ions
^*&^@*&$@$*%*$&^+*&T@$^&$@**&$@^$*&@$^*&$@@^$@&$R^RF&V&EBD*&DBN(*OIU@R)(@+_R)R_(R@))(!))*)_~)~()@(@))U89010/19/2026,
Exam
2026/10/19GNUR
3.pdf(*&*@T*^#&*^&$^&^&*$^*&^@*&$@$*%*$&^+*&T@$^&$@**&$@^$*&@$^*&$@@^$@&$R^RF&V&EBD*&DBN(*OIU@R)(@+_R)R_(R@))(!))*)_~)~()@(@
238 Foundations Exam 3.pdf(*&*@T*^#&*^&$^&^&*$^*&^@*&$@$*%*$&^+*&T@$^&$@**&$@^$*&@$^*&$@@^$@&$R^RF&V&EBD*&DBN(*O
1:39:29 PM
GNUR 238 Foundations Exam 3
Barrel Chest - ANS-• Caused by over-inflation of the lungs, ribs are more widely spaced
and bulge (eg. emphysema)
Xiphoid Process - ANS-• Lower portion of the sternum
Clubbing - ANS-• Broadening and thickening of fingernails or toes in associating with
increased angle of the nail greater than 180*. Associated with Hypoxia
Aveoli - ANS-• Tiny sacs in the lungs which gas exchange takes place. Each bronchiole
opens up into alveolar duct that is subdivided.
Visceral Lining - ANS-• Serous membrane
• Lines the lungs
Parietal Lining - ANS-• Serous membrane
• Protects the chest cavity walls and the diaphragm
(Wilson & Giddens, 2017, p. 182)
Anterior-posterior to Transverse diameters - ANS-Transverse Diameters are 2x the
diameters of the Anterior-posterior diameters
Costal Angle - ANS-• The angle between the ribs at the costal margins. Usually 90
degrees or less.
Oxygenation - ANS-• Processes that facilitate and impair carrying oxygen to tissues and
carrying carbon dioxide from tissues
• Required for optimal function of perfusion, intracranial regulation, metabolism, motion,
tissue integrity, nutrition, and sleep
(Wilson & Giddens, 2017, p. 181)
Ventilation - ANS-• The process of moving gases in and out of the lungs by inspiration
and expiration
(Wilson & Giddens, 2017, p. 181)
^*&^@*&$@$*%*$&^+*&T@$^&$@**&$@^$*&@$^*&$@@^$@&$R^RF&V&EBD*&DBN(*OIU@R)(@+_R)R_(R@))(!))*)_~)~()@(@))U89010/19/2026,
dations Exam
2026/10/19GNUR
3.pdf(*&*@T*^#&*^&$^&^&*$^*&^@*&$@$*%*$&^+*&T@$^&$@**&$@^$*&@$^*&$@@^$@&$R^RF&V&EBD*&DBN(*OIU@R)(@+_R)R_(R@))(!))*)_~)~()@
238 Foundations Exam 3.pdf(*&*@T*^#&*^&$^&^&*$^*&^@*&$@$*%*$&^+*&T@$^&$@**&$@^$*&@$^*&$@@^$@&$R^RF&V&EBD*&DBN(*O
1:39:29 PM
,ions
^*&^@*&$@$*%*$&^+*&T@$^&$@**&$@^$*&@$^*&$@@^$@&$R^RF&V&EBD*&DBN(*OIU@R)(@+_R)R_(R@))(!))*)_~)~()@(@))U89010/19/2026,
Exam
2026/10/19GNUR
3.pdf(*&*@T*^#&*^&$^&^&*$^*&^@*&$@$*%*$&^+*&T@$^&$@**&$@^$*&@$^*&$@@^$@&$R^RF&V&EBD*&DBN(*OIU@R)(@+_R)R_(R@))(!))*)_~)~()@(@
238 Foundations Exam 3.pdf(*&*@T*^#&*^&$^&^&*$^*&^@*&$@$*%*$&^+*&T@$^&$@**&$@^$*&@$^*&$@@^$@&$R^RF&V&EBD*&DBN(*O
1:39:29 PM
Diffusion - ANS-• The process by which oxygen and carbon dioxide move from areas of
high concentration to areas of lower concentration
(Wilson & Giddens, 2017, p. 181-182)
Midclavicular lines - ANS-• Imaginary vertical lines on the right and left sides of the
