Bates Chapter 8: Lung and Thorax Exam Questions and Answers

Bates Chapter 8: Lung and Thorax Exam Questions and Answers Where do you insert the needle for a tension pneumothorax? -Answer-2nd intercostal space In what intercostal space do you insert a chest tube? -Answer-4th intercostal space Where do you check for the lower margin of an endotracheal tube on a chest Xray? - Answer-T4 What is another term for the sternal angle? -Answer-Angle of Louis Which ribs articulate with the sternum directly? -Answer-1-7 Which ribs articulate with the costal cartilage just above them? -Answer-8, 9, 10 Which ribs have no anterior attachments? What are they called? -Answer-11, 12 floating ribs At approximately what interspace does the inferior tip of the scapula lie? -Answer-7th rib or interspace How many lobes does the right lung have? the left? where can they best be ausculated from? -Answer-Left has 2- upper(easier anterior) and lower(easier posterior) Right has 3- upper(both, but anterior show more SA), middle(easier anterior), and lower(easier from the posterior side) What are the fissures that seperate the R lung lobes? The L? -Answer-Left- oblique fissure Right- RUL and RML are divided by the horizontal fissure. RML and RLL are divided by the oblique fissure What do the following terms mean anatomically: supraclavicular infraclavicular interscapular infrascapular base of the lungs -Answer-supraclavicular-above clavicles infraclavicular- below clavicles interscapular- between scapulae infrascapular-below scapulae base of lungs- lowermost portions Abnormal signs in the right upper lung field almost always originate in which lobe? - Answer-RUL Where does the trachea bifurcate in to the L and R bronchi? anteriorly and posteriorly - Answer-anteriorly- sternal angle posteriorly- T4 spinous process What membrane covers the outer surface of the lung? -Answer-visceral pleura What membrane covers the inner rib cage and upper surface of the diaphragm? - Answer-parietal pleura What is the function of the pleural fluid? Where is it found? -Answer-lubricates pleural surfaces, allowing lungs to move more easily(less friction) during inspiration and expiration found between visceral and parietal pleura What is a pleural effusion? -Answer-buildup of fluid in the pleural space What diseases may lead to pleural effusion? name 8 and what category(transudate vs exudate) they fall under -Answer-transudate buildup(due to imbalaced hydrostatic/osmotic pressures) -atelectasis -heart failure -nephrotic syndrome exudate buildup(due to inflammatory response or tissue injury- ex pus) -pneumonia - tuberculosis -pulmonary embolus -pancreatitis -malignancy What is the principle muscle of inspiration? -Answer-diaphragm What other 2 muscles besides the diaphragm are helpful in expanding the thorax on inspiration? -Answer-scalenes- run from cervical vertebrae to first 2 ribs parasternals- cross obliquely from sternum to the ribs As the thorax expands, the interthoracic pressure_________. -Answer-decreases. In what position is it easiest to see thoracic movement in a patient with healthy breathing? -Answer-seated is easier to see thorax movements supine is easier to see abdominal movements What are some of the accessory muscles recruited during forced respiration? -Answer- sternocleidomastoids scalenes intercostals Chest pain can come from many structures and causes. What are diseases/causes associated with pain in the following structures? myocardium -Answer-angina pectoris myocardial infarction myocarditis What causes of chest pain are related to the following source: pericardium -Answer- pericarditis What causes of chest pain are related to the following source:aorta -Answer-dissecting aortic aneurysm What causes of chest pain are related to the following source:trachea and large bronchi -Answer-bronchitis What causes of chest pain are related to the following source:parietal pleura -Answer- pericarditis pneumonia pneumothorax pleural effusion pulmonary embolus costochondritis herpes zoste