THORAX AND LUNGS

THORAX AND LUNGS

1. RESPIRATION PATTERNS

   • NORMAL
     • 14-20/MIN AND REGULAR
     • NORMAL BREATHING PATTERN
   • TACHYPNEA
     • 24/MIN AND SHALLOW
       • MAY BE A NORMAL RESPONSE TO FEVER, EXERCISE AND ANXIETY
   • BRADYPNEA
     • <10/MIN AND REGULAR
       • MAY BE REGULAR IN WELL CONDITIONED ATHLETES.
       • CAN OCCUR IN MEDICATION INDUCED DEPRESSION OF THE RESPIRATORY SYSTEM
   • HYPERVENTILATION
     • INCREASED RATE AND DEPTH
       • USUALLY OCCURS IN EXTREME EXERCISE, FEAR OR ANXIETY
   • HYPOVENTILATION
     • DECREASED RATE AND DEPTH IRREGULAR PATTERN
       • USUALLY ASSOCIATED W/ OVERDOSE OF NARCOTICS AND ANETHETICS
   • CHEYNE-STOKES RESPIRATION
     • REGULAR PATTERN CHARACTERIZED BY ALTERNATING PERIODS OF DEEP, RAPID BREATHING FOLLOWED BY PERIODS OF APNEA
       • MAY RESULT FROM SEVERE CONGESTIVE HEART FAILURE, DRUG OVERDOSE INCREASED INTRACRANIAL PRESSURE OR RENAL FAILURE. MAY BE NOTED IN ELDERLY PERSON DURING SLEEP
   • BIOT'S RESPIRATION
     • IRREGULAR PATTERN CHARACTERIZED BY VARYING DEPTH RATE OF RESPIRATION FOLLOWED BY PERIODS OF APNEA
     • MAY BE SEEN W/ MENINGITIS OR SEVERE BRAIN DAMMAGE

2. FINDINGS

   • NORMAL
     • PINK
     • INTERCOSTAL SPACE SHOULD BE EVEN AND RELAXED
     • CHEST SYMMETRY IS EQUAL
     • RESPIRATION PATTERNS IS EVEN WITH 14-20 MIN UNLABORED
     • ANTERIOR & POSTERIOR TO LATERAL DIAMETER IS 1:2 RATIO
     • SHAPE & POSITION IS LEVEL W/ RIBS
     • CHEST EXPANSION IS 3 INCHES W/ DEEP INSPIRATION
     • POSITION OF TRACHEA IS IN MIDLINE
   • DEVIATION FROM NORMAL
     • PALLOR, CYANOSIS
     • BULGING AND RETRACTING
     • UNEQUAL
     • UNEVEN, LABORED, <12/MIN OR >20/MIN, SHALLOW AND DEEP
     • >1:2 RATIO OR <1:2
     • SHAPE & POSITION IS DEPRESSED OR PROJECTING
     • POSITION OF TRACHEA IS DEVIATED TO ONE SIDE
     • LESS THAN 3 INCHES W/ DEEP INSPIRATION & DECREASED CHEST EXCURSION

3. ALTERED VOICE SOUND OVER LUNGS PERIPHERY

   • BRONCHOPHONY
     • SOUND MUFFLED
     • SOUND LOUD AND CLEAR OVER CONSOLIDATION FROM PNEUMONIA ATELECTASIS OR TUMOR
   • WHISPERED PECTORILOQUY
     • SOUND MUFFLED
     • SOUND LOUD AND CLEAR OVER AREAS OF CONSOLIDATION
   • EGOPHONY
     • SOUND LIKE MUFFLED "EE"
     • SOUND LIKE "AY" OVER ARES CONSOLIDATION OR COMPRESSION

4. TECHNIQUE

   • AUSCULTATION
   • INSPECTION
   • PALPATION
   • PERCUSSION
   • EQUIPMENTS
     • STETHOSCOPE
     • SKIN MARKER
     • CENTIMETER RULER

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