1
, CVA tenderness- kidney problems
References Lines – anterior, posterior, and lateral thorax
Anterior- sternal, midclavicular, anterior axillary
Posterior- vertebral, scapular, posterior axillary
Lateral- anterior axillary, midaxillary, posterior axillary
Lobes (3 on right, 2 on left), apex versus base
Right- upper, middle, lower lobes
Left- upper, lower lobes
Apex (highest point) anterior and 3-4 cm above clavicle
Base (lower border)
Pediatric (AP:Transverse diameter, abdominal breathing, role of surfactant)
AP: transverse 1:1 ratio
Abdominal breathing until 5-7 yrs
Pregnant (Diaphragmatic breathing, SOB, costal angle changes, lordosis)
Muscles and cartilage of the ribs relaxes
o Diaphragm rises into chest to accommodate fetus
o Diaphragmatic breathing
o Shortness of breath (SOB), dyspnea, increase awareness of breathing in last trimester
Total oxygen demand can increase 20%
Costal angle widens
Deeper breathing, respiratory rate unchanged
Lordosis or swayback, “waddling” gait
Geriatric (overall aging changes to respiratory rate and depth, vital capacity, alveoli); cough ability, kyphosis
, Aging lung is more rigid, harder to inflate
o Decrease vital capacity, increased residual volume
o Decreased number of alveoli
o Decreased in respiratory depth
o Slight increase in respiratory rate
Decrease in cough ability
o Weakening of the chest muscles, decrease cilia
o Compromises airway clearance
Kyphosis “hunchback”
Subjective
Cough – differences between acute versus chronic; time of day; productive versus non-productive; color
of phlegm or sputum; descriptions and meaning; associated symptoms; possible treatments
Acute (lasts 2 or 3 weeks), chronic (over 2 months)
Often? Time of day?
o Continuous – acute illness, respiratory infection
o Afternoon/evening – may irritants at work
o Night – postnasal drip
o Early morning – chronic bronchial inflammation, smokers
Productive or non-productive? Phlegm or sputum?
o Hemoptysis (blood), frank blood versus streaks of blood
o White or clear – colds, bronchitis, viral infections
o Yellow or green – bacterial infections
o Rust colored – TB, pneumonia
, CVA tenderness- kidney problems
References Lines – anterior, posterior, and lateral thorax
Anterior- sternal, midclavicular, anterior axillary
Posterior- vertebral, scapular, posterior axillary
Lateral- anterior axillary, midaxillary, posterior axillary
Lobes (3 on right, 2 on left), apex versus base
Right- upper, middle, lower lobes
Left- upper, lower lobes
Apex (highest point) anterior and 3-4 cm above clavicle
Base (lower border)
Pediatric (AP:Transverse diameter, abdominal breathing, role of surfactant)
AP: transverse 1:1 ratio
Abdominal breathing until 5-7 yrs
Pregnant (Diaphragmatic breathing, SOB, costal angle changes, lordosis)
Muscles and cartilage of the ribs relaxes
o Diaphragm rises into chest to accommodate fetus
o Diaphragmatic breathing
o Shortness of breath (SOB), dyspnea, increase awareness of breathing in last trimester
Total oxygen demand can increase 20%
Costal angle widens
Deeper breathing, respiratory rate unchanged
Lordosis or swayback, “waddling” gait
Geriatric (overall aging changes to respiratory rate and depth, vital capacity, alveoli); cough ability, kyphosis
, Aging lung is more rigid, harder to inflate
o Decrease vital capacity, increased residual volume
o Decreased number of alveoli
o Decreased in respiratory depth
o Slight increase in respiratory rate
Decrease in cough ability
o Weakening of the chest muscles, decrease cilia
o Compromises airway clearance
Kyphosis “hunchback”
Subjective
Cough – differences between acute versus chronic; time of day; productive versus non-productive; color
of phlegm or sputum; descriptions and meaning; associated symptoms; possible treatments
Acute (lasts 2 or 3 weeks), chronic (over 2 months)
Often? Time of day?
o Continuous – acute illness, respiratory infection
o Afternoon/evening – may irritants at work
o Night – postnasal drip
o Early morning – chronic bronchial inflammation, smokers
Productive or non-productive? Phlegm or sputum?
o Hemoptysis (blood), frank blood versus streaks of blood
o White or clear – colds, bronchitis, viral infections
o Yellow or green – bacterial infections
o Rust colored – TB, pneumonia
