330 quiz

Function of Breathing

Brings oxygen in (21% in room air) and removes CO₂.

Main function of the ribs

Protect the lungs and heart; lower ribs protect liver and stomach.

Major muscle of breathing

Diaphragm.

Intercostal muscles

Muscles between ribs; assist in breathing; active during respiratory distress.

Intercostal space

The space between ribs.

Trachea

Flexible tube anterior to esophagus; made of C-shaped hyaline cartilage rings; 10–12 cm long in adults.

Right mainstem bronchus

Shorter, more vertical, three lobes; more likely site for aspirated objects.

Left mainstem bronchus

Longer, more horizontal, two lobes.

Terminal bronchioles

Lead to alveolar ducts and sacs; channel air into alveoli.

Alveoli

Increase surface area for gas exchange.

Medulla and pons

Control respiratory drive; respond to CO₂ levels.

Ventilation

Process of breathing air in and out.

Right lung accessibility

Right lateral lobe easiest to access.

Lung maturity in infants

38 weeks gestation.

Delayed cord clamping

~1 minute after birth.

Normal infant RR

30–60 breaths/min.

Acrocyanosis

Bluish discoloration in newborns’ extremities.

Effect of cold stress in infants

Hypothermia → respiratory compromise.

Pregnancy respiratory changes

Increased RR, shallow breaths, increased O₂ use, dyspnea, congestion.

Kyphosis

Outward curvature of the spine.

Gibbus

Sharp spinal curve deformity.

Common elderly lung conditions

COPD, emphysema.

Chief complaints for chest/lung assessment

Dyspnea, cough, chest pain, trauma.

HPI includes

Onset, location, duration, character, aggravating/relieving factors, timing, severity.

Respiratory illnesses in PMH

TB, pneumonia, asthma, COPD, cystic fibrosis, emphysema.

Family history concerns

Asthma, allergies, cystic fibrosis.

Pack-year formula

(Packs per day) × (Years smoked).

Orthopnea clue

Number of pillows used when sleeping.

ROS highlights

Chest pain, snoring, sleep apnea, night sweats, sputum, wheezing, allergies.

IPPA order

Inspection, Palpation, Percussion, Auscultation.

Normal chest shape

A/P diameter < transverse diameter.

Barrel chest

A/P diameter ≈ transverse diameter; seen in COPD.

Pectus carinatum

Pigeon chest (chest out).

Pectus excavatum

Funnel chest (chest in).

Clubbing

Rounded nailbeds; sign of chronic hypoxia.

Normal skin/nail color

Pink; indicates good oxygenation.

Crepitus

Air trapped under skin; trauma-related.

Tracheal deviation

Sign of pneumothorax or lung collapse.

Thoracic expansion check

Hands at T10 level; should be symmetrical.

Tactile fremitus

Vibration felt when patient speaks; decreased in obstruction.

Percussion tone: Resonance

Normal, healthy lung.

Percussion tone: Hyperresonance

COPD or excess air.

Percussion tone: Dullness

Over organs like the liver.

Percussion tone: Flatness

Over bone.

Percussion tone: Tympany

Pneumothorax (air-filled).

Vesicular breath sounds

Soft, low-pitched; over peripheral lungs.

Bronchovesicular sounds

Medium pitch; over main bronchi.

Bronchial sounds

Loud, high-pitched; over trachea.

Crackles

Bubbling, discontinuous; may indicate fluid or atelectasis.

Rhonchi

Snoring, coarse, continuous; may clear with cough.

Wheezes

Musical, high-pitched; continuous; seen in bronchitis or asthma.

Pleural rub

Grating, low-pitched; seen in pleurisy.

Bronchophony

Increased clarity of spoken words.

Whispered pectoriloquy

Whispered words heard distinctly through stethoscope.

Egophony

“E” sounds like “A” during auscultation.

Eupnea

Normal breathing.

Tachypnea

Rapid breathing.

Bradypnea

Slow breathing.

Dyspnea

Shortness of breath.

Apnea

Absence of breathing.

Hyperpnea

Deep, rapid breathing.

Cheyne-Stokes

Alternating fast/slow/apneic; end-of-life pattern.

Kussmaul

Deep, rapid breathing (metabolic acidosis).

Stridor

High-pitched sound from upper airway obstruction.

Pneumonia

Dull percussion; bronchial breath sounds.

Pleurisy

Grating “pleural rub” sound.

Bronchitis

Wheezing and productive cough.

Pneumothorax

Tracheal shift, unequal expansion, absent sounds, tympany.

Hemothorax

Blood in pleural space.

Emphysema

Barrel chest, wheezing, hyperresonance, clubbing.

Respiratory distress signs

RR > 20, difficulty speaking, accessory muscle use, cyanosis, panic.

Respiratory distress treatments

Nebulizer, oxygen therapy, steroids.

Respiratory exam sequence

Inspection → Palpation → Percussion → Auscultation.

Be systematic

Always follow the same pattern for both anterior and posterior chest.

Know landmarks

Helps locate lobes and interpret findings.

Goal of assessment

Identify normal vs. abnormal respiratory patterns and sounds.