Download The Respiratory System and Oxygenation

Nursing 2220
The Respiratory System
Nursing Assessment (Auscultation)
By Ginger VanDenBerg
Respiratory & Auscultation
Course Objectives

Discuss upper and lower respiratory anatomy

Discuss ventilation versus oxygenation

Identify nursing auscultation assessment of the
respiratory system

Define assessment of normal versus abnormal
respiratory sounds
Respiratory Anatomy
Overview

Upper Respiratory System
-Nasal Cavity
-Oral Cavity
-Pharnyx
Respiratory Anatomy
Overview

Lower Respiratory System
-Larnyx (Opening of the trachea)
-Trachea (Windpipe)
-Lungs (right/left)
-Bronchus (divides into right/left)
Upper & Lower Respiratory anatomy is consider to be the CONDUCTING portion
No Gas Exchange Occurs
Respiratory Anatomy
Overview

Terminal Bronchioles (<1mm
diameter

Alveolar Ducts

Alveolar Sacs -Actual units of
gaseous exchange in lungs
Respiratory bronchioles to alveoli is consider to be the Respiratory Portion
Gas Exchange does occur
POP Quiz
 Structures
of the upper airway include all
of the following except?
Nasal Cavity
a.
Oral Cavity
b.
c.
d.
Pharnyx
Larnyx
Nursing Auscultation
Assessment

Place the diaphragm of your
stethoscope over the posterior
chest between the ribs

Ask patient to take slow – deep
breaths

Listen to an entire inspiration &
expiration cycle at each position

Compare the sounds in one region
to sounds in the same region on
the opposite side

Anterior follows same pattern as
posterior, with attention to the
lower lobes for increased
secretions
Normal Breath Sounds
Posterior Thorax
Posterior Thorax Sounds

Bronchovesicular – medium
pitched blowing sounds, between
the scapulae. Equal inspiratory
& expiratory phases

Vesicular- heard over the lung
periphery, smaller airways, soft
& low pitched. Inspiratory phase
is about 3x longer than
expiratory phase
Normal Breath Sounds
Anterior Thorax
Anterior Thorax Sounds

Bronchovesicular & vesicular
sounds-are heard above & below
the clavicles and along the lung
periphery

Bronchial-loud, high pitched,
hollow sound, heard over the
trachea, expiration last longer than
inspiration
POP Quiz

During auscultation the nurse compares lung sounds on
one side of the body to lung sounds in the same field on
the opposite of the body?
a.
True
b.
False
Abnormal Breath Sounds
(Adventitious)

Crackles-heard in dependent lobes,
lung bases, sudden reinflation of
alveoli. Bowl of rice krispies

Ronchi-heard over trachea & bronchi,
caused by muscular spasm, fluid or
mucus in larger airways, turbulent
sound

Wheezes-heard over all lung fields,
high-velocity airflow through narrow
bronchus

Pleural friction rub-heard over
anterior lung surface, parietal pleura
rubbing against visceral pleura
Final POP Quiz

The following lungs sounds are considered to be
advantitious except?
a.
b.
Crackles
Ronchi
c.
Vescular
d.
Wheezes
The End
Questions and Answers
Please referred to the our assigned discussion board for
questions and answers
References

Nursing Assessing Lung Sounds (n.d.). Retrieved from
http://www.barcharts.com/Inventory/Navision/97815722276133.

Potter, P. A., Perry, A. G., Stocker, P. A. & Hall, A. (2010). Basic
Nursing (7th ed.), St. Louis, MO: Elsevier Health Science.

Respiratory System (n.d.). Retrieved from
http://www.medical/exam-essentials.com/respiratory-systemdiagram.html.