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Questions and Answers
The anteroposterior diameter of the chest is normally approximately the same as the transverse diameter in which age group?
The anteroposterior diameter of the chest is normally approximately the same as the transverse diameter in which age group?
- Elderly
- Infants (correct)
- Children
- Adults
During your inspection of a chest, the most appropriate lighting source to highlight chest movement is:
During your inspection of a chest, the most appropriate lighting source to highlight chest movement is:
- Fluorescent lighting
- Bright tangential lighting (correct)
- Spot lighting
- Dim lighting
When auscultating the apex of the lung, you should listen at a point:
When auscultating the apex of the lung, you should listen at a point:
- 4 cm above the first rib (correct)
- At the base of the lung
- At the diaphragm
- Along the midclavicular line
You are documenting a rash between the eighth and ninth ribs on the lateral border. This intercostal space will be documented in terms of the:
You are documenting a rash between the eighth and ninth ribs on the lateral border. This intercostal space will be documented in terms of the:
To count the ribs and the intercostal spaces, you begin by palpating the reference point of the:
To count the ribs and the intercostal spaces, you begin by palpating the reference point of the:
When the umbilical cord is cut:
When the umbilical cord is cut:
Fetal gas exchange is mediated by the:
Fetal gas exchange is mediated by the:
The foramen ovale should close:
The foramen ovale should close:
Increased oxygen tension in the arterial blood of a newborn infant causes:
Increased oxygen tension in the arterial blood of a newborn infant causes:
To accommodate the enlarging uterus of pregnancy, chest changes result in:
To accommodate the enlarging uterus of pregnancy, chest changes result in:
The characteristic barrel chest of the older adult is the result of a combination of factors, including:
The characteristic barrel chest of the older adult is the result of a combination of factors, including:
Which potential risk factor is most important to assess regarding Nancy's current problem?
Which potential risk factor is most important to assess regarding Nancy's current problem?
The patient tells you that she uses herbal and other alternative therapies to maintain her health. This information is recorded in the:
The patient tells you that she uses herbal and other alternative therapies to maintain her health. This information is recorded in the:
To document Mr. Curtis's shortness of breath worsening when he sits up, you will use the term:
To document Mr. Curtis's shortness of breath worsening when he sits up, you will use the term:
Bradypnea may accompany:
Bradypnea may accompany:
Which chest structure contains all the thoracic viscera except the lungs?
Which chest structure contains all the thoracic viscera except the lungs?
Which bronchial structure(s) is most susceptible to aspiration of foreign bodies?
Which bronchial structure(s) is most susceptible to aspiration of foreign bodies?
Which finding suggests a minor structural variation?
Which finding suggests a minor structural variation?
Which symptom is associated with intrathoracic infection?
Which symptom is associated with intrathoracic infection?
The best time to observe and count respirations is while:
The best time to observe and count respirations is while:
In regard to Mr. Barrow's respirations, you note that he has 40 breaths per minute. You would categorize this as:
In regard to Mr. Barrow's respirations, you note that he has 40 breaths per minute. You would categorize this as:
In which patient situation would you expect to assess tachypnea?
In which patient situation would you expect to assess tachypnea?
Which term would you use to document a respiratory rate more than 20 breaths per minute in an adult?
Which term would you use to document a respiratory rate more than 20 breaths per minute in an adult?
Respiratory effort usually exhibited by a patient with cerebral brain damage is called:
Respiratory effort usually exhibited by a patient with cerebral brain damage is called:
Which site of chest wall retractions indicates a more severe obstruction in the asthmatic patient?
Which site of chest wall retractions indicates a more severe obstruction in the asthmatic patient?
Laryngeal obstructions would elicit which breath sound?
Laryngeal obstructions would elicit which breath sound?
Mr. L has cyanotic lips and nail beds with pursed lips and nasal flaring. Which additional sign would support further cardiac or pulmonary difficulty?
Mr. L has cyanotic lips and nail beds with pursed lips and nasal flaring. Which additional sign would support further cardiac or pulmonary difficulty?
