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how many lobes are in the right lung?
3
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how many lobes are in the left lung?
2 lobes
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where is this landmark? midsternal line.
through the center of the sternum
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where is this landmark? midclavicular line.
through the midpoint of the clavicle
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where is this landmark? anterior axillary line.
through the anterior axillary folds
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where is this landmark? midaxiallary line.
through the apex of the axillae
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where is this land mark? posterior axillary line.
throught the posterior axillary fold
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where si this land mark? right/left scapular lines.
through the inferior angle of the scapula
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where is this landmark? vetebral line.
along the center of the spine
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where are percussion & ausculatory sites?
- posterior thorax
- anterior throax
- should occur side to side
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how can you maxamize the sounds heard?
- have client take deep breaths w/ open mouth each time stethescope is moved
- placing the stethescope directly on clients skin
- facillitating client breathing by medicating for pain, giving clear direction, and assisting the client to sitting position
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how is the posterior thorax best assessed?
sitting or standing
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how is the anterior throax best assessed?
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what types of things should be noted while inspecting cleints respiratory effort?
- rate and pattern- should be regular 16-20 min
- character of breathing (diphragmatic, abdominal, thoracic)
- use of accessory muscles
- chest wall expansion
- depth of respiration- unlabored, queit breathing
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how do you assess tactile fremitus?
- palpate the chest wall using the ulnar suface of both hands comparng side to side
- ask the client to say "99" each time hands are moved
- expected finding- vibration is symmetrical and more pronounced over large airways
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what should the normal sound by percussion be over the throax?
resonance
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what would dullness indicate?
fluid or solid tissue which may be indicative of pneumonia or a tumor
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what would hyperresonance indicate?
caused by the presence of air which may be indicative of pneumothorax or emphysema
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defn. is it normal or abnormal?
bronchial
- loud
- high pitched
- expiration heard longer than inspiration over trachea
- expected
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defn. expected or unexpected?
bronchovesicular
- medium pitch and intensity, equal inspiration and expiration, heard over large airways
- expected
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defn. expected or unexpected?
vesicular
- soft, low-pitched, inspiration heard long expiration heard over most of the lung
- expected
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crackles/rales: explain what causes it
fine to coarse popping heard as air passess through fluid or re-expands collapsed small airways
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wheezes: explain what causes it and what it sounds like
high pitched whistling, musical sounds, heard as air passes through narrowed airways
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pleural friction rub: explain what it sounds like and what causes it
grating sound produced as the inflammed visceral and parietal pleura rub against each other during insperation
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