NDSU NUR 360 Exam 3 Questions With
Correct Answers
What is the trachea? - answer✔-Anterior to the esophagus
-Bifurcates into the left and right branch (right bronchi is shorter, more wide, and more vertical)
what is the Pleurae? - answer✔-serous membranes that form an envelope between the lungs
and chest wall
What is the dead space? - answer✔space filled with air, but does not take part in gas exchange
what are the alveoli? - answer✔terminal "ends" to respiratory tree that form an outcrop of sacs
or ducts within the lung (gas exchange occurs here)
how many lobes does the right lung have? - answer✔3 lobes
how many lobes does the left lung have? - answer✔2 lobes
what is the degree of the costal angle (where ribs span out) usually in a normal person? -
answer✔90 degrees of less
what are the anterior thoracic landmarks? - answer✔1. suprasternal notch
2. sternum
3. manubriosternal angle (continuous with second rib)
4. Costal angle
What are the four posterior thoracic landmarks? - answer✔1. vertebra prominens (part that
sticks out behind neck on C7)
2. spinous processes (used to count ribs)
3. inferior border of scapula (7th or 8th rib)
4. Twelfth rib (midway between spine and person's side)
what is a normal pulse oximeter reading? - answer✔97%+
What to inspect for the anterior chest? - answer✔1. Shape and configuration
-do ribs slope downward
-costal angle is less than 90 degrees
2. Facial expression should be relaxed
3. LOC
-should be alert, oriented, and cooperative
4. skin color and condition
5. quality of respirations
-rate, rhythm, effort
6. Rib interspaces
7. RR
8. accessory muscles (shouldn't be using any other muscles to breathe other than lungs)
What to inspect for the posterior chest? - answer✔1. thoracic cage
-shape and configuration
-anteroposterior/Transverse diameter should be 1:2
3. position of person
-Tripod position (leaning forward is someone is having a hard time breathing)
4. skin color and condition
-peripheral (fingers and toes are blue) or central cyanosis (lips and face are blue)
What to palpate for anterior chest - answer✔1. symmetry chest expansion
2. Tactile fremitus (vibrations felt over chest) listen over supraclavicular area
what to palpate for posterior chest - answer✔1. symmetric expansion
-places hands on patient's back and hands should fan out evenly when patient breathes
2. Tactile fremitus
-use ulnar edge of hand and have patient say 99 or blue moon
3. palpate entire chest wall
What does increased tactile fremitus mean? - answer✔consolidation (ex: pneumonia)
what does decreased tactile fremitus mean? - answer✔obstruction
What is crepitus? - answer✔course crackling sensation that is palpable over the skin surface
what would you hear with pleural effusion - answer✔there is fluid in the lungs so there would
be decreased lung sounds and expansion
What will you hear when percussing on the posterior chest - answer✔-will hear resonance (low
pitched, clear, and hollow sound) over the lung area
-will hear cardiac dullness over heart
-will hear liver dullness over liver
-will hear tympany over stomach
-will hear flatness or heaviness over muscle and bones
what is most likely happening if you hear a dull noise while percussing over the lung -
answer✔most likely results from increased density of lung tissue
What are the different types of breath sounds? - answer✔1. bronchial: heard over the tracheal
areas
2. bronchovesicular: heard over major bronchi (fewer alveoli, between scapulae, upper sternal
borders by 1st and 2nd intercostal spaces)
3. vesicular: heard over peripheral lung fields with smaller bronchioles/alveoli
What are adventitious sounds? - answer✔added/extra breath sounds not normally heard
what are the different types of adventitious breath sounds? - answer✔1. crackles (rales):
discontinuous popping with inspiration
2. Wheeze (Rhonchi): continuous musical
3. Atelectatic crackles: short popping crackles last few breaths
What does bronchophony indicate and how to assess this? - answer✔1. indicates decreased air
in the lungs (obstructions or consolidation)
-Ask the patient to say 99 during auscultation
***consolidated lung tissue has better sound transmission, so 99 is heard more clearly, which is
not normal
What does ego phony indicate and how to assess this? - answer✔1. indicate decreased air in
the lungs (obstruction or consolidation)
- ask patron to say E during auscultation (should hear E)
*** consolidated lung tissue make this sound like A
what doe whispered pectoriloquy indicate and how to assess this? - answer✔1. indicates
decreased air in the lungs (obstruction or consolidation)
-ask patient to whisper 1,2,3 (healthy lung areas should not be able to make this out
***frequencies more able to be transmitted in abnormal lungs
What happens to mothers during pregnancy to their diaphragm, costal angle, and tidal volume -
answer✔1. their diaphragm increases up to 4cm
2. costal angle widens
3. increase in tidal volume (deep breathing)
what happen to infants respiratory functions? - answer✔1. infants lungs begin to function at
birth, but are smaller and immature
2. AP diameter= 1:1 until age 6
3. obligate nose breathers
4. retraction of sternum ands of intercostal muscle use indicate increased respiratory effort
such as pneumonia, asthma, or an airway obstruction
what happens to the elderly respiratory functions? - answer✔1. bones become thiner
2. costal cartilage calcifies (rib cage becomes more stiff)
-may change shape of ribcage
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