chest that are "drawn" through the clavicle midpoints parallel to the midsternal line
(Wilson & Giddens, 2017, p. 185)
Dyspnea - ANS-• Breathing that is labored or difficult
Adventitious breath sounds - ANS-• Breath sounds that are not normal
• Includes the following: crackles (previously called rales), wheeze, rhonchi, and pleural
friction rub
(Wilson & Giddens, 2017, p. 194)
Respiratory stridor - ANS-• Harsh, high-pitched sound associated with breathing often
caused by laryngeal or tracheal obstruction
• More prominent over the neck than the chest
(Wilson & Giddens, 2017, p. 194)
Fine crackles - ANS-• Soft, high-pitched, and very brief sounds during late inspiration
and not cleared by coughing or altered by changing body position
• Popping noises (discontinuous sounds)
(Wilson & Giddens, 2017, p. 194; Yoost & Crawford, 2016, p. 369)
Coarse crackles - ANS-• Loud, effervescent sounds heard best during inspiration and
not relieved after coughing
(Yoost & Crawford, 2016, p. 369)
Crackles Presenting in - ANS-Pneumonia, heart failure, restrictive pulmonary disease
^*&^@*&$@$*%*$&^+*&T@$^&$@**&$@^$*&@$^*&$@@^$@&$R^RF&V&EBD*&DBN(*OIU@R)(@+_R)R_(R@))(!))*)_~)~()@(@))U89010/19/2026,
dations Exam
2026/10/19GNUR
3.pdf(*&*@T*^#&*^&$^&^&*$^*&^@*&$@$*%*$&^+*&T@$^&$@**&$@^$*&@$^*&$@@^$@&$R^RF&V&EBD*&DBN(*OIU@R)(@+_R)R_(R@))(!))*)_~)~()@
238 Foundations Exam 3.pdf(*&*@T*^#&*^&$^&^&*$^*&^@*&$@$*%*$&^+*&T@$^&$@**&$@^$*&@$^*&$@@^$@&$R^RF&V&EBD*&DBN(*O
1:39:29 PM
,ions
^*&^@*&$@$*%*$&^+*&T@$^&$@**&$@^$*&@$^*&$@@^$@&$R^RF&V&EBD*&DBN(*OIU@R)(@+_R)R_(R@))(!))*)_~)~()@(@))U89010/19/2026,
Exam
2026/10/19GNUR
3.pdf(*&*@T*^#&*^&$^&^&*$^*&^@*&$@$*%*$&^+*&T@$^&$@**&$@^$*&@$^*&$@@^$@&$R^RF&V&EBD*&DBN(*OIU@R)(@+_R)R_(R@))(!))*)_~)~()@(@
238 Foundations Exam 3.pdf(*&*@T*^#&*^&$^&^&*$^*&^@*&$@$*%*$&^+*&T@$^&$@**&$@^$*&@$^*&$@@^$@&$R^RF&V&EBD*&DBN(*O
1:39:29 PM
Wheeze - ANS-• High-pitched, musical sound similar to a squeak
• Heard more commonly during expiration but may also be heard during inspiration
• Occurs in small airways
(Wilson & Giddens, 2017, p. 194)
Wheezing Presenting in - ANS-Airway disease, thickness of airway increases
Rhonchi - ANS-• Low-pitched, coarse, loud, low snoring or moaning tone; sounds like
snoring
• Heard primarily during expiration but may also be heard during inspiration
• Coughing may clear the sound
(Wilson & Giddens, 2017, p. 194)
Rhonchi presenting in - ANS-Disorders caused by obstruction of trachea or bronchus -
bronchitis + COPD
Pleural Friction Rub - ANS-• Low pitched, course rubbing or grating sound heard
throughout inspiration and expiration. Source (lung or heart) can be determined by
patient holding his/her breath. Persistent.
