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Study Guide

Assessing the Thorax and Lungs


READ CAREFULLY:

  1. Taylor, Lillis, & LeMone, Chapter 25 (pp. 477 - 480)
  2. Bickley, Chapter 6 (pp. 209 - 243)
  3. Class lecture notes off the Internet

TERMS TO KNOW:

  1. Apnea
    1. breathing pattern evidenced by absence of respirations
  2. Ataxic (Biot's) respirations
    1. breathing pattern evidenced by periods of deep breathing that alternate with periods of apnea in an irregular pattern
  3. Barrel chest
    1. chest shape in which the AP = transverse diameter; the costal angle is greater than 90 degrees; the rib slope is 45 degrees or horizontal; and the sternum is positioned even with the ribs
  4. Bradypnea
    1. breathing pattern evidenced by slow (less than 12 per minute) respirations
  5. Bronchophony
    1. an abnormal increase in tone or clarity in vocal resonance emanating from a bronchus surrounded by consolidated lung tissue
  6. Bronchial breath sounds
    1. normal breath sounds heard over the trachea that are high in pitch and intensity with expiration being longer than inspiration
  7. Bronchovesicular breath sounds
    1. normal breath sounds heard over the 1st and 2nd interspaces anteriorly and between the scapulae posteriorly that are medium in pitch and intensity with inspiration being equal to expiration
  8. Cheyne-Stokes respirations
    1. breathing pattern evidenced by periods of deep breathing that alternate with periods of apnea in a regular pattern
  9. Crackles (coarse)
    1. low-pitched; "bubbling" or "gurgling" sounds on inspiration that may or may not be cleared by coughing
  10. Crackles (fine)
    1. high-pitched; "crackling" or "popping" sounds on inspiration that are not cleared by coughing
  11. Dullness
    1. a medium, medium-pitched, "thudlike" sound of moderate duration typically heard over the liver, heart
  12. Dyspnea
    1. breathing pattern evidenced by a subjective feeling of difficulty or distressful respirations
  13. Egophony
    1. an abnormal change in tone, somewhat like the bleat of a goat, heart in ausculatiaon of the chest when the subject speaks normally
  14. Friction rub
    1. low-pitched; "grating" sounds on inspiration and expiration that are not cleared by coughing
  15. Hyperresonance
    1. a very loud, very low-pitched, "booming" sound of very long duration typically heard over the emphysematous lung
  16. Hypernea, hyperventilation
    1. respiration that is deeper and more rapid than expected
  17. Kyphosis
    1. exaggerated convex curvature of the spinal column
  18. Lordosis
    1. exaggerated concave curvature of the spinal column
  19. Obstructive
    1. breathing pattern evidenced by normal inspiration and prolonged expiration
  20. Pectus carniatum (pigeon chest)
    1. chest shape in which the AP diameter is greater than transverse diameter; the costal angle is greater than 90 degrees; the rib slope less than 45 degrees; and the sternum is protruding
  21. Pectus excavatum (funnel chest)
    1. chest shape in which the AP diameter is less than transverse diameter; the costal angle is 90 degrees; the rib slope less than 45 degrees; and the sternum depressed
  22. Resonance
    1. a loud, low-pitched, "hollow" sound of long duration typically heard over the lung
  23. Rhonchi
    1. low-pitched; "snoring", monophonic (single notes in a chord) sounds on expiration that may or may not be cleared by coughing
  24. Scoliosis
    1. exaggerated s-shaped curvature of the spinal column
  25. Sighing
    1. breathing pattern evidenced by frequent sighing
  26. Stridor
    1. high-pitched; "crowing", monophonic (single notes in a chord) sounds on inspiration that are not cleared by coughing
  27. Tachypnea
    1. breathing pattern evidenced by rapid (greater than 20 per minute), shallow respirations
  28. Tactile (vocal) fremitus
    1. a tremor vibration in any part of the body detectable on palpation
  29. Tympany
    1. a loud, high-pitched, "musical" sound of moderate duration typically heard over the stomach filled with gas
  30. Vesicular breath sounds
    1. normal breath sounds heard over the periphery of the lung that low-pitched and soft intensity with inspiration being longer than expiration
  31. Wheezes
    1. high-pitched; "musical", polyphonic (multiple notes in a chord) sounds on expiration that are not cleared by coughing
  32. Whispered pectoriloquy
    1. a striking transmission of a whisper through the pulmonary structures so that they are clearly audible through the stethoscope that is commonly detected when the lung is consolidated by pneumonia

