NUR 505 M8 Advanced Health
Assessment Module 8 Chest and
Lungs Study Guide Rated A+
1. Kindly Explain the below terms:
• Apnea: absence of spontaneous respiration, which could be due to the resp system or
CNS. Common causes: seizures, NCS trauma, hypoperfusion, a variety of resp infections.,
drug ingestions, and obstructive sleep disorders.
o Primary apnea: self-limiting, common after a blow to the head or immediately
after the birth of a newborn, who breathe spontaneously when sufficient CO2
accumulates in the circulation.
o Secondary apnea: breathing stops and will not begin again unless resuscitative
measures are taken immediately. Any event that severely limits the absorption
of O2 into the bloodstream will lead to secondary apnea.
o Reflex apnea: a temporary involuntary halt to respiration caused by irritation and
nausea-provoking vapors or gases are inhaled.
o Sleep apnea: Periods of absence of breathing and oxygenation during sleep due
to blockage of the airway when the soft tissue in the back of the throat collapses
during sleep, airflow is not maintained through the nose and mouth.
o Apneustic breathing: characterized by long inspiration and what amounts to
expiration apnea. The neural center for control is in the pons medulla. When it is
affected, breathing can become gasping because inspirations are prolonged and
expiration constrained.
o Periodic apnea of the newborn: a NORMAL condition characterized by an
irregular pattern of rapid breathing mixed with brief periods of apnea that one
usually associated with REM sleep.
• Biot respirations: respiration consists of irregular respirations varying in depth and
interrupted by intervals of apnea but lacking the repetitive pattern of periodic
respiration. On occasion, the respirations may be regular, but the apneic periods may
occur in an irregular pattern. Biot respiration usually is associated with severe and
persistent increased intracranial pressure, respiratory compromise resulting from drug
poisoning, or brain damage at the level of the medulla and generally indicates a poor
prognosis.
• Bronchovesicular breath sounds: heard over the main bronchus area and over the upper
right posterior lung field; medium pitch, expiration equals inspiration.
, • Cheyne-Stokes respirations: Varying periods of increasing depth interspersed
(combined) with apnea.
• Crackles: lower, more moist sound heard during inspiration, not cleared by a cough.
Caused by disruptive passage of air through the small airways in the respiratory tree.
May sound like Velcro being torn open.
• Coarse crackles: loud, bubbly noise heard during inspiration, not cleared by cough.
• Fine crackles: High-pitched, discrete, discontinuous crackling sounds heard during the
end of inspiration, not cleared by a cough.
• Egophony: increased resonance of voice sounds heard when auscultating the lungs.
When spoken voices are auscultated over the chest, a nasal quality is similar to the
sound which resembles the bleating of a goat.
• Hamman sign: a clicking, popping or crunching sound auscultated over the precordium
during systole, is due to the presence of air and fluid churning in the mediastinum.
Indicative of a spontaneous pneumomediastinum- a rare condition characterized by free
air in the mediastinum not preceded by thoracic trauma, surgery, or any other medical
procedure.
• Kussmaul breathing: always deep,most often rapid and labored, a type of
hyperventilation that is the lung's emergency response to acidosis. Kussmaul breathing
causes a labored, deeper breathing rate. It is most commonly associated with conditions
that cause metabolic acidosis, particularly diabetes.
• Pectoriloquy: the increased resonance of the voice through the lung structures, so that
it is clearly comprehensible using a stethoscope on the chest. It usually indicates
consolidation of the underlying lung parenchyma. (Whispered pectoriloquy test- when
consolidation is present the whispered sound can be heard with stethoscope clearly.
Should not normally be heard.)
• Pleural friction rub: Occurs outside the respiratory tree, has a dry crackly, grating, low
pitched sound and is heard in both expiration and inspiration. May be described as
machine like, if heard over the heart or lungs it is caused by inflamed, roughened
surfaces rubbing together. Over pericardium = pericarditis. Over lungs= pleurisy.
Respiratory friction rub disappears when breath is held, cardiac friction rub does not.
• Rhonchi: loud, low, coarse sounds like a snore. Deeper mor rumbling, more pronounced
during expiration, more likely to be prolonged and continuous, less discrete than
crackles. Caused by the passage of air through an airway obstructed by thick secretions,
muscular spasm, tumor, or external pressure. Ronchi clear after cough, crackles do not.
Usually indicates mucus accumulation in trachea or large bronchi.