Breath odors may alert the examiner to certain underlying metabolic conditions. The odor of ammonia on the breath may signify:
Breath odors may alert the examiner to certain underlying metabolic conditions. The odor of ammonia on the breath may signify:
An expected finding of chest palpation in the adult would be:
An expected finding of chest palpation in the adult would be:
You would expect to document the presence of a pleural friction rub for a patient being treated for:
You would expect to document the presence of a pleural friction rub for a patient being treated for:
Which type of apnea requires immediate action?
Which type of apnea requires immediate action?
During the most effective percussion technique for the posterior lung fields, the patient cooperates by:
During the most effective percussion technique for the posterior lung fields, the patient cooperates by:
The examiner percusses for diaphragmatic excursion along the:
The examiner percusses for diaphragmatic excursion along the:
The diaphragm of the stethoscope is better than the bell for auscultation of the lungs because it:
The diaphragm of the stethoscope is better than the bell for auscultation of the lungs because it:
Breath sounds normally auscultated over most of the lung fields are called:
Breath sounds normally auscultated over most of the lung fields are called:
Breath sounds normally heard over the trachea are called:
Breath sounds normally heard over the trachea are called:
With consolidation in lung tissue, the breath sounds are louder and easier to hear. This is because:
With consolidation in lung tissue, the breath sounds are louder and easier to hear. This is because:
The middle lobe of the right lung is best auscultated in the:
The middle lobe of the right lung is best auscultated in the:
You should begin the chest examination for a patient with pneumonia by:
You should begin the chest examination for a patient with pneumonia by:
Your trauma patient has no auscultated breath sounds in the right lung field. A likely cause could be that the patient:
Your trauma patient has no auscultated breath sounds in the right lung field. A likely cause could be that the patient:
The term rales has been replaced with:
The term rales has been replaced with:
To distinguish crackles from rhonchi, you should auscultate the lungs:
To distinguish crackles from rhonchi, you should auscultate the lungs:
A musical squeaking noise heard on auscultation of the lungs is called:
A musical squeaking noise heard on auscultation of the lungs is called:
To distinguish between a respiratory friction rub and cardiac friction rub, ask the patient to:
To distinguish between a respiratory friction rub and cardiac friction rub, ask the patient to:
In which position can the mediastinal crunch (Hamman sign) best be heard?
In which position can the mediastinal crunch (Hamman sign) best be heard?
Changes in the clarity and volume of spoken sounds during auscultation of the lungs can help you distinguish:
Changes in the clarity and volume of spoken sounds during auscultation of the lungs can help you distinguish:
During a chest assessment, you note the patient's voice quality while auscultating the lung fields. The voice sound is intensified, the voice has nasal quality, and the e's sound like a's. This is indicative of:
During a chest assessment, you note the patient's voice quality while auscultating the lung fields. The voice sound is intensified, the voice has nasal quality, and the e's sound like a's. This is indicative of:
While auscultating the lung fields, you note that the patient's voice sound is intensified, the voice has a nasal quality, and e's sound like a's. This describes:
While auscultating the lung fields, you note that the patient's voice sound is intensified, the voice has a nasal quality, and e's sound like a's. This describes:
Tactile fremitus is best felt:
Tactile fremitus is best felt:
How is the sputum of a viral infection different from the sputum of a bacterial infection?
How is the sputum of a viral infection different from the sputum of a bacterial infection?
A cause for alarm during chest assessment of a newborn is:
A cause for alarm during chest assessment of a newborn is:
Which of the following is an expected finding in newborns?
Which of the following is an expected finding in newborns?
Loud, harsh bronchovesicular breath sounds in young children are an indication of:
Loud, harsh bronchovesicular breath sounds in young children are an indication of:
A pregnant woman is expected to develop:
A pregnant woman is expected to develop:
Expected respiratory changes of normal aging include:
Expected respiratory changes of normal aging include:
Which symptom is the most significant indicator of asthma and should be identified in the health history?
Which symptom is the most significant indicator of asthma and should be identified in the health history?
Dullness to percussion in intercostal spaces suggests the presence of:
Dullness to percussion in intercostal spaces suggests the presence of:
Which condition requires immediate emergency intervention?