LEARNING ACTIVITIES:

  1. Lecture
  2. Discussion
  3. Read the following PRIOR to class:
    1. Taylor, Lillis, & LeMone, Chapter 25 (pp. 477 - 480)
    2. Bickley, Chapter 6 (pp. 209 - 243)
    3. Class lecture notes off the Internet

STUDY QUESTIONS TO REVIEW FOR TEST:

  1. Purposes of assessing the thorax and lungs.
  2. Function of the thorax and lungs.
  3. Structures of the thorax and lungs.
  4. Pertinent history related to assessing the thorax and lungs.
  5. Correct technique for inspecting the rate, rhythm, pattern, depth, sound, and effort of respirations of the posterior and anterior thorax, inspecting the shape and configuration of the posterior and anterior thorax, inspecting the respiratory movement of the posterior and anterior thorax, inspecting the skin over the posterior and anterior thorax, inspecting the spinal alignment of the posterior thorax, inspecting the accessory muscles of the posterior and anterior thorax, inspecting the supraclavicular spaces of the anterior thorax, inspecting the substernal area of the anterior thorax, inspecting the intercostal spaces of the posterior and anterior thorax, palpating the posterior and anterior thorax, palpating the posterior and anterior thorax for respiratory expansion, palpating the posterior and anterior thorax for tactile (vocal) fremitus, percussing the posterior and anterior thorax for the distribution of resonance, dullness, and tympany, percussing the posterior thorax to determine the level of diaphragmatic dullness, percussing the posterior thorax to determine diaphragmatic excursion, auscultating the posterior and anterior thorax for normal and adventitious breath sounds, auscultating the posterior and anterior thorax for bronchophony, auscultating the posterior and anterior thorax for egophony, auscultating the posterior and anterior thorax for whispered pectorilioquy.
  6. Normal findings obtained from inspecting the rate, rhythm, pattern, depth, sound, and effort of respirations of the posterior and anterior thorax, inspecting the shape and configuration of the posterior and anterior thorax, inspecting the respiratory movement of the posterior and anterior thorax, inspecting the skin over the posterior and anterior thorax, inspecting the spinal alignment of the posterior thorax, inspecting the accessory muscles of the posterior and anterior thorax, inspecting the supraclavicular spaces of the anterior thorax, inspecting the substernal area of the anterior thorax, inspecting the intercostal spaces of the posterior and anterior thorax, palpating the posterior and anterior thorax, palpating the posterior and anterior thorax for respiratory expansion, palpating the posterior and anterior thorax for tactile (vocal) fremitus, percussing the posterior and anterior thorax for the distribution of resonance, dullness, and tympany, percussing the posterior thorax to determine the level of diaphragmatic dullness, percussing the posterior thorax to determine diaphragmatic excursion, auscultating the posterior and anterior thorax for normal and adventitious breath sounds, auscultating the posterior and anterior thorax for bronchophony, auscultating the posterior and anterior thorax for egophony, auscultating the posterior and anterior thorax for whispered pectorilioquy.
  7. Implications of variations from normal findings obtained from inspecting the rate, rhythm, pattern, depth, sound, and effort of respirations of the posterior and anterior thorax, inspecting the shape and configuration of the posterior and anterior thorax, inspecting the respiratory movement of the posterior and anterior thorax, inspecting the skin over the posterior and anterior thorax, inspecting the spinal alignment of the posterior thorax, inspecting the accessory muscles of the posterior and anterior thorax, inspecting the supraclavicular spaces of the anterior thorax, inspecting the substernal area of the anterior thorax, inspecting the intercostal spaces of the posterior and anterior thorax, palpating the posterior and anterior thorax, palpating the posterior and anterior thorax for respiratory expansion, palpating the posterior and anterior thorax for tactile (vocal) fremitus, percussing the posterior and anterior thorax for the distribution of resonance, dullness, and tympany, percussing the posterior thorax to determine the level of diaphragmatic dullness, percussing the posterior thorax to determine diaphragmatic excursion, auscultating the posterior and anterior thorax for normal and adventitious breath sounds, auscultating the posterior and anterior thorax for bronchophony, auscultating the posterior and anterior thorax for egophony, auscultating the posterior and anterior thorax for whispered pectorilioquy.

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This page was last modified on 1/1/03