Where is the apex of the lungs?
top, above the clavicular line
How many lobes are in the right lung?
3
How many lobes are in the left lung?
2
Where is the base of the lungs?
The bottom of the rib cage, above the diaphragm
Where does gas exchange take place?
In the alveoli of the lungs
What are some common things that happen to the older adult in the respiratory system?
Chest wall becomes stiffer and lung muscles lose elasticity, less room for lung expansion
What is a common aging problem that can effect the respiratory system?
Kyphosis - curvature of the back, can reduce lung capacity
What is the order for ruling out casues of chest pain?
Heart 1st! Lungs 2nd! GI 3rd
What are common pulmonary complaints?
Dyspnea, Wheezing, Cough and Hemoptysis
Initial inspection of resp sys consists of?
Observe breathing(rate, rhythm, effort), assess pt color, listen to breathing/lung sounds, shape of chest, 02 sat
How does scoliosis effect the resp system?
reduces the lung capacity of lung on the squished side
Grunting sounds while breathing are usually indicative of?
pt trying to keep alveoli open, means the alveoli are collapsing which can be very bad
Is the use of accessory muscles in the neck and shoulders while breathing normal?
No - can be a bad sign
When assessing the lungs its good to use a __________ approach?
systematic
Use the _________ of the stethoscope to listen to lung sounds?
diaphragm
What are the 4 sounds sections of the resp. system?
Bronchial (throat)
Bronchovesicular (sternal)
Tracheal
Vesicular (lungs)
Adventitious =
Abnormal
What is an infection of unknown causes that leaks fluid and takes up valuable space in thoracic cavity?
Empyema
What lung sounds can you expect to hear with pulmonary edema?
diminished
Air will come in but is hard to get out, Oxygen goes in but carbon dioxide is not released properly, Alveoli get inflamed and want to shut down.
Non-reversible, oxygen helps relieve symptoms but can actually be bad for pt because no release of oxygen to c
Emphysema
On an Xray for lungs the area where the lungs are should be?
Black - any white showing is usually neg. sign
Air going into the lung space is known as?
Pneumothorax
Fluid in the alveoli is known as?
Pneumonia
What are normal sounds heard in someone who has pneumonia?
crackles
What is fluid filling the pleural space of the lungs known as?
Pleural effusion
Crackle sounds are usually indicative of?
Collapsed or fluid filled alveoli
Wheeze sounds are usually indicative of?
blocked airflow b/c of asthma, infection, or foreign body obstruction
Rhonchi sounds(snoring) are usually indicative of?
fluid-blocked airways
Stridor sounds are usually indicative of?(loud crowing)
obstructed upper airway
Friction rub sounds are usually indicative of?(sand paper rubs)
Pleural inflammation
If the trachea is not positioned midline, it can be a sign of?
Tension pneumothorax - can be an emergency situation
What is sign of crepitus?
sounds like bubble wrap underneath the skin, lung has a leak
Checking for thoracic expansion is part of ________ _____________.
Focused Assessment
How do you assess pt for tactile fremitus?
hand on upper back, ask pt to say "99", should feel vibrations
Decreased fremitus is sign of?
large air pockets in lungs - Pneumothorax, Emphysema, Asthma
Increased fremitus is sign of?
consolidation of lung tissue -Pneumonia, Atelectasis, Bronchitis
Added sounds superimposed on normal breath sounds and often indicative of underlying airway problems or diseases of the cardiovascular or respiratory systems
Adventitious Sounds
A horizontal ridge formed at the point where the manubrium joins the body of the sternum.
Angle of Louis
Loud, high-pitched sounds heard next to the trachea and are longer on exhalation.
Bronchial Sounds
Sounds that are medium in loudness and pitch, heard between the scapula, posteriorly and next to the sternum, and anteriorly upon inhalation and exhalation.
Bronchovesicular Sounds
A change in normal breathing pattern, producing shortness of breath or difficulty in breathing.
Dyspnea
The regular, even-depth, rhythmic pattern of inspiration and expiration; normal breathing.
Eupnea
Slow respiratory rate, usually less than 8
Bradypnea
Rapid respiratory rate, usually greater than 20
Tachypnea
The palpable vibration on the chest wall when the client speaks.
Fremitus
Thoracic reference points and specific anatomical structures used to help provide an exact location for the assessment findings and an accurate orientation for documentation of findings.
Landmarks
The superior portion of the sternum
Manubrium
Part of the thorax, or thoracic cavity, that contains the heart, trachea, esophagus, and major blood vessels of the body.
Mediastinum
The usual sound in the thorax, a long, low-pitched hollow sound.
Resonance
Consists of an inspiratory phase and an expiratory phase of breathing.
Respiratory Cycle
Harsh, high-pitched sounds heard over the trachea when the client inhales and exhales.
Tracheal Sounds
Sounds are soft and low-pitched and heard over the remainder of the lungs, longer on inhalation than exhalation.
Vesicular Sounds
Sounds that are high-pitched with a shrill quality.
Wheezes
Sounds that are low-pitched with a snoring quality.
Rhonchi
Discontinuous sounds which are intermittent, nonmusical, and brief.
Crackles