34 Questions
What is the vertebra prominens?
The spinous process of C7
What is the significance of the vertebra prominens in counting thoracic processes and identifying landmarks on the posterior chest?
It is easier to identify and serves as a starting point
What does a costal angle of approximately 90 degrees indicate in a respiratory assessment?
A normal finding in a healthy adult
What happens to the costal angle when the rib cage is chronically overinflated, as in emphysema?
It increases
During an assessment of an adult, what does unequal chest expansion indicate?
When part of the lung is obstructed or collapsed
What is the most likely condition associated with the presence of bronchophony during auscultation of the lungs?
Pulmonary consolidation
Where are bronchovesicular breath sounds expected to be heard?
Expected near the major airways
What is the characteristic sound produced by air passing through narrowed bronchioles in severe asthma?
Wheezes
What assessment is included when inspecting the anterior chest of an adult?
Shape and configuration of the chest wall
Where would fine crackles most likely be noticed?
The immediate newborn period
What is the expected location of vesicular breath sounds?
Over the peripheral lung fields
What does a dull percussion note signal in the lungs?
Abnormal density
What occurs when the bronchial tree is obstructed?
Decreased or absent breath sounds
What is the significance of retractions of the sternum and intercostal muscles in an infant?
Increased inspiratory effort
What is a normal finding for bronchovesicular breath sounds in children up to age 5 or 6 years?
In the peripheral lung fields
What is not an expected finding in a 4-year-old child regarding crepitus palpation?
Crepitus palpated at the costochondral junctions
What is not an expected finding in a 4-year-old child regarding diaphragmatic excursion?
No diaphragmatic excursion
What is not an expected finding in a 4-year-old child regarding respiratory rate?
Irregular respiratory pattern and a respiratory rate of 40 breaths per minute at rest
What is not a priority when significant retractions of the sternum and intercostal muscles are present in an infant?
Assessment of the infant's feeding
What is the correct way to auscultate breath sounds?
Firmly holding the diaphragm of the stethoscope against the chest
What is crucial in auscultating the chest?
Side-to-side comparison
What happens to the thorax with aging?
Becomes less mobile and increases anteroposterior diameter
How many lobes does the left lung consist of?
Two lobes
Where is the apex of the lung located on the anterior chest?
3 to 4 cm above the inner third of the clavicles
What does the sternal angle mark the site of?
Tracheal bifurcation
What is a characteristic of paroxysmal nocturnal dyspnea?
Difficulty in breathing when lying down
Which muscles are the major muscles of respiration?
Diaphragm and intercostals
Where is tactile fremitus most prominent?
Between the scapulae and around the sternum
What is fremitus caused by?
Sounds generated from the larynx
What does a dull percussion note over a lung lobe most likely indicate?
Pleural effusion
What are normal lung findings characterized by?
Vesicular breath sounds over the peripheral lung fields
Where do vesicular breath sounds occur?
Over the peripheral lung fields
What does symmetric chest expansion indicate?
Normal lung function
Where is the major bronchi closest to the chest wall?
Between the scapulae and around the sternum
Study Notes
Respiratory Assessment Key Points
- The left lung consists of two lobes, and the right lung has three lobes.
- The apex of the lung on the anterior chest is located 3 to 4 cm above the inner third of the clavicles.
- The sternal angle marks the site of tracheal bifurcation into the right and left main bronchi.
- Normal lung findings include symmetric chest expansion, resonant percussion tones, vesicular breath sounds over the peripheral lung fields, muffled voice sounds, and no adventitious sounds.
- The major muscles of respiration are the diaphragm and intercostals.
- Paroxysmal nocturnal dyspnea is characterized by being awakened from sleep with shortness of breath and the need to be upright to achieve comfort.
- Tactile fremitus is most prominent between the scapulae and around the sternum, where the major bronchi are closest to the chest wall.
- Fremitus is a palpable vibration caused by sounds generated from the larynx transmitted through patent bronchi and the lung parenchyma to the chest wall.
- A dull percussion note elicited over a lung lobe most likely results from increased density of lung tissue, as seen in pneumonia, pleural effusion, atelectasis, or a tumor.
Test your knowledge of respiratory assessment with this quiz covering key points such as lung anatomy, normal findings, major muscles of respiration, and common respiratory assessment findings. Brush up on your understanding of lung percussion, breath sounds, and respiratory conditions.
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