Assessment of the Thorax and Lungs – Key Vocabulary

Vocabulary flashcards covering anatomic landmarks, normal and abnormal breath sounds, inspection findings, respiratory patterns, nursing diagnoses, and key assessment concepts for thorax and lung examination.

Suprasternal Notch

U-shaped depression above the sternum between the clavicles; common anterior thoracic landmark.

Angle of Louis (Manubriosternal Angle)

Junction of manubrium and body of sternum at 2nd rib; reference point for rib counting and tracheal bifurcation level.

Costal Angle

Angle formed by right and left costal margins meeting at the xiphoid; normally ≤ 90° in adults.

Midsternal Line

Vertical line running down the center of the sternum on the anterior chest.

Midclavicular Line

Vertical line drawn through the midpoint of the clavicle; used to locate lung and heart sounds.

Anterior Axillary Line

Vertical line along the anterior axillary fold; helps locate lung lobes laterally.

Midaxillary Line

Line running vertically through the apex of the axilla; lateral reference for lung assessment.

Posterior Axillary Line

Vertical line along the posterior axillary fold on the back.

Scapular Line

Vertical line through the inferior angle of the scapula on the posterior chest.

Vertebral Prominens

Spinous process of C7; palpable landmark for counting thoracic vertebrae.

Vesicular Breath Sounds

Soft, low-pitched, breezy sounds heard over most peripheral lung fields; inspiration > expiration with no gap.

Bronchovesicular Breath Sounds

Medium-pitched, equal inspiration and expiration, heard over major bronchi (1st–2nd interspaces anteriorly, between scapulae).

Bronchial Breath Sounds

Loud, high-pitched, tubular sounds heard over the manubrium; expiration ≥ inspiration with a short gap.

Tracheal Breath Sounds

Very loud, harsh, high-pitched sounds heard over the trachea above the clavicles.

Wheeze

High-pitched, musical, continuous adventitious sound from narrowed airways; may occur on inspiration or expiration (e.g., asthma, COPD).

Stridor

Loud, high-pitched, predominantly inspiratory sound louder over the neck; indicates upper airway obstruction.

Fine Crackles (Rales)

Short, high-pitched, discontinuous popping heard mainly at lung bases during inspiration; seen in CHF, pneumonia, atelectasis.

Coarse Crackles

Low-pitched, bubbling or gurgling sounds, longer in duration than fine crackles; associated with chronic bronchitis, severe pulmonary edema.

Rhonchi

Coarse, low-pitched, snoring sounds produced by fluid/mucus in large bronchi; may clear with coughing.

Pleural Friction Rub

Grating, creaky, biphasic sound caused by inflamed pleural surfaces rubbing together; not cleared by cough.

Squawk

Short inspiratory wheeze (≈200 ms) often preceded by crackles; found in pulmonary fibrosis, pneumonitis, allergic alveolitis.

Accessory Muscle Use

Recruitment of neck, shoulder or abdominal muscles to aid breathing; indicates increased work of breathing.

Barrel Chest

Increased AP diameter (>1:2) with horizontal ribs; typical in emphysema and lung hyperinflation.

Nasal Flaring

Widening of nostrils during inspiration; sign of hypoxia or labored breathing.

Pursed-Lip Breathing

Exhalation through semi-closed lips to prevent airway collapse; seen in COPD, emphysema.

Clubbing

Enlarged, spongy nail bases with angle >180°; suggests chronic hypoxia.

Crepitus

Palpable crackling sensation under skin caused by air in subcutaneous tissue.

Thoracic Expansion

Symmetric outward movement of the chest during deep inspiration; asymmetry suggests atelectasis, pneumothorax, or pneumonia.

Diminished Breath Sounds

Quiet or absent normal breath sounds due to obesity, pleural effusion, pneumothorax, or airway obstruction.

Eupnea

Normal rate and depth of breathing.

Tachypnea

Rapid breathing rate (>20 breaths/min).

Bradypnea

Slow breathing rate (<10 breaths/min).

Apnea

Absence of breathing for a period of time.

Hyperpnea

Increased depth and rate of breathing, often with metabolic acidosis or exercise.

Cheyne-Stokes Respiration

Cyclic pattern of gradual increases and decreases in respirations with periods of apnea; seen in heart failure, neurologic injury.

Biot’s Respiration

Irregular clusters of rapid breaths of equal depth followed by apnea; associated with CNS damage.

Kussmaul’s Respiration

Deep, rapid, labored breathing associated with metabolic acidosis (e.g., DKA).

Apneustic Breathing

Prolonged inspiratory phase followed by prolonged expiratory phase; indicates brainstem injury.

Impaired Gas Exchange

Nursing diagnosis: excess or deficit in oxygenation and/or carbon dioxide elimination at the alveolar-capillary membrane.

Ineffective Airway Clearance

Nursing diagnosis: inability to clear secretions or obstructions to maintain airway patency.

Ineffective Breathing Pattern

Nursing diagnosis: inspiration and/or expiration that does not provide adequate ventilation.

Activity Intolerance

Nursing diagnosis: insufficient energy to endure or complete required or desired daily activities.

Tracheal Bifurcation

Point where trachea divides into right and left main bronchi at the level of the Angle of Louis (2nd rib).

Floating Ribs

11th and 12th ribs that are not attached anteriorly to the sternum.

Spinous Process of T3

Posterior landmark roughly corresponding to the level where upper lobes end and lower lobes begin.

Diaphragmatic Dome

Curved superior surface of the diaphragm; separates thoracic and abdominal cavities.

Stethoscope Placement Technique

Move side-to-side on bare skin, comparing symmetrical areas during full inspiration and expiration.

Adventitious Sounds

Extra breath sounds (e.g., wheezes, crackles, rubs) superimposed on normal breath sounds.