Term
| What are the primary muscles of inspiration? |
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Definition
The diaphragm.
Contracts downward during inspiration |
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Term
| What is an excessory muscle of inspiration? |
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Definition
External intercostal muscles
Increase the anteroposterior chest diamete during inspiration |
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Term
What are the muscles of expiration.
Which are primary and which are secondary? |
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Definition
Primary-Internal intercostal muscles0 drease the trnasverse chest diameter during expiration.
Accessory muslces of expiration
-sternocleidomastoid and trapezius |
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Term
| What muscles are often used during pulmonary problems and compromise? |
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Definition
| Sternocleidomastoid and trapezius muscles. |
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Term
| What three purposes does the tracheobronchial tree serve? |
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Definition
-Filter air
-Humidify air
-warm air |
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Term
| Where does the trachea lie in regards to the esophagus and thyroid? |
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Definition
| Anterior to the esophagus and posterior to the thyroid. |
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Term
| Which bronchus is more susceptible to aspirations? |
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Definition
| The right bronchus b/cis is wider shorter and more vertically placed than the left bronchus. |
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Term
| T/F. Lungs are fully formed in an infant. |
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Definition
| False. Lungs do not fully form until about age 8. |
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Term
| A child presents with a chest circumference about the same as the head circumferance. Is this normal? |
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Definition
| Until the age of 2 it is normla past that it is abnormal. |
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Term
| What questions as far as history should be asked when screening an infant in regards to respiratory health? |
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Definition
-Low birth weight
-premature
-history of intubation
couching or difficulty breathing
-ingestion of chemicals
-apneic episodes
=recurrent spitting up
History or pneumococcal and influenza vaccination |
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Term
| What are two common chest abnormalities? |
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Definition
-Pectus carinatum-prominent sternal protrusion
-Pectus excavatum-indention of the lowe sternum |
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Term
| What is a normal respiratory rate? |
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Definition
12-20 bpm
Below 12 is bradypnea |
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Term
| What is the normal thoracic ratio? |
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Definition
| .70-the anterior to posterior diameter should be less than the lateral diameter. This ratio becomes closer to 1.0 with chronic lung conditions. |
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Term
| What is barrell chest? When is it often seen? |
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Definition
| Increase A/P diameter of the chest and is often seen in the case of COPD or cystic fibrosis. |
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Term
| Describe flail chest. What is it indicative of? |
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Definition
Flail chest is when a portion of the lower chest moves inward during inspiration.
It is indicative of at least one rib fracture ?? |
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Term
| What are some changes that occur in the characterictics of respriration in pregnant women? |
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Definition
Lower ribs flare
Subcostal angle increases from 68.5 degrees to about 103.5 degrees
Diaphragm at rest rises as much as 4 cm above its usual resting position
Diaphragm movement increases so that the diaphragm is still doing most of the work of inspriation
Minute ventilation increases due to increased tidal volume, though the respiratory rate remains unchanged. |
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Term
| What are two characteristics of the older adult that predispose them to bacterial infections? |
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Definition
-mucous membranes become drier
elderly are less able to rid themselves of mucus |
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Term
| What can the scent of cinnamon on someone's breath indicate? |
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Definition
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Term
| In a patient with phrenic nerve palsy what characteristic would the physician note? |
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Definition
| Absence of diaphragmatic movement during diaphragmatic excursion |
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Term
| Where can the middle lobe of the right lung and lingula best be heard? |
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Definition
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Term
| T/F. The respiratory rate increases in a preganant woman. |
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Definition
False. The respiratory rate remains the same in a pregnant female.
