structure
what is the thoracic cage defined by (name all)
1. sternum
2. 12 pairs of ribs
3. 12 thoracic vertebraes
what part of the chest are you looking at
anterior
posterior
lateral
what is included in the mediastinum
esophagus
trachea
great vessels
heart
what are the 3 functions of respiration
1. supply oxygen for energy production
2. remove CO2 from energy production
3. maintain homeostasis (acid-base balance)
what are the structural/ histological changes for aging adults
structural: increase in residual volume, decrease in vital capacity
histological: decrease in gas exchange
increase in AP diameter, kyphosis
chest expansion decreases and tire easily
what is it called when the ribs join the cartilages
costochondral junctions
what degree should the persons arm be with the lateral chest
90
what are the differences between the left and right lungs
extra: point to the apex and base of the lungs
right: shorter (because of the liver), 3 lobes, wider
left: longer, narrower (because of the heart), 2 lobes
apex: top
base: bottom
what happens to your muscles when you inhale and exhale
inhale: diaphragm descends and chest expands
exhale: diaphragm ascends and muscles relax
what do you ask about SOB with the aging adult
name what each of the ribs attaches to
first 7: sternum by costal cartilage
8,9,10: costal cartilage above
11-12: free floating
what are the anterior thoracic reference lines
and SHOW
midsternal
midclavicular
anterior axillary
what is pleurae, and describe the 2 different types
slippery substance to help the lungs glide with breathing
visceral: out of lungs, into fissures
pleural cavity: negative pressure to hold lungs to the chest wall
name 3 diseases of the lungs in today's culture
1. lung cancer (from smoking)
2. TB
3. Asthma (poverty and #1 chronic childhood illness)
for the thoracic cage, what do you inspect
shape/configuration
position when breathing
skin color/lesions
what are the parts of the anterior thoracic
sternum
manubrosternal (manubrium and sternum articulation/continuous with 2nd rib
costal angle:right and left margins meet at the xiphoid process
what are the posterior reference lines
and SHOW
vertrebral
scapular
what is the purpose of the trachea and bronchi
transport gases between environment and lungs
examples of subjective data for the lungs
then give questions you ask
1. cough (productive, timing)
2. SOB
3. chest pain (look for MI)
4. history and smoking history
5. environment
6. patient-centered care (TB, x-ray, and flu test)
what is the purpose of palpating the thoracic cage and how do you test
symmetry and tactile fremitus (vibrations)
using hands and having them say "99"
what are the parts of the posterior thoracic
vertebra prominens
spinous process
inferior border of the scapula
12th rib
what are the lateral chest reference lines
and SHOW
anterior axillary
midaxillary
posterior axillary
what is the difference between the left and right bronchi, and what is the functional unit of the bronchioles
right: shorter, wider, and more vertical
unit: acinus (alveoli/ducts/sacs)
what are the 5 A's with smoking
ask
advice
assess
assist
arrange
what should you hear when percussioning/ausculating the posterior chest
resonance and breathing through the chest walls