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88 Cards in this Set
- Front
- Back
consists of the nasophaynx, oropharynx, laryngopharynx, and larynx
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upper airway
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consists of the trachea, bronchi, bronchioles, and alveoli
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lower airway
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How many lobes does the right lung have?
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3
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How many lobes does the left lung have?
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2
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How do women breathe?
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thoracically
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How do men and infants breathe?
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abdominally
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abnormality of the chest characterized by a rounded appearance, horizontal ribs, slight kyphosis of the thorax, and a prominent sternal angle
the chest appears in constant inspiration Ex. infant's chest or an adult with pulmonary disease |
barrel chest
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abnormality of the chest in which the sternum projects foward
there is an increase in the AP diameter |
pectus carinatum (pigeon chest)
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abnormality of the chest in which the sternum points posteriorly and may cause abnormal pressure on the heart
if severe, it can cause respiratory failure |
pectus excavatum (funnel chest)
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an exaggerated curvature of the thoracic vertebrae
can cause significant backpain and limited mobility |
kyphosis (humpback)
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What has been found to decrease kyphosis?
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adequate exercise
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a lateral curvature of the thoracic and lumbar spine
reduces chest wall compliance |
scoliosis
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an exaggerated curvature of the lumbar vertebrae
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lordosis
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What angle should the ribs insert into the spine?
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45 degrees
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A horizontal slope of the ribs will be assessed on a person with:
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emphysema
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What can cause retraction or bulging of the interspaces during inspiration or expiration?
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asthma
emphysema pleural effusion tension pneumothorax |
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What can cause tachypnea?
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fever
pain anxiety anemia pneumonia pleurisy lesion in the pons |
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Respirations increase about ____ breaths per minute for every 1 degree increase in temp above normal.
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4
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What can cause bradypnea?
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increased intracranial pressure
diabetic coma opiate narcotic overdose brain tumor |
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total absence of breathing; may be periodic
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apnea
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increased depth of respirations
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hyperpnea
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What can cause hyperpnea?
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strenuous exercise
diabetic ketoacidosis |
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increased rate and depth of respirations
offsets the O2-CO2 balance often stress related |
hyperventilation
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What causes Cheyne-Stokes respirations?
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increased intracranial pressure
severe congestive heart failure renal failure drug overdose |
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interrupted breathing like Cheyne-Stokes except that each breath is of the same depth
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biots
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What causes biots?
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spinal meningitis
heat stroke head trauma encephalitis |
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a panting, labored kind of respiration with increased rate and depth
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Kussmaul's respirations
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tube-like structures opening onto the skin
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sinus tracts
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indicates subcutaneous air in the chest
feels like puffed rice cereal crackling under the skin indicates air leaking from the airways/lungs |
crepitus
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performed to assess range and symmetry of respiratory movement
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respiratory excursion
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Where do you place your thumbs to assess for respiratory excursion?
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at the level of and parallel to the 10th ribs
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When testing for respiratory excursion, the thumbs should move _________ as the person inhales and __________ as the person exhales.
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outward
inward |
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What can cause unequal chest expansion (as noted by respiratory excursion test)?
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pleural effusion
rib fractures pneumothorax tumors |
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a vibration transmitted through the chest wall as the person speaks
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fremitis
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To assess for fremitis, what part of your hand do you touch the chest with?
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the palmar surface (of your dominant hand)
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With fremitis, where should vibrations be the strongest?
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between the scapulae on the posterior chest
on either side of the sternum on the anterior chest |
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What causes decreased fremitis?
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anything that obstructs the vibration:
obstructed bronchus COPD pleural thickening pneumothorax emphysema pleural effusion |
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What causes increased fremitis?
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Compression or consolidation of lung tissue caused by:
mass (tumor consolidated area such as with pneumonia or other inflammatory processes |
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Where is fremitus no longer felt?
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at the level of the diaphragm
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What is the normal sound you will hear when you percuss the lung tissue?
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resonance
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Why do we percuss the posterior chest?
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to determine whether the underlying tissue is air-filled, fluid-filled, or solid
(the normal lung should be air-filled) |
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What does resonance sound like?
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loud intensity and low pitched
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What does a dull sound indicate when you percuss the posterior chest?
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abnormal density in the lung
(caused by lung tumor, pneumonia, pleural effusion, and atelectasis) |
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What does a hyperresonant sound indicate when you percuss the posterior chest?
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too much air is present
(caused by emphysema or pneumothorax) |
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When you percuss the posterior chest, when the sound changes from ________ to _________, you are at the estimated level of the diaphragm.
