Respiratory, Thorax/Breast, and Lymphatics Lecture Review

This set of vocabulary flashcards covers respiratory anatomy, breathing patterns, lung percussion and auscultation findings, breast anatomy and disorders, and lymphatic system assessment.

Thorax

The region of the body surrounded by ribs to protect organs such as the heart and lungs.

Angle of Louis

The sternal angle located at the level of the $2nd$ costal cartilage.

Tachypnea

A breathing pattern characterized by respirations greater than $20$ per minute.

Bradypnea

A breathing pattern characterized by respirations less than $12$ per minute.

Apnea

The temporary or permanent arrest of respirations.

Cheyne-Stokes

A breathing pattern featuring gradual increases and decreases in respirations with periods of apnoea.

Biot's

An abnormal breathing pattern with groups or clusters of rapid respiration of equal depth and regular apnea periods.

Kussmaul's

A breathing pattern characterized by both tachypnoea and hyperpnoea.

Hypoxemia

A condition where oxygen saturation is less than $90\%$, though $>94\%$ is preferred.

Hemoptysis

The act of coughing up blood or blood-stained mucus from the bronchi, larynx, trachea, or lungs.

A/P ratio

The ratio of the anteroposterior diameter to the transverse diameter of the chest, which should be $2:1$.

Barrel chest

A chest deformity that can develop in patients with COPD where the A/P ratio increases.

Crepitus

A crackling or rattling sound or feeling produced by air in the subcutaneous tissue, assessed during thorax palpation.

Tactile Fremitus

Vibrations felt on the chest wall during palpation, typically assessed using the ulnar side of the hands.

Dullness (Percussion)

The sound heard during percussion over areas of consolidation, such as Pleural Effusion, Pneumonia, or Solid Tumors.

Hyper resonant

The percussion note heard in conditions involving trapped air, such as Emphysema or Pneumothorax.

Bronchial sounds

Normal breath sounds heard specifically over the trachea and larynx.

Vesicular sounds

Normal breath sounds heard over the peripheral lung fields, specifically the alveoli and bronchioles.

Crackles (Rales)

Adventitious breath sounds caused by air flowing by liquid, often sounding like a plastic bag crinkling; associated with pneumonia or pulmonary edema.

Rhonchi

Low-pitched, rumbling or rattling breath sounds usually caused by mucus-related obstructions in the bronchi.

Friction Rubs

A dry, rubbing, or crackling sound caused by inflammation of the pleural space or loss of pleural fluid.

Egophony

An auscultation finding where the patient's 'E' sounds like an 'A' through the stethoscope, indicating consolidation.

Bronchophony

An auscultation finding where the word '$99$' is heard clearly instead of muffled, suggesting lung consolidation.

Whispered Pectoriloquy

The increased clear transmission of a whispered 'ninety-nine' during auscultation over areas of consolidation.

Peak Flow Meter

An inexpensive, hand-held device used to monitor pulmonary function in asthma patients which roughly correlates with the $FEV1$.

Tail of Spence

The extension of breast tissue into the axilla, located in the upper outer quadrant.

Cooper ligaments

Fibrous bands that extend vertically from the skin to attach to the chest wall, providing support for breast tissue.

Montgomery glands

Sebaceous glands in the areola that secrete a protective lipid substance during lactation.

Tanner Stages

A $5$-stage scale used to describe the development of the breast from preadolescent to mature stages.

Intraductal papilloma

Small, benign tumors in the papillary ducts that may cause serous or sanguinous nipple discharge.

Mastitis

An inflammatory mass in the breast often associated with breastfeeding, characterized by redness, swelling, and systemic symptoms like fever.

Gynecomastia

Enlargement of the male breast caused by an estrogen level higher than the testosterone level.

Lymphedema

Swelling that occurs when the amount of lymph exceeds the capacity of the lymphatic system, often due to scarring, radiation, or node removal.

B-symptoms

A group of systemic symptoms including unexplained weight loss, appetite loss, night sweats, and fevers or chills.

left lung

2; upper and lower

right lung

3; upper, middle, lower

eupnoea

normal, comfortable breathing at rest.

S/S of hypoxia

Headache

Shortness of breath

Fast heartbeat

Coughing

Wheezing

Confusion/hallucinations

Cyanosis

Hyperventilation

A/P ratio

2:1

thorax palpitation

■Palpate the thorax for Lumps, masses

■Tenderness

■Symmetry

■Crepitus

■heaves

Chest excursion

The chest should expand symmetrically

Place hands on either side of the posterior chest,

Have the patient take a deep breath in, hands should

Move symmetrically

tactile fremitus

■Ulnar side of the hands are more sensitive to vibration

decreased: lung collapse

increased: lung cancer

lung percussion

Hyperextend the middle finger of one hand and place the distal interphalangeal joint firmly against the patient's chest. With the end (not the pad) of the opposite middle finger, use a quick flick of the wrist to strike first finger. Categorize what you hear as normal, dull, resonant or hyper resonant. Practice your technique until you can consistently produce a "normal" percussion note on your (presumably normal) partner before you work with patients.

flat/dull percussions

  Pleural Effusion

  Pneumonia

  Solid Tumors 

resonant percussion

Healthy Lung

  Bronchitis

hyper resonant percussion

Emphysema

  Pneumothorax

Bronchovesicular

heard over major bronchi

crackles pathology

–Pneumonia, atelectasis, interstitial lung disease, pulmonary edema

–Pneumonia can be viral or bacterial and effect the alveoli, bronchi, or the interstitium

ateletactisis

–collapse of the alveoli, usually related to poor airflow or hypoventilation (increased risk for pneumonia)

pulmonary edema

fluid that backs up from the heart/systemic vasculature and fills the airspace of the lungs (heart failure)