Pleural Friction Rub presenting in - ANS-Pleurisy (inflammation of the pleural surfaces)
or with pericarditis
Pleural effusion - ANS-• An accumulation of serous fluid in the pleural space between
the visceral and parietal pleurae
• Manifestations depend on the amount of fluid accumulation and the position of the
patient
• Signs may be fever, tachypnea, dyspnea, tachycardia, decreased fremitus, trachea
shifted to the other side, and absent breath sounds on the affected side
• Symptoms may include sharp chest pain that is worse with cough or deep breaths
^*&^@*&$@$*%*$&^+*&T@$^&$@**&$@^$*&@$^*&$@@^$@&$R^RF&V&EBD*&DBN(*OIU@R)(@+_R)R_(R@))(!))*)_~)~()@(@))U89010/19/2026,
dations Exam
2026/10/19GNUR
3.pdf(*&*@T*^#&*^&$^&^&*$^*&^@*&$@$*%*$&^+*&T@$^&$@**&$@^$*&@$^*&$@@^$@&$R^RF&V&EBD*&DBN(*OIU@R)(@+_R)R_(R@))(!))*)_~)~()@
238 Foundations Exam 3.pdf(*&*@T*^#&*^&$^&^&*$^*&^@*&$@$*%*$&^+*&T@$^&$@**&$@^$*&@$^*&$@@^$@&$R^RF&V&EBD*&DBN(*O
1:39:29 PM
^*&^@*&$@$*%*$&^+*&T@$^&$@**&$@^$*&@$^*&$@@^$@&$R^RF&V&EBD*&DBN(*OIU@R)(@+_R)R_(R@))(!))*)_~)~()@(@))U89010/19/2026,
Exam
2026/10/19GNUR
3.pdf(*&*@T*^#&*^&$^&^&*$^*&^@*&$@$*%*$&^+*&T@$^&$@**&$@^$*&@$^*&$@@^$@&$R^RF&V&EBD*&DBN(*OIU@R)(@+_R)R_(R@))(!))*)_~)~()@(@
238 Foundations Exam 3.pdf(*&*@T*^#&*^&$^&^&*$^*&^@*&$@$*%*$&^+*&T@$^&$@**&$@^$*&@$^*&$@@^$@&$R^RF&V&EBD*&DBN(*O
1:39:29 PM
GNUR 238 Foundations Exam 3
Barrel Chest - ANS-• Caused by over-inflation of the lungs, ribs are more widely spaced
and bulge (eg. emphysema)
Xiphoid Process - ANS-• Lower portion of the sternum
Clubbing - ANS-• Broadening and thickening of fingernails or toes in associating with
increased angle of the nail greater than 180*. Associated with Hypoxia
Aveoli - ANS-• Tiny sacs in the lungs which gas exchange takes place. Each bronchiole
opens up into alveolar duct that is subdivided.
Visceral Lining - ANS-• Serous membrane
• Lines the lungs
Parietal Lining - ANS-• Serous membrane
• Protects the chest cavity walls and the diaphragm
(Wilson & Giddens, 2017, p. 182)
Anterior-posterior to Transverse diameters - ANS-Transverse Diameters are 2x the
diameters of the Anterior-posterior diameters
Costal Angle - ANS-• The angle between the ribs at the costal margins. Usually 90
degrees or less.
Oxygenation - ANS-• Processes that facilitate and impair carrying oxygen to tissues and
carrying carbon dioxide from tissues
• Required for optimal function of perfusion, intracranial regulation, metabolism, motion,
tissue integrity, nutrition, and sleep
(Wilson & Giddens, 2017, p. 181)
Ventilation - ANS-• The process of moving gases in and out of the lungs by inspiration
and expiration
(Wilson & Giddens, 2017, p. 181)
^*&^@*&$@$*%*$&^+*&T@$^&$@**&$@^$*&@$^*&$@@^$@&$R^RF&V&EBD*&DBN(*OIU@R)(@+_R)R_(R@))(!))*)_~)~()@(@))U89010/19/2026,
dations Exam
2026/10/19GNUR
3.pdf(*&*@T*^#&*^&$^&^&*$^*&^@*&$@$*%*$&^+*&T@$^&$@**&$@^$*&@$^*&$@@^$@&$R^RF&V&EBD*&DBN(*OIU@R)(@+_R)R_(R@))(!))*)_~)~()@
238 Foundations Exam 3.pdf(*&*@T*^#&*^&$^&^&*$^*&^@*&$@$*%*$&^+*&T@$^&$@**&$@^$*&@$^*&$@@^$@&$R^RF&V&EBD*&DBN(*O
1:39:29 PM
,ions
^*&^@*&$@$*%*$&^+*&T@$^&$@**&$@^$*&@$^*&$@@^$@&$R^RF&V&EBD*&DBN(*OIU@R)(@+_R)R_(R@))(!))*)_~)~()@(@))U89010/19/2026,
Exam
2026/10/19GNUR
3.pdf(*&*@T*^#&*^&$^&^&*$^*&^@*&$@$*%*$&^+*&T@$^&$@**&$@^$*&@$^*&$@@^$@&$R^RF&V&EBD*&DBN(*OIU@R)(@+_R)R_(R@))(!))*)_~)~()@(@
238 Foundations Exam 3.pdf(*&*@T*^#&*^&$^&^&*$^*&^@*&$@$*%*$&^+*&T@$^&$@**&$@^$*&@$^*&$@@^$@&$R^RF&V&EBD*&DBN(*O
1:39:29 PM
Diffusion - ANS-• The process by which oxygen and carbon dioxide move from areas of
high concentration to areas of lower concentration
(Wilson & Giddens, 2017, p. 181-182)
Midclavicular lines - ANS-• Imaginary vertical lines on the right and left sides of the