Tidal volume however does increase. |
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Term
If a pain is:
-Constant ache lasting all day
-Pain stays in one location
-made worse with pressure on the precordium
-very short, sharp pain lasting 1-2 seconds
-located in th shoulders or between the scapula in the back
Is it normally cardiac or non cardiac? |
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Definition
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Term
| When collecting a history from a patient with respiratory symptoms what questions should you specifically ask about medical illnesses? |
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Definition
Use of oxygen
ventilation assisting devices
TB
COPD
Asthma
Cystic fibrosis
Chest trauma |
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Term
| how are pack years calculated? |
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Definition
| Packs per day times the number of years smoked |
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Term
| When seeing a patient with respiratory symptoms what questions about habits should be asked? |
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Definition
-Use of alcohol
-Use of recreational drugs--cocaine
-Tobacco use including second hand smoke |
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Term
| What specific questions should be asked of pregnant women when gathering a history related to respiratory symptoms? |
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Definition
-weeks of gestation
-number of fetuses
-polyhydramnios (excess amniotic fluid)
-exercise type and energy expenditure
-exposure to respiratory infections, annual influenza immunications, pertussis vaccine |
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Term
| Describe retraction of the chest wall. WHat does it suggest? |
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Definition
-chest wall caves in at the sternum and between the ribs, at the suprasternal notch, above the clavicles, and at the lowest costal margins.
Suggests and obstruction to inspiration at any point int he respiratory tract |
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Term
| Describe paradoxic breathing. |
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Definition
On inspiration the lower thorax is drawn in and on expriation the lower thorax expands out.
Sign of weak diaphragm or obstruction |
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Term
| A patient exhibits periodic breathing or cheyne stokes respiration during their sleep. Is this healthy. If it occurs while they are awake is it healthy? |
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Definition
| Many children and older adults exhibit this pattern of breathing while they are asleep and it is not a cause for concern. However, this pattern of breathing also occurs in the seriously ill an d also patients with brain damage at the cerebral level or with drug associated respiratory compromise. |
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Term
| What are some symptoms of respiratory distress? |
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Definition
-Increased respiratory rate
-Tripoding
-Difficult or labored breathing
-Sweating
-Cyanosis
-Accessory muslce use
-Nasal flaring
-Lip pursing |
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Term
| What is the term for deep breathing at a rate greater than 20 bpm? |
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Definition
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Term
| What is the term applied to frequently interspresed deeper breaths? |
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Definition
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Term
| If a patient has increased difficulting in exhaling what term is applied to this pattern of breathing? |
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Definition
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Term
| Describe cheyne-stokes breathing? |
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Definition
| Varying periods of increasing depth interspersed with apnea. |
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Term
| Describe Kussmaul breathing patterns. |
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Definition
| Rapid deep and labored breathing |
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Term
| What type of breathing is indicated by irregularly interspersed periods of apnea in a disorganized sequence of breaths? |
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Definition
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Term
| Describe ataxic breathing. |
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Definition
| Significant disorganization with irregular and varying depths of respiration. |
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Term
| What type of breathing is associated with DKA? |
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Definition
| Deep and rapid breathing--Kussmaul. |
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Term
| Describe crepitus. What does it indicate. |
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Definition
Crackly or crinkly snesation that can be both palpated and heard.
Indicated air in the subcutaneous tissue caused by either infection by a gas producing organism or rupture somewhere in the respiratory system. |
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Term
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Definition
| Palpable, coarse, grating vibration, usually on inspiration |
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Term
| What does hyperressonance indicate? |
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Definition
| Hyperinflation for example emphasema |
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Term
| What does dullness during percussion indicate? |
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Definition
| Diminished air exchange--example pneumonia. |
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Term
| Describe vesicular breath sounds. What do they indicate? |
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Definition
| Low pitched, low intensity sounds heard over healthy lung tissue. |
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Term
| Describe bronchovesicular breath sounds. |
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Definition
| Hear over the major bronchio and are typically moderate in ptich and intensity. |
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Term
| Describe bronchial breath sounds. |
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Definition
| Highest in pitch and intensity. Usually heard only over the trachea. |
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Term
| T/F. Bronchovesicular and bronchial breath sounds can be heard over the peripheral of healthy lung tissue. |
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Definition
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