THORAX CHAP 19

• NASAL flaring is seen with


  labored respirations
• KYPHOSIS


  increased curved of the thoracic spine
• TRIPOD POSITION


  Client leans forward and uses arms to support weight and lift chest to increase breathing capacity,
• Pectus excavatum


  a markedly sunken sternum adjacent cartilages (often referred to as FUNNEL CHEST)
• *Pectus carinatum / pigeon chest


  a forward protrusion of the sternum causing the Ajacent ribs to slope backward
• BARREL CHEST


  configuration results in a more horizontal of the ribs and costal angle of more than 90 degrees. This often results from long-standing emphysema.
• Labored breathing


  Is indicative of hypoxia
• Purse lip breathing


  May be seen in COPD, asthma, emphysema, or CHF
• Ruddy to purple complexion


  May be seen In client with COPD
• Scoliosis


  Spinous process that deviate laterally
• Crepitus


  Is also called subcutaneous emphysema, it is a crackling sensation that occurs when air passes through fluid or exudates.
• Fremitus


  Is the vibration of air in the bronchial tube transmitted to the chest wall. ask the client to say "ninety nine”
• Anterior apex of each lungs

  slightly above the clavicle
• is @ the level of the diaphragm. Lung extend approximately the 6 ribs

  Anterior base of each lung
• Laterally lung tissue 


  reaches the level of the eighth ribs
• Posteriorly apex of each lung


  is @ the level of C7 or slightly above the clavicle
• Posteriorly the base of each lung


  lies @ about 9 to 10 thoracic vertebrae
• Resonance


  Is the percussion tone elicited over a normal lung tissue, and flat tone over the scapula. - Is the quality of sound of being deep
• Hyperresonance


  Is the tone elicited in cases of trapped air such as emphysema or pneumothora
• Three types of normal breath


  bronchial, bronchovesicular,vesicular
• Bronchial


  Can be heard @ the trachea and thorax. Short during inspiration, long in expiratio
• Bronchovesicular


  Can be heard @ the posterior between scapula. Also can be heard around the upper sternum in the 15& 2nd intercostal space. Same during inspiration & expiration
• Vesicular


  Can be heard peripheral lung fields. Long in inspiration, short in expiration
• Crackles


  High-pitch, short, popping sounds heard during inspiration and not cleared when coughinAre also known as alveolar rales.
• Wheeze


  High-pitched, musical sounds heard primarily during expiration but may heard on inspiration
• Bronchophony


  Ask the client to repeat the phrase "ninety-nine" while you auscultate the chest wall.
• Egophony


  Ask the client to repeat the letter "E" while you listen over the chest wall.
• Whispered pectoriloguy


  Ask the client to whisper the phrase "one-two three" while you auscultate the chest wall.
• Barrel-chest


  Is a configuration results in a more horizontal position of the ribs and costal of more than 90 degree
• Stridor


  Is a continuous high-pitched, crowing sound heard predominantly on inspiration. - The cause of this sound is generally the partial obstruction of the larynx or trachea
• sonorous wheeze


  which refers to a deep, lowpitched rumbling or coarse sound as air moves through tracheal/bronchial passages in the presence of mucus or respiratory secretions
• Coarse crackles


  sound quality is low-pitched and moist, may be heard in pulmonary edema and bronchitis.
• Fine crackles


  sound quality is like hair rubbing near the ear and may be heard in congestive heart failure and pulmonary fibrosis.
• Pleural Rub


  Results from the movement of inflamed pleural surfaces against one another during chest wall movement - The sound quality is considered a harsh grating or creaking
• Early clubbing


  180 degree angle
• late clubbing 


  greater than a 180 degree angle
• diagphram


  major muscle at work
• inflamed fibrous tissue


  tender or painful areas
• inflamed pleura


  pain over intercostal space
• fractured ribs


  pain over the ribs especially at the costal chondral junctions