Which condition requires immediate emergency intervention?
A 29-year-old patient presents with a new complaint of productive cough, with purulent sputum. You suspect pneumonia in which lobe?
A 29-year-old patient presents with a new complaint of productive cough, with purulent sputum. You suspect pneumonia in which lobe?
Which of the following are signs and symptoms of atelectasis?
Which of the following are signs and symptoms of atelectasis?
Both pleural effusion and lobar pneumonia are characterized by __________ percussion.
Both pleural effusion and lobar pneumonia are characterized by __________ percussion.
The respiratory rate of a sleeping newborn is expected to be __________ breaths/min.
The respiratory rate of a sleeping newborn is expected to be __________ breaths/min.
In barrel chest, the ratio of the anteroposterior diameter to the transverse (lateral) diameter is __________.
In barrel chest, the ratio of the anteroposterior diameter to the transverse (lateral) diameter is __________.
Study Notes
Chest Anatomy and Physiology
- Infants have an equal anteroposterior and transverse chest diameter, generally round in shape.
- Bright tangential lighting is optimal for visualizing chest movement during inspection.
- The apex of the lung is auscultated 4 cm above the first rib.
Chest and Intercostal Spaces
- Intercostal spaces (ICS) are documented based on the rib immediately above them.
- The manubriosternal junction (Angle of Louis) helps locate the second rib, serving as a reference for counting ribs and ICS.
Fetal and Newborn Lung Function
- After cutting the umbilical cord, blood flow to infant lungs increases; lungs fill with air on the first gasp.
- Fetal gas exchange occurs via the placenta; lungs are collapsed and non-functional prior to birth.
- The foramen ovale closes minutes after birth due to decreasing pulmonary pressures.
- Increased arterial oxygen tension in newborns prompts closure of the ductus arteriosus.
Respiratory Changes in Pregnancy and Aging
- Pregnant women exhibit a progressively increasing subcostal angle to accommodate the enlarging uterus.
- Barrel chest in older adults results from skeletal changes, particularly the thoracic spine curve.
Chest Pain Assessment
- Cocaine use is a significant risk factor in adolescents with chest pain.
- Document herbal and alternative therapies in the social history section.
- Platypnea describes worsening shortness of breath when sitting up.
Respiratory Patterns and Terminology
- Bradypnea can indicate a strong cardiovascular fitness level.
- The mediastinum houses thoracic viscera, excluding the lungs.
- Right mainstem bronchus is more susceptible to foreign body aspiration due to its anatomical slope.
Abnormal Breath Sounds and Signs
- Pectus carinatum indicates a minor structural variation in the chest.
- Stridor, an alarming sign in any age, signifies upper respiratory obstruction.
- Loud bronchovesicular sounds in young children are normal due to thin chest wall structures.
Auscultation Techniques
- Auscultate lung bases first in fatigued patients, especially if pneumonia is suspected.
- Egophony indicates lung consolidation when e sounds shift to a.
- Document a respiratory rate over 20 breaths per minute as tachypnea.
Conditions Requiring Emergency Attention
- Absent breath sounds with dull percussion tones indicate a critical condition needing immediate intervention.
- Signs of pneumonia may include dullness to percussion and can result in referred abdominal pain due to diaphragm irritation.
Sputum Characteristics and Age-Related Changes
- Bacterial sputum is typically yellow, green, or rust-colored; viral sputum is mucoid.
- Newborns can have expected conditions like sneezing; significant respiratory distress, such as stridor, is alarming.
- Aging respiratory changes include more prominent bony structures due to subcutaneous tissue loss.
Summary of Symptoms
- Symptoms of atelectasis include tachypnea, shortness of breath, and low-grade fever.
- Patient assessment should recognize signs indicating lung issues or respiratory distress, ensuring timely medical responses.
Conclusion
- Understanding chest and lung physiology, age-related changes, and auscultation techniques is essential in respiratory assessments and interventions.
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Test your knowledge of chest anatomy and common respiratory conditions with these flashcards. Focused on key definitions and clinical scenarios, this quiz is perfect for medical students and healthcare professionals.