Thorax and Lungs Examination Practice Flashcards

Flashcards covering Chapter 19: Thorax and Lungs, including anatomical landmarks, respiratory mechanics, developmental changes, and physical examination techniques.

What structures define the bony thoracic cage?

The sternum, $12$ pairs of ribs, and $12$ thoracic vertebrae.

How do the first seven ribs attach to the sternum?

They attach directly to the sternum by costal cartilages.

Which ribs are considered 'floating' ribs and why?

Ribs $11$ and $12$ are floating because they have free palpable tips and do not attach to the sternum.

What is the suprasternal notch?

A U-shaped depression located just above the sternum between the clavicles.

What is the significance of the Angle of Louis (manubriosternal angle)?

It marks the site of tracheal bifurcation into right and left main bronchi, corresponds with the upper border of the atria of the heart, and lies above the fourth thoracic vertebra on the back.

Where is the costal angle located?

It is the angle where the right and left costal margins meet at the xiphoid process.

How is the vertebra prominens identified?

By flexing the head and feeling for the most prominent bony spur protruding at the base of the neck ($C7$).

Which reference lines are used to pinpoint findings on the anterior chest?

The midsternal line and the midclavicular line.

What are the three reference lines used to divide the lateral chest?

Anterior axillary line, posterior axillary line, and midaxillary line.

What components are contained within the mediastinum?

The esophagus, trachea, heart, and great vessels.

How do the right and left lungs differ in structure?

The right lung is shorter because of the underlying liver and has $3$ lobes; the left lung is narrower because the heart bulges to the left and has $2$ lobes.

What type of pressure is normally found in the pleural cavity?

A vacuum, or negative pressure, which holds the lungs tightly against the chest wall.

What is the typical length of the trachea in an adult?

$10$ to $11\text{ cm}$.

What is 'dead space' in the respiratory system?

Space filled with air that is not available for gaseous exchange, totaling about $150\text{ ml}$ in the adult.

What are the four major functions of the respiratory system?

Supplying oxygen, removing carbon dioxide, maintaining homeostasis (acid-base balance), and maintaining heat exchange.

What is the normal primary stimulus to breathe for humans?

An increase of carbon dioxide in the blood, known as hypercapnia.

What are the two dimensions in which the thoracic container alters size during respiration?

Vertical diameter and anteroposterior (A-P) diameter.

How does the respiratory system change in aging adults?

Decreased vital capacity, increased residual volume, and histologic changes that lead to decreased gas exchange.

What are the five A's used in smoking cessation counseling?

Ask, Advise, Assess, Assist, and Arrange.

How is tactile (vocal) fremitus assessed during palpation?

By using the hands to feel for palpable vibrations while the patient repeats phrases such as '$99$' or 'blue moon'.

What is resonance in lung percussion?

A low-pitched, clear, hollow sound that predominates in healthy lung tissue in adults.

What are the three normal types of breath sounds heard in adults and older children?

Bronchial (tracheal), bronchovesicular, and vesicular.

What are atelectatic crackles?

A non-pathologic adventitious sound consisting of short, popping, crackling sounds that do not last beyond a few breaths.

What does a pulse oximeter measure and what is a normal reading for a healthy person?

It measures $SpO_2$; a healthy person normally has a reading of $97$ to $98$.

What is the Apgar scoring system used for?

It is the newborn’s first respiratory assessment to measure the successful transition to extrauterine life.

Describe 'barrel chest'.

An abnormal thoracic configuration where there is an equal anteroposterior-to-transverse diameter ($1:1$ ratio) and ribs are horizontal.

Define Cheyne-Stokes respiration.

A breathing pattern characterized by a gradual wax and wane in depth and rate, with periods of apnea.

What are the symptoms/clues used to assess the quality of a cough?

Duration, frequency, timing, presence of phlegm (productive vs. non-productive), quality (description), and precipitating/alleviating factors.