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Assessing Thorax and lungs
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Haruhi Buya
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Cards (31)
Thorax
Identifies the portion of the body extending from the base of the neck superiorly to the level of the diaphragm inferiorly.
Lungs
Distal portion of the trachea.
Thoracic
cage
Outer structure of the thorax.
Thoracic cavity
Contains the respiratory components.
Inspect configuration
Observe the position of scapulae. Should be symmetric and non-protruding. If it deviates laterally, may indicate scoliosis.
Barrel chest
Ribs appearing at an angle greater than 45 degrees with the spinal column are frequently the result of an increased ratio between the anteroposterior.
Result of emphysema
Observe accessory muscles
Watch the client breathe. The client does not use the accessory muscle to help breathe.
If client leans forward or uses accessory muscles, this is seen in COPD (cardio obstructive pulmonary disease)
Inspect clients positioning
Note
posture. Tender
or
painful areas
may be may indicate inflamed tissues.
Inflamed pleurae
Pain over intercostal spaces.
Fractured ribs
Pain over ribs, especially at the chondral junctions.
Palpate for tenderness
No tenderness or pain. The zig-zag palpation.
Crepitus
Crackling sensation that occurs when air passes through fluid or exudate.
Fremitus
vibrations of air in the bronchial tubes transmitted to the chest wall.
Assess chest expansion (Diaphragmatic excursion)
at
T9
or
T10
Atelectasis
Collapse or incomplete expansion
Pneumothorax
Air in the pleural space.
Percuss for tone
Shoulders then zig-zag motion.
Resonance
is the percussion tone heard over normal lung tissue.
Hyperesonance
Emphysema of pneumothorax.
Bronchial
High, loud, located in the trachea and thorax. Short during inspiration and long during expiration.
Bronchovesicular
Moderate pitch and amplitude. Same duration during inspiration and expiration. Located at the bronchi and peripheral lung fields.
Vesicular
Low pitch, and soft amplitude. Duration is long in inspiration and short in expirations. Located in peripheral lung fields.
Crackles Fine
High pitched short popping sounds, during inspiration and not cleared with coughing.
Crackles course
Low-pitched
,
bubbling
,
moist
sounds, that may persist from early inspiration and expiration. Like softly separating
velcro.
Pleural friction rub
Low-pitched dry grating sound.
Wheeze Sibilant
High pitched, musical sounds heard primarily during expiration.
Wheeze sonorous
Low pitched snoring or moaning sound heard, primarily during expirations but may be heard throughout the respiratory cycle.
Bronchophony
Ninety-nine. Voice is muffled and indistinct.
Egophony
E. Letter
E should be distinguishable.
Whispered pectoriloquy
Ask the client to whisper 1-2-3.
Pectus Excavatum
Funnel chest. Markedly sunken and adjacent cartilages.
Pectus carinatum
Pigeon chest. Forward protrusion of the sternum causes the adjacent limbs to slope backward.