

What are bronchial sounds and where are they heard?

Loud, high-pitched sounds heard above the clavicles.

What are vesicular sounds and where are they heard?

Soft, low-pitched sounds heard over the lung field itself.