Chest and Lungs Flashcards
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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?

  • Elderly
  • Infants (correct)
  • Children
  • Adults
  • 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:

  • 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:

    <p>Rib immediately above it</p> Signup and view all the answers

    To count the ribs and the intercostal spaces, you begin by palpating the reference point of the:

    <p>Manubriosternal junction</p> Signup and view all the answers

    When the umbilical cord is cut:

    <p>Blood flows through the infant lungs more vigorously</p> Signup and view all the answers

    Fetal gas exchange is mediated by the:

    <p>Placenta</p> Signup and view all the answers

    The foramen ovale should close:

    <p>Within minutes of birth</p> Signup and view all the answers

    Increased oxygen tension in the arterial blood of a newborn infant causes:

    <p>Closure of ductus arteriosus</p> Signup and view all the answers

    To accommodate the enlarging uterus of pregnancy, chest changes result in:

    <p>Increase in subcostal angle</p> Signup and view all the answers

    The characteristic barrel chest of the older adult is the result of a combination of factors, including:

    <p>Skeletal changes of aging</p> Signup and view all the answers

    Which potential risk factor is most important to assess regarding Nancy's current problem?

    <p>Cocaine use</p> Signup and view all the answers

    The patient tells you that she uses herbal and other alternative therapies to maintain her health. This information is recorded in the:

    <p>Social history</p> Signup and view all the answers

    To document Mr. Curtis's shortness of breath worsening when he sits up, you will use the term:

    <p>Platypnea</p> Signup and view all the answers

    Bradypnea may accompany:

    <p>Good cardiovascular fitness</p> Signup and view all the answers

    Which chest structure contains all the thoracic viscera except the lungs?

    <p>Mediastinum</p> Signup and view all the answers

    Which bronchial structure(s) is most susceptible to aspiration of foreign bodies?

    <p>Right mainstem bronchus</p> Signup and view all the answers

    Which finding suggests a minor structural variation?

    <p>Pectus Carinatum</p> Signup and view all the answers

    Which symptom is associated with intrathoracic infection?

    <p>Malodorous breath</p> Signup and view all the answers

    The best time to observe and count respirations is while:

    <p>Palpating the pulse</p> Signup and view all the answers

    In regard to Mr. Barrow's respirations, you note that he has 40 breaths per minute. You would categorize this as:

    <p>Above average rate</p> Signup and view all the answers

    In which patient situation would you expect to assess tachypnea?

    <p>Patient with metabolic acidosis</p> Signup and view all the answers

    Which term would you use to document a respiratory rate more than 20 breaths per minute in an adult?

    <p>Tachypnea</p> Signup and view all the answers

    Respiratory effort usually exhibited by a patient with cerebral brain damage is called:

    <p>Cheyne-Stokes respiration</p> Signup and view all the answers

    Which site of chest wall retractions indicates a more severe obstruction in the asthmatic patient?

    <p>Above the clavicles</p> Signup and view all the answers

    Laryngeal obstructions would elicit which breath sound?

    <p>Stridor</p> Signup and view all the answers

    Mr. L has cyanotic lips and nail beds with pursed lips and nasal flaring. Which additional sign would support further cardiac or pulmonary difficulty?

    <p>Clubbing of fingers</p> Signup and view all the answers

    Breath odors may alert the examiner to certain underlying metabolic conditions. The odor of ammonia on the breath may signify:

    <p>Uremia</p> Signup and view all the answers

    An expected finding of chest palpation in the adult would be:

    <p>Inflexibility of xiphoid</p> Signup and view all the answers

    You would expect to document the presence of a pleural friction rub for a patient being treated for:

    <p>Pleurisy</p> Signup and view all the answers

    Which type of apnea requires immediate action?