Assessment Module 8 Chest and
Lungs Study Guide Rated A+
1. Kindly Explain the below terms:
• Apnea: absence of spontaneous respiration, which could be due to the resp system or
CNS. Common causes: seizures, NCS trauma, hypoperfusion, a variety of resp infections.,
drug ingestions, and obstructive sleep disorders.
o Primary apnea: self-limiting, common after a blow to the head or immediately
after the birth of a newborn, who breathe spontaneously when sufficient CO2
accumulates in the circulation.
o Secondary apnea: breathing stops and will not begin again unless resuscitative
measures are taken immediately. Any event that severely limits the absorption
of O2 into the bloodstream will lead to secondary apnea.
o Reflex apnea: a temporary involuntary halt to respiration caused by irritation and
nausea-provoking vapors or gases are inhaled.
o Sleep apnea: Periods of absence of breathing and oxygenation during sleep due
to blockage of the airway when the soft tissue in the back of the throat collapses
during sleep, airflow is not maintained through the nose and mouth.
o Apneustic breathing: characterized by long inspiration and what amounts to
expiration apnea. The neural center for control is in the pons medulla. When it is
affected, breathing can become gasping because inspirations are prolonged and
expiration constrained.
o Periodic apnea of the newborn: a NORMAL condition characterized by an
irregular pattern of rapid breathing mixed with brief periods of apnea that one
usually associated with REM sleep.
• Biot respirations: respiration consists of irregular respirations varying in depth and
interrupted by intervals of apnea but lacking the repetitive pattern of periodic
respiration. On occasion, the respirations may be regular, but the apneic periods may
occur in an irregular pattern. Biot respiration usually is associated with severe and
persistent increased intracranial pressure, respiratory compromise resulting from drug
poisoning, or brain damage at the level of the medulla and generally indicates a poor
prognosis.
• Bronchovesicular breath sounds: heard over the main bronchus area and over the upper
right posterior lung field; medium pitch, expiration equals inspiration.
, • Cheyne-Stokes respirations: Varying periods of increasing depth interspersed
(combined) with apnea.
• Crackles: lower, more moist sound heard during inspiration, not cleared by a cough.
Caused by disruptive passage of air through the small airways in the respiratory tree.
May sound like Velcro being torn open.
• Coarse crackles: loud, bubbly noise heard during inspiration, not cleared by cough.
• Fine crackles: High-pitched, discrete, discontinuous crackling sounds heard during the
end of inspiration, not cleared by a cough.
• Egophony: increased resonance of voice sounds heard when auscultating the lungs.
When spoken voices are auscultated over the chest, a nasal quality is similar to the
sound which resembles the bleating of a goat.
• Hamman sign: a clicking, popping or crunching sound auscultated over the precordium
during systole, is due to the presence of air and fluid churning in the mediastinum.
Indicative of a spontaneous pneumomediastinum- a rare condition characterized by free
air in the mediastinum not preceded by thoracic trauma, surgery, or any other medical
procedure.
• Kussmaul breathing: always deep,most often rapid and labored, a type of
hyperventilation that is the lung's emergency response to acidosis. Kussmaul breathing
causes a labored, deeper breathing rate. It is most commonly associated with conditions
that cause metabolic acidosis, particularly diabetes.
• Pectoriloquy: the increased resonance of the voice through the lung structures, so that
it is clearly comprehensible using a stethoscope on the chest. It usually indicates
consolidation of the underlying lung parenchyma. (Whispered pectoriloquy test- when
consolidation is present the whispered sound can be heard with stethoscope clearly.
Should not normally be heard.)
• Pleural friction rub: Occurs outside the respiratory tree, has a dry crackly, grating, low
pitched sound and is heard in both expiration and inspiration. May be described as
machine like, if heard over the heart or lungs it is caused by inflamed, roughened
surfaces rubbing together. Over pericardium = pericarditis. Over lungs= pleurisy.
Respiratory friction rub disappears when breath is held, cardiac friction rub does not.
• Rhonchi: loud, low, coarse sounds like a snore. Deeper mor rumbling, more pronounced
during expiration, more likely to be prolonged and continuous, less discrete than
crackles. Caused by the passage of air through an airway obstructed by thick secretions,
muscular spasm, tumor, or external pressure. Ronchi clear after cough, crackles do not.
Usually indicates mucus accumulation in trachea or large bronchi.
