Exam (elaborations)
IPA Exam III
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Exam of 51 pages for the course IPA at IPA (IPA Exam III ...)
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IPA Exam III 2024-2025-Red is aortic: 2nd ICS right sternal border
-blue is pulmonic: 2nd ICS left sternal border
-green is tricuspid: left lower sternal border (near 4th ICS)
-purple is mitral: left 5th ICS
Cardio Auscultation/ Palpation Sites:
-name each auscultation site and describe where it is
NMT
The mitral valve; this is due to the fact that gallops (S3/S4) are best heard around this
region; commonly listen at the 4th intercostal space or around the PMI
Auscultation site of the heart that you should also listen with the bell?
Why?
apex of the heart, left ventricle. Usually located at the left 5th ICL @ midclavicular line
-an enlarged heart would move the PMI laterally towards the axilla
Heart: Point of Maximal Impulse (PMI)
-what are we feeling for?
-what would an enlarged heart do to the PMI?
If they are damaged!
When do you hear opening of heart valves?
Ribs 1-7: true ribs they attach to the sternum
Ribs 8-10: false ribs they attach to the cartilage
Ribs 11-12: floating ribs
Ribs 1-7
,Ribs 8-10
Ribs 11-12
at the alveoli and capillaries
External respiration of gas exchange occurs where?
ONLY the front cannot be auscultated from the back
Where can you auscultate the middle lobe of the right lung
only has two lobes the upper and lower lobe- divided by oblique fissure
-only two lobes because the <3 lies on it cardiac notch
Anatomical Structures of the left lung
three lobes the upper, middle and lower lobes
-horizontal fissure divides the upper and middle
-oblique fissures divides the middle and lower
-bigger than the L lung
Anatomical Structures of the right lung
pneumothorax or other lung issues could cause deviation of trachea
Trachea
- -what can cause deviation of trachea
Controlled by medulla
- -ventilation is the movement of air in and out of the lungs
- -inhalation: intercostal muscles and diaphragm. The diaphragm contracts flattening
,the muscle and increasing the volume of the thoracic cavity. Acting as a bellow that
sucks air into the lung
- -exhalation is a passive process; relaxation of the diaphragm moves air out
Mechanics of Normal Respiration
Controlled by
Ventilation
Inhalation vs. exhalation
-normal is 12-20 breaths per minute
-bradypnea: abnormal slowing of respiration
-tachypnea: abnormal increase of respiration
-apnea: temporary cessation of breathing
-hypernea: increased depth of breathing usually associated with metabolic acidosis
Normal Respiratory Rate
-slow breathing
-fast breathing
-cessation of breathing
-increased depth (associated with what)
-substance expelled by coughing; 75-100 mL secreted daily by the bronchi
-contains: cellular debris, mucus, blood, pus or microorganism
-smoking: paralyzes cilia in trachea and hence unable to remove sputum bring up debris
or microorganisms
, Sputum
-what is it and contents
-effects of smoking
Peripheral: cyanosis due to excessive peripheral extraction of oxygen, visible in
toes/fingers and extremities
Central: due to poor gas exchanging in lungs leading to arterial oxygenation reduction;
visible around the oral cavity and mucous membrane; a more serious condition
Cyanosis
-central vs peripheral
nocturnal dyspnea @ night during sleep
-feel sudden onset of shortness of breath
-strangling sensation; sit up and run to window for air
paroxysmal dyspnea
-what is it
-symptoms
Shaneka Evans
difficulty breathing while laying down
-patients with <3 failure, COPD, emphysema present with this; slee sitting upright in
chair or lots of pillows
orthopnea
-what is it
-patients who would present with this
Shaneka Evans
difficulty breathing while sitting up and relieved by recumbent position
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