It contracts and moves downward during inspiration, lowering the abdominal contents to increase the intrathoracic space.
diaphragm
The ________ intercostal muscles increase the AP chest diameter during inspiration, and the _______ intercostal muscles decrease the lateral diameter during forceful expiration
external; internal
the ____ lung having three lobes and the ____ lung having two
right; left
The _____ lung may ride higher because of the fullness of the dome of the liver
right
A depression, easily palpable and most often visible at the base of the ventral aspect of the neck, just superior to the manubriosternal junction.
The suprasternal notch.
Chest of healthy infant, the anteroposterior diameter is approximately ______ as the lateral diameter.
A.
Barrel chest with _______ anteroposterior diameter
increased
The sequence of steps in examination of the chest and lungs is
D.
the ratio of respirations to heartbeats is approximately
D.
A regular periodic pattern of breathing with intervals of apnea followed by a crescendo/decrescendo sequence of respiration is called periodic breathing or
Cheyne-Stokes respiration
____ respiration usually is associated with severe and persistent increased intracranial pressure, respiratory compromise resulting from drug poisoning, or brain damage at the level of the medulla and generally indicates a poor prognosis
Biot
A self-limited condition, and not uncommon after a blow to the head. It is especially noted immediately after the birth of a newborn, who will breathe spontaneously when sufficient carbon dioxide accumulates in the circulation.
A.
primary apnea
Breathing stops and will not begin spontaneously unless resuscitative measures are immediately instituted. Any event that severely limits the absorption of oxygen into the bloodstream will lead to
A.
secondary apnea.
Characterized by a long inspiration and what amounts to expiration apnea. The neural center for control is in the pons and medulla. When it is affected, breathing can become gasping because inspirations are prolonged and expiration constrained
C.
Apneustic breathing
a crackly or crinkly sensation, can be both palpated and heard—a gentle, bubbly feeling
Crepitus
A palpable, coarse, grating vibration, usually on inspiration, suggests a _____ _____ ___ caused by inflammation of the pleural surfaces
pleural friction rub
Note the quality of the ______ _____, the palpable vibration of the chest wall that results from speech or other verbalizations.
tactile fremitus
dullness to percussion is most useful finding for _____ ______.
pleural effusion.
The absence of reduced tactile vocal fremitus makes _____ ______ less likely.
pleural effusion
Decreased or absent fremitus may be caused by excess air in the lungs or may indicate _________.
emphysema
_______ breath sounds are low-pitched, low-intensity sounds heard over healthy lung tissue.
Vesicular
____________ sounds are heard over the major bronchi and are typically moderate in pitch and intensity
Bronchovesicular
The sounds highest in pitch and intensity are the _______ breath sounds, which are ordinarily heard only over the trachea
bronchial
A ______ is an abnormal respiratory sound heard more often during inspiration and characterized by discrete discontinuous sounds, each lasting just a few milliseconds.
crackle
______ (sonorous wheezes) are deeper, more rumbling, more pronounced during expiration, more likely to be prolonged and continuous
Rhonchi
A musical noise most often heard continuously during inspiration or expiration; usually louder during expiration
Wheeze (sibilant wheeze)
Mediastinal crunch (_____ ____) is found with mediastinal emphysema
Hamman sign
When the intensity of the spoken voice is increased and there is a nasal quality (e.g., “e” becomes a stuffy, broad “a”), the auditory quality is called _______.
egophony
_______ is a high-pitched, piercing sound most often heard during inspiration. It is the result of an obstruction high in the respiratory tree
Stridor
A 44-year-old male patient who complains of a cough has presented to the emergency department. He admits to smoking one pack per day. During your inspection of his chest, the most appropriate lighting source to highlight chest movement is
C.
When auscultating the apex of the lung, you should listen at a point
B.
To count the ribs and the intercostal spaces, you begin by palpating the reference point of the
C.
The angle of Louis, the junction of the manubrium and the sternum, corresponds to the second
rib, the reference point for counting ribs and intercostal spaces.
Mr. Curtis is a 44-year-old patient who has presented to the emergency department with
shortness of breath. During the history, the patient describes shortness of breath that gets
worse when he sits up. To document this, you will use the term
C.
Which finding suggests a minor structural variation?
C.
Pectus carinatum (pigeon chest) is a minor structural variation. Barrel chest, clubbing of the fingers, and chest wall retractions result from compromised respirations
Ms. Rudman, age 74 years, has no known health problems or diseases. You are doing a preventive healthcare history and examination. Which symptom is associated with intrathoracic infection?
C.
In which patient situation would you expect to assess tachypnea?
B.
Which site of chest wall retractions indicates a more severe obstruction in the asthmatic patient?
C.
You would expect to document the presence of a pleural friction rub for a patient being treated for
C.
Which type of apnea requires immediate action?
C.
Secondary apnea is a grave condition, and unless resuscitative measures are instituted immediately, breathing will not resume spontaneously.
With consolidation in the lung tissue, the breath sounds are louder and easier to hear, whereas healthy lung tissue produces softer sounds. This is because
B.
Air is a poor conductor of sound.
Which lung sounds are associated with atelectasis? (Select all that apply.)
a. Wheezes
b. Ronchi
c. Crackles
d. Crepitus
e. Rales
