HPD - Thorax/Lungs, CV, PV
1. When does the trachea bifurcate and what does it bifurcate into?: - traches
bifurcates into right and left main bronchus at the sternal angle
2. What is the visceral vs. parietal pleura?: - Visceral pleura: covers the outer surface of the lungs
- Parietal pleura: lines the pleural cavity along the inner rib cage and the upper surface of the diaphragm
3. What is contained between the visceral and parietal pleura?: - serous pleural fluid
4. What happens during inspiration?: - diaphragm contracts and moves DOWN
- scalenes and parasternal muscles help expand the thorax
- intrathoracic pressure DECREASES
- air flows into the alveoli
- O2 diffuses from pulmonary capillaries and CO2 diffuses from capillaries into alveoli
5. What happens during expiration?: - diaphragm relaxes
- chest wall and lungs recoil
- air flows out
6. When are accessory muscles recruited for respiration?: - during exercise
,- SCM and the scalenes may become visible
7. What is dyspnea?: - painless, uncomfortable awareness of breathing that is inappropriate to the level of
exertion
8. What is wheezing?: - musical respiratory sounds that are HIGH pitch
9. When does wheezing occur?: - in partial lower airway obstruction from secretions and tissue inflam-
mation in asthma, or from a foreign body
10. What is a cough?: - reflex response to stimuli that irritates receptors in the larynx, trachea, or large bronchi
11. How is the duration of a cough classified as?: - Acute: <3 weeks
- Subacute: 3-8 weeks
- Chronic: >8 weeks
12. What are some other causes of a cough?: - acute (acute bronchitis, PNA)
- chronic inflammation (PND, COPD) of respiratory mucosa
- CV (pulmonary edema, pulmonary embolism)
13. What is hemoptysis?: - blood coughed up from the lower respiratory tract
14. Why must the term hemoptysis be used carefully?: - you must confirm that the source of
,the blood is from the lower respiratory tract
- if a patient has bloody nose, bleeding gums or mouth, this may seem like hemoptysis, although it is not
, 15. If a patient complains of chest pain, what must you look into?: - pursue dual
investigation of both thoracic and cardiac causes
- also pursue GI causes
16. What is a cardiac cause of chest pain?: - myocardial infarction
17. What is a pulmonary causes of chest pain?: - pleuritic (due to pneumonia)
18. What are GI causes of chest pain?: - GERD
- chest well
- costochondritis
19. What is snoring associated with?: - daytime sleepiness
20. What is the likely cause of chest pain with deep breathing?: - pleuritis, as there are
very few pain receptors in the lungs
21. What is the order of examination for pulmonary exam?: 1. Inspection
2. Palpation
3. Percussion
4. Auscultation
1. When does the trachea bifurcate and what does it bifurcate into?: - traches
bifurcates into right and left main bronchus at the sternal angle
2. What is the visceral vs. parietal pleura?: - Visceral pleura: covers the outer surface of the lungs
- Parietal pleura: lines the pleural cavity along the inner rib cage and the upper surface of the diaphragm
3. What is contained between the visceral and parietal pleura?: - serous pleural fluid
4. What happens during inspiration?: - diaphragm contracts and moves DOWN
- scalenes and parasternal muscles help expand the thorax
- intrathoracic pressure DECREASES
- air flows into the alveoli
- O2 diffuses from pulmonary capillaries and CO2 diffuses from capillaries into alveoli
5. What happens during expiration?: - diaphragm relaxes
- chest wall and lungs recoil
- air flows out
6. When are accessory muscles recruited for respiration?: - during exercise
,- SCM and the scalenes may become visible
7. What is dyspnea?: - painless, uncomfortable awareness of breathing that is inappropriate to the level of
exertion
8. What is wheezing?: - musical respiratory sounds that are HIGH pitch
9. When does wheezing occur?: - in partial lower airway obstruction from secretions and tissue inflam-
mation in asthma, or from a foreign body
10. What is a cough?: - reflex response to stimuli that irritates receptors in the larynx, trachea, or large bronchi
11. How is the duration of a cough classified as?: - Acute: <3 weeks
- Subacute: 3-8 weeks
- Chronic: >8 weeks
12. What are some other causes of a cough?: - acute (acute bronchitis, PNA)
- chronic inflammation (PND, COPD) of respiratory mucosa
- CV (pulmonary edema, pulmonary embolism)
13. What is hemoptysis?: - blood coughed up from the lower respiratory tract
14. Why must the term hemoptysis be used carefully?: - you must confirm that the source of
,the blood is from the lower respiratory tract
- if a patient has bloody nose, bleeding gums or mouth, this may seem like hemoptysis, although it is not
, 15. If a patient complains of chest pain, what must you look into?: - pursue dual
investigation of both thoracic and cardiac causes
- also pursue GI causes
16. What is a cardiac cause of chest pain?: - myocardial infarction
17. What is a pulmonary causes of chest pain?: - pleuritic (due to pneumonia)
18. What are GI causes of chest pain?: - GERD
- chest well
- costochondritis
19. What is snoring associated with?: - daytime sleepiness
20. What is the likely cause of chest pain with deep breathing?: - pleuritis, as there are
very few pain receptors in the lungs
21. What is the order of examination for pulmonary exam?: 1. Inspection
2. Palpation
3. Percussion
4. Auscultation
