lungs

left lung

2 lobes

right lung

3 lobes

above shoulder balde

APEX

COPD

EMPHYSEMA AND BRONCHITIS

scoliosis

S curve

aging person has less area of gas exchange

easier to have SOB

Bronchial breath sounds can be auscultated where

Tracheal area

cheyne stokes

abnormal severe congested heart failure , DM,

kyphosis

candy cane elderly pain

tachypnea

increased respiration fever stress exercise

Select all of the following that are considered discontinuous breath sounds:

Pleural friction rub Fine crackles Coarse Crackles

5th intercostal

under nipple

First above the clavicle

APEX of lung

The right middle lobe is auscultated with the stethoscope where

Anteriorly on the right at the 4th intercostal space

When auscultating the posterior part of the chest the upper lobes are found?

Between C7 to T3

These type of breath sounds are found at the site of the bronchi and are located anteriorly at the 1st and 2nd intercostal space & posteriorly in between the scapulae?

Bronchovesicular

barrel chest

COPD, cystic fibrosis, emphysema long term hypoxia . looks like less than the length of the chest from the sides. if it is greater than the transverse (length of chest) it is barrel chest

Low-pitched wheezes are polyphonic sounds that can be cleared when coughing.

False *Low-pitched wheezes are MONOPHONIC (have one sound quality to them) that are not usually cleared by coughing.

The left lung has 3 lobes: left upper lobe, left middle lobe, and left lower lobe.

False *The right lung has THREE lobes and the left lung has TWO lobes.

You are auscultating a patient's lung sounds. During your assessment, you note there is a low-pitched harsh, grating sound that sounds like a pleural friction rub. However, you're not sure if this is a pleural friction rub or pericardial friction rub. What do you do next to determine the difference?

Have the patient hold their breath and note if the sound is still present

Select all of the following that are considered continuous breath sounds:

High-pitched wheeze Stridor Low-pitched wheeze

While assessing a patient's lung sounds you note bronchial breath sounds in the peripheral lung fields. What could this finding represent?

Lung consolidation like with pneumonia *Bronhical breath sounds should only be heard in the trachael area. It is ABNORMAL to hear them in the perpherial lung fields

When auscultating the anterior part of the chest, specifically the apex of the lungs, it is best to auscultate where with the stethoscope?

Slightly above the clavicle

This lung sound is continuous, high-pitched with musical instrument sound that is polyphonic and occurs mainly during expiration but can be present with inspiration as well?

Stridor

During auscultation, the anterior part of the chest mainly provides an assessment of the upper lobes of the right and left lungs, while the posterior part of the chest provides mainly provides an assessment of the lower lobes of the right and left lungs

True

chest expansion

UNEQUAL ATELECTASIS , LOBAR PNEUMONIA, pleural effusion, thoracic trauma- fractured ribs, or pneumothorax Pain accompanies deep breathing when the pleurae are inflamed

These breath sounds are found anteriorly and posteriorly throughout the peripheral lung fields?

Vesicular

elderly have a increase in residual volume

air left in lungs

2nd intercosial

all little over where the breast bone is the sternum

crepitus

coarse crackling sensation felt over the skin happens with subcutaneous emphysema

wheeze

continuous high pitch musical expiration. not changed by coughing. Airway constriction or swelling asthma or allergic reaction

gurgles rhonchi

continuous low pitched coarse gurgling, harsh louder sounds with a moaning or snoring sound Inspiration and Expiration . secretions in lungs

crackles or rales

discontinuous pooping sounds inspiration, fine crackling pneumonia. caused by fluid in small airway or atelectasis .inflammation or infection. bronchi, bronchioles, and alveoli

posterior

flipped

pleural friction

grating or creaking sounds Inspiration and Expiration . Inflammation

trick

in between the scapula to get best sound. on each side of the spine

chest pain

infection, inflammation, coughing, upper GERD, lower pneumonia or pleurisy . Fever could be pneumonia , bronchitis

history

infection, smoking, surgery

T3 to T 10

lower lobes

health promotion

mask , vaccines, chest xray

6th intercostal

mid axillary lower lobe

apnea

no breath sounds

stridor

noisy

resonance

normal sound, low pitched clear hollow sound .

4th intercostal

right middle lobe left upper lobe still upper of left lung

bradypnea

slower respirations

posterior vertebral

spine

pectus carinatum

sticking out

pectus excavatum

sunken in

elderly have a decrease in vital capacity

the amount they can expel from lungs

C7 to T3

upper lobs of posterior

fremitis tactile

vibrations in the chest normal . less vibration might be pneumonia rhonchal thick bronchial secretions pleural friction fremitis inflammation of the pleura

shortness of breath

what brings it on, what time, activity, SOB all the time is left sided heart failure only while walking DOE dyspnea on excretion day or night allergies Orthopnea how many pillows do you need Paroxysmal nocturnal dyspnea awaken from sleep with SOB cyanosis, diaphoresis

subjective

what the pt tells us

objective

what we see, lab test, xrays

Cough

when, night, day time, makes it better or worse, productive, white , red, dry, painful, meds worked. Hemoptysis blood in sputum