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Pleural layers of the lungs - parietal -adheres to thorax wall (outer)
visceral- adheres to lungs (inner)
principle muscle of respiration - Diaphram
How many lobes of the lung - 3 on right: LUL, LML, LLL
2 on left: LLL, LUL
Pulseox - measures oxygen saturation, norm is >95%
ABGs - arterial blood gases - blood drawn from arteries
thoracentesis - aspirated fluid from pleural space
broncoscopy - visualization via the mouth to see the larynx, trachea, bronchi
Lung biopsy - tissue sample to diagnose cancer cells
Pneumovax vaccine - Primary health prevention for pneumonia - recommend for peopler older than 65
and also for those with high-risk medical conditions
dyspnea - shortness of breath
orthopnea - difficulty breathing while laying supine
,paroxysmal nocturnal dyspnea - when sleeping, waking with shortness of breath
symptoms of respiratory concern relalted to breathing - elevating head with pillows to ease breathing
reducing activity due to breathing
increased SOB with talking or eating
What to ask about a cough - frequency, onset, productive? if yes, describe color/ consistency/
consistency of phlem
tripod position - may help patients better expand lungs when in resp distress
AP Diameter (normal) - Normal AP diameter is one half of transverse diameter. (1:2 ratio)
Barrel Chest - AP diameter to transverse diameter is 1:1. Common in those with chronic lung disease
Normal resp findings - RR 12 - 20
skin color appropriate for race, without discoloration in mucous membranes (varies by race)
no accessory muscle use
no nasal flaring
easy, even pattern breaths
pursed lip breathing - exhaling through pursed lips of used in patients with chronic lung disease to
reduce the work of breathing
bradypnea - <12 BPM
tachypnea - >20 BMP
, apnea - Absence of breathing
How does color change with low oxygen levels in dark skinned patients - mucous membranes may take
on gray or whitish color
clubbing of nails - long term effect of chronic respiratory disease. Nail angle is greater than 180 degrees
Normal palpation findings for thorax on rep assmt - smooth, warm, dry, no tenderness
crepitus on palpation of thorax - popping in skin tissue due to leakage of air from lung to tissue
palpation for symmetrical expansion - Thumbs move apart symmetrically with inspiration and back
together with expiration
Palpating tactile fremitus - use ulnar side of your hand and have patient say ninety-nine,
Vibrations should be felt equally on both sides of lungs
Abnormal findings for tactile fremitus - increased or decreased fremitus on one side - could be from
increased fluid or phlem in lobe
Where should you percuss the lungs - in the intercostal spaces of the thorax - and NOT over bone
Normal lung percussion findings - resonance
abnormal percussion findings in lungs - dullenss (increased density), hyperresonance (air trapping like in
COPD)
Normal findings in lung auscultation - bronchial sounds over trachea and bronchi
Bronchovesicular sounds over right and left bronshi (next to sternum)
Vesicular sounds throughout periphery