Anterior Reference Points
Midsternal Line
Midclavicular Line
Anterior Axillary Line
Posterior Reference Points
Vertebral Line
Scapular Line
Pneumothorax
air in pleural space
Effusion
Serous fluid in pleural space
Hemothroax
Blood in pleural space
Empyema
puss in pleural space
Pleurisy
inflammation of pleura
Right Lung Characteristics
3 lobes (upper,middle,lower)
Wider bc liver pushes it up, but shorter
Left Lung Characteristics
2 lobes
narrow bc heart pushes it in, but taller
When auscultating the lungs posteriorly. What lobe predominates? Which lobe is missing?
Posterior is mainly Lower Lobe on both lungs, small portion of Upper lobe
Right Middle Lobe can only be auscultated anteriorly
Right Mainstem Bronchi
Larger and starighter than left
tubes inserted into trachea more likely to follow right bc straighter
secretes mucus to trap particles
cillia elivator
Mediastinum
Located: behind sternum
@ center lower region of chest, slightly to left
surrounded by pleura
contains esophagus, trachea, heart, and great vessels
Hyperventalation
Increase resp output (co2 leaving), blood becomes basic
Hypoventalation
dec resp output (shallow breathing), CO2 buildup, blood becomes acidic
Voluntary Heart Rate Lowers HR bc
activates parasymp system
Pediatric respirations in the throacic cavity differ bc
they have deeper anterioir-posterior dimensions
peds risks respiratory
exposure to smoke or prenatal smoke inc risk of sudden infant death syndrome and respiratory illness
pregnancy causes what changes in the respiratory system
pregnancy causes:
elevated diaphragm
throacic cavity has enlarged width to compensate for dec length bc baby
older adult respiratory risks
loss of elasticity in cartilage that connects ribs to sternum so they have in inc risk or fractures during CPR
chronic respiratory disease can cause development of barrell chest
Signs of TB
cough lasts 3 weeks +
pain in chest
cough up blood ( or pink frothy sputum)
Orthopnea
airway improves when sitting up
associated with Congestive Heart Failure
Healthy SO2
97-98
Physical assessment of Respiratory System includes:
Inspection
Palpation
Percussion
Auscultation
Clubbing
fingernails grow out and wide
indicates chronic hypoxemia
Barrell Chests indicates
COPD
Tactile Fremitus
palpate areas with palm of hand by having PT say 99 or blue moon, compare sides
compare density
areas of inc density=sternum, scapula
areas of inc density when there should be an aerated lung would be abnormal and indicate liquid or mass in lung
APE To Man
Aortic Valve (2nd intercostal space, Right Side)
Pulmonary Valve (2nd intercostal space, Left Side)
ERB's Point (3rd intercostal space, Left Side)
Tricuspid Valve (4th intercostal space, Left Side)
Mitral (5th intercostal space, Right Side, Midclavicular)
Bronchial Sounds
Heard over trachea
Long Inhalation, short exhale
Crackles
aka rales
alveoli popping open or air movement past secretions
Weezing
musical sound
restriction in lower airway
stridor
high pitched sound,
restriction of upper airway
S1 is the sound of
Lub
AV valves closing at the beginning of systole.
s2 is the sound of
Dub
SL valves closing at the end of systole
When heart is in diastole the ventricles...
are relaxed and the AV valves are open allowing ventricles to fill
Systole begins when
ventricles fill to capacity and the ventricular pressure cause the AV valves to close
Cardiac Output
4-6L per minute