    <p>Secondary apnea</p> Signup and view all the answers

    During the most effective percussion technique for the posterior lung fields, the patient cooperates by:

    <p>Folding their arms in front</p> Signup and view all the answers

    The examiner percusses for diaphragmatic excursion along the:

    <p>Scapular line</p> Signup and view all the answers

    The diaphragm of the stethoscope is better than the bell for auscultation of the lungs because it:

    <p>Transmits high-pitched sounds</p> Signup and view all the answers

    Breath sounds normally auscultated over most of the lung fields are called:

    <p>Vesicular sounds</p> Signup and view all the answers

    Breath sounds normally heard over the trachea are called:

    <p>Bronchial sounds</p> Signup and view all the answers

    With consolidation in lung tissue, the breath sounds are louder and easier to hear. This is because:

    <p>Liquid enhances sound conduction</p> Signup and view all the answers

    The middle lobe of the right lung is best auscultated in the:

    <p>Axilla</p> Signup and view all the answers

    You should begin the chest examination for a patient with pneumonia by:

    <p>Auscultating the lung bases</p> Signup and view all the answers

    Your trauma patient has no auscultated breath sounds in the right lung field. A likely cause could be that the patient:

    <p>Has fluid in the pleural space</p> Signup and view all the answers

    The term rales has been replaced with:

    <p>Crackles</p> Signup and view all the answers

    To distinguish crackles from rhonchi, you should auscultate the lungs:

    <p>Before and after the patient coughs</p> Signup and view all the answers

    A musical squeaking noise heard on auscultation of the lungs is called:

    <p>Wheezing</p> Signup and view all the answers

    To distinguish between a respiratory friction rub and cardiac friction rub, ask the patient to:

    <p>Hold breath</p> Signup and view all the answers

    In which position can the mediastinal crunch (Hamman sign) best be heard?

    <p>Lying on the left side</p> Signup and view all the answers

    Changes in the clarity and volume of spoken sounds during auscultation of the lungs can help you distinguish:

    <p>Consolidation from airway constriction</p> Signup and view all the answers

    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:

    <p>Lung consolidation</p> Signup and view all the answers

    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:

    <p>Egophony</p> Signup and view all the answers

    Tactile fremitus is best felt:

    <p>Parasternally in the 2nd intercostal space</p> Signup and view all the answers

    How is the sputum of a viral infection different from the sputum of a bacterial infection?

    <p>The sputum is yellow, green, or rust-colored in bacterial infections and mucoid in viral infections</p> Signup and view all the answers

    A cause for alarm during chest assessment of a newborn is:

    <p>Stridor</p> Signup and view all the answers

    Which of the following is an expected finding in newborns?

    <p>Sneezing</p> Signup and view all the answers

    Loud, harsh bronchovesicular breath sounds in young children are an indication of:

    <p>Normal, thin chest wall structures</p> Signup and view all the answers

    A pregnant woman is expected to develop:

    <p>Deep breathing but not more frequent breathing</p> Signup and view all the answers

    Expected respiratory changes of normal aging include:

    <p>More prominent bony structures</p> Signup and view all the answers

    Which symptom is the most significant indicator of asthma and should be identified in the health history?

    <p>Paroxysmal dyspnea</p> Signup and view all the answers

    Dullness to percussion in intercostal spaces suggests the presence of:

    <p>Consolidation</p> Signup and view all the answers

    Which condition requires immediate emergency intervention?

    <p>Patient with absent breath sounds and dull percussion tones</p> Signup and view all the answers

    A 29-year-old patient presents with a new complaint of productive cough, with purulent sputum. You suspect pneumonia in which lobe?

    <p>Right lower lobe</p> Signup and view all the answers

    Which of the following are signs and symptoms of atelectasis?

    <p>Tachypnea</p> Signup and view all the answers

    Both pleural effusion and lobar pneumonia are characterized by __________ percussion.

    <p>Dullness</p> Signup and view all the answers

    The respiratory rate of a sleeping newborn is expected to be __________ breaths/min.

    <p>40-60</p> Signup and view all the answers

    In barrel chest, the ratio of the anteroposterior diameter to the transverse (lateral) diameter is __________.

    <p>1.0</p> Signup and view all the answers

    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.
    • 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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    Description

    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.

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