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resonance
dullness |
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the movement of the diaphragm as it descends on inspiration and rises on expiration
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diaphragmatic excursion
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With diaphragmatic excursion, the 2 lines on the right side may be slightly higher due to:
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the presence of the liver
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The normal range for diaphragmatic excursion in females is:
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3-5 cm
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The normal range for diaphragmatic excursion in males is:
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5-7 cm
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When auscultating the lungs posteriorly, what part of the stethoscope do you use?
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diaphragm
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soft, low-pitched fine rustling sounds located over the periphery of the lungs
they are loud on inspiration and soft/absent on expiration |
vesicular breath sounds
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most predominant breath sounds
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vesicular breath sounds
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Decreased vesicular breath sounds over the periphery may indicate:
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pneumonia
emphysema pleural effusion atelectasis |
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loud, high-pitched tubular sounds located over the trachea (suprasternal area) and major bronchi
they are louder and longer during EXPIRATION |
bronchial/tracheal breath sounds
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If bronchial/tracheal breath sounds are heard over the periphery, this may indicate:
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consolidation or atelectasis
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moderately pitched breath sounds located between the scapulae posteriorly and on either side of the sternum at the first and second intercostal space anteriorly
no pause between inspiration and expiration |
bronchovesicular breath sounds
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If bronchovesicular breath sounds are heard over the periphery, it may indicate:
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consolidation (lungs are filled with exudate)
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Which breath sounds are heard on the posterior chest?
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bronchovesicular
vesicular |
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Which breath sounds are heard on the anterior chest?
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bronchial
bronchovesicular vesicular |
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Inaudible breath sounds may indicate:
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atelectasis
pneumothorax |
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adventitious breath sound created when air is traveling through vessels containing abnormal moisture
more pronounced on inspiration |
crackles (rales)
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What are the 2 types of crackles?
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fine
coarse |
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type of crackle that is soft and high pitched
it sounds like 2 hairs being rubbed together |
fine
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type of crackle that is louder and lower pitched
has a bubbly quality |
coarse
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high pitched sound produced by air passing through a narrowed passageway in the small airways
may occur during inspiration, expiration, or both |
wheezes (sibilant rhonchi)
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What causes wheezes?
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mucous plug
bronchospasms tumor |
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coarse rattling sounds more like a snore, moan, or groan
louder and lower in pitch than crackles and caused by narrowed or constricted large airways more pronounced on EXPIRATION |
rhonchi (sonorous rhonchi)
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What causes rhonchi (sonorous rhonchi)?
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asthma
bronchitis bronchospasm |
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high pitched sound produced by air passing through a narrowed passageway in the small airways
may occur during inspiration, expiration, or both |
wheezes (sibilant rhonchi)
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What causes wheezes?
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mucous plug
bronchospasms tumor |
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coarse rattling sounds more like a snore, moan, or groan
louder and lower in pitch than crackles and caused by narrowed or constricted arge airways more pronounced on EXPIRATION |
rhonchi (sonorous rhonchi)
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What causes rhonchi (sonorous rhonchi)?
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asthma
bronchitis bronchospasm |
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crackling, grating sounds produced when 2 roughened or inflamed pleural spaces rub across each other during respiration
heard on both inspiration and expiration sounds like sand paper |
friction rub
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loud high-pitched crowing sound heard usually without a stethescope during inspiration
requires immediate attention! |
stridor
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What causes stridor?
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upper airway obstruction
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What are the S/S of upper airway obstruction?
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anxiety
dyspnea stridor wheezes decreased/absent breath sounds use of accessory muscles inability to speak cyanosis seesaw movement of chest |
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Sound carries best through __________, not as well through _________, and poorly through _________.
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solid
fluid air |
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Instruct the person to say 99 while you auscultate the posterior chest. Normally the sound should be muffled and indistinct. If the sound is clear, it is called:
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bronchophony
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Instruct the person to say "ee" while you auscultate the posterior chest. Normally the sound should be muffled and indistinct. If the sound is heard as "ay", this is called:
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egophony
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Instruct the person to WHISPER 99 while you auscultate. The sound should be faint and indistinct. If the sound is louder and clear, it is called:
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whispered pectoriloquy
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What should the width of the costal angle be?
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less than 90 degrees
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When you inspect for the use of accessory muscles, which muscles are you looking at?
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trapezius
sternocleidomastoid abdominal muscles |
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In a normal adult, what is the ratio of the anterioposterior (AP) diameter to the lateral diameter?
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1:2
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Does the AP diameter usually increase or decrease in the older adult?
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increase (b/c of barrel chest or pectus carinatum)
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When palpating the anterior chest for respiratory excursion, where do you place your thumbs?
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along the costal margins pointing toward the xyphoid process
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The assessment of fremitis differs anteriorly due to the decreased or absent vibration over the _____________.
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precordium
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When you percuss over the liver and heart, what sound will you hear?
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dull
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When you percuss over the stomach, what sound will you hear?
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tympany
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