chest that are "drawn" through the clavicle midpoints parallel to the midsternal line
(Wilson & Giddens, 2017, p. 185)
Dyspnea - ANS-• Breathing that is labored or difficult
Adventitious breath sounds - ANS-• Breath sounds that are not normal
• Includes the following: crackles (previously called rales), wheeze, rhonchi, and pleural
friction rub
(Wilson & Giddens, 2017, p. 194)
Respiratory stridor - ANS-• Harsh, high-pitched sound associated with breathing often
caused by laryngeal or tracheal obstruction
• More prominent over the neck than the chest
(Wilson & Giddens, 2017, p. 194)
Fine crackles - ANS-• Soft, high-pitched, and very brief sounds during late inspiration
and not cleared by coughing or altered by changing body position
• Popping noises (discontinuous sounds)
(Wilson & Giddens, 2017, p. 194; Yoost & Crawford, 2016, p. 369)
Coarse crackles - ANS-• Loud, effervescent sounds heard best during inspiration and
not relieved after coughing
(Yoost & Crawford, 2016, p. 369)
Crackles Presenting in - ANS-Pneumonia, heart failure, restrictive pulmonary disease
^*&^@*&$@$*%*$&^+*&T@$^&$@**&$@^$*&@$^*&$@@^$@&$R^RF&V&EBD*&DBN(*OIU@R)(@+_R)R_(R@))(!))*)_~)~()@(@))U89010/19/2026,
dations Exam
2026/10/19GNUR
3.pdf(*&*@T*^#&*^&$^&^&*$^*&^@*&$@$*%*$&^+*&T@$^&$@**&$@^$*&@$^*&$@@^$@&$R^RF&V&EBD*&DBN(*OIU@R)(@+_R)R_(R@))(!))*)_~)~()@
238 Foundations Exam 3.pdf(*&*@T*^#&*^&$^&^&*$^*&^@*&$@$*%*$&^+*&T@$^&$@**&$@^$*&@$^*&$@@^$@&$R^RF&V&EBD*&DBN(*O
1:39:29 PM
,ions
^*&^@*&$@$*%*$&^+*&T@$^&$@**&$@^$*&@$^*&$@@^$@&$R^RF&V&EBD*&DBN(*OIU@R)(@+_R)R_(R@))(!))*)_~)~()@(@))U89010/19/2026,
Exam
2026/10/19GNUR
3.pdf(*&*@T*^#&*^&$^&^&*$^*&^@*&$@$*%*$&^+*&T@$^&$@**&$@^$*&@$^*&$@@^$@&$R^RF&V&EBD*&DBN(*OIU@R)(@+_R)R_(R@))(!))*)_~)~()@(@
238 Foundations Exam 3.pdf(*&*@T*^#&*^&$^&^&*$^*&^@*&$@$*%*$&^+*&T@$^&$@**&$@^$*&@$^*&$@@^$@&$R^RF&V&EBD*&DBN(*O
1:39:29 PM
Wheeze - ANS-• High-pitched, musical sound similar to a squeak
• Heard more commonly during expiration but may also be heard during inspiration
• Occurs in small airways
(Wilson & Giddens, 2017, p. 194)
Wheezing Presenting in - ANS-Airway disease, thickness of airway increases
Rhonchi - ANS-• Low-pitched, coarse, loud, low snoring or moaning tone; sounds like
snoring
• Heard primarily during expiration but may also be heard during inspiration
• Coughing may clear the sound
(Wilson & Giddens, 2017, p. 194)
Rhonchi presenting in - ANS-Disorders caused by obstruction of trachea or bronchus -
bronchitis + COPD
Pleural Friction Rub - ANS-• Low pitched, course rubbing or grating sound heard
throughout inspiration and expiration. Source (lung or heart) can be determined by
patient holding his/her breath. Persistent.
Pleural Friction Rub presenting in - ANS-Pleurisy (inflammation of the pleural surfaces)
or with pericarditis
Pleural effusion - ANS-• An accumulation of serous fluid in the pleural space between
the visceral and parietal pleurae
• Manifestations depend on the amount of fluid accumulation and the position of the
patient
• Signs may be fever, tachypnea, dyspnea, tachycardia, decreased fremitus, trachea
shifted to the other side, and absent breath sounds on the affected side
• Symptoms may include sharp chest pain that is worse with cough or deep breaths
^*&^@*&$@$*%*$&^+*&T@$^&$@**&$@^$*&@$^*&$@@^$@&$R^RF&V&EBD*&DBN(*OIU@R)(@+_R)R_(R@))(!))*)_~)~()@(@))U89010/19/2026,
dations Exam
2026/10/19GNUR
3.pdf(*&*@T*^#&*^&$^&^&*$^*&^@*&$@$*%*$&^+*&T@$^&$@**&$@^$*&@$^*&$@@^$@&$R^RF&V&EBD*&DBN(*OIU@R)(@+_R)R_(R@))(!))*)_~)~()@
238 Foundations Exam 3.pdf(*&*@T*^#&*^&$^&^&*$^*&^@*&$@$*%*$&^+*&T@$^&$@**&$@^$*&@$^*&$@@^$@&$R^RF&V&EBD*&DBN(*O
1:39:29 PM
