Chapter 11

Respiratory System

Structures of the Respiratory Tract

Chest Wall Landmarks

Systematic Pattern for Palpation and Auscultation

Normal Breath Sounds

Signs and Symptoms of Hyperventilation

Signs and Symptoms of Hypoventilation

Signs and Symptoms of Hypoxia

Abnormal and Adventitious Sounds

Common Lung Disorders

Oxygen Therapy

For an in-depth study of the respiratory system, consult the following publications:

Lewis SM, et al: Medical-surgical nursing, ed 8, St. Louis, 2011, Mosby.

Nugent P, Green J, Hellmer Saul MA, Pelikan P: Mosby’s comprehensive review of nursing for the NCLEX-RN examination, ed 20, St. Louis, 2012, Mosby.

Patton K, Thibodeau G: Structure and function of the human body, ed 14, St. Louis, 2012, Mosby.

Potter PA, Perry AG, Stockert PA, Hall A: Fundamentals of nursing, ed 8, St. Louis, 2013, Mosby.

Weilitz P, Potter PA: Pocket guide for health assessment, ed 6, St. Louis, 2007, Mosby.

Structures of the Respiratory Tract

FIGURE 11-1 Upper respiratory tract. (Modified from Thibodeau G, Patton K: Structure and function of the human body, ed 14, St. Louis, 2012, Mosby.)

FIGURE 11-2 Structures of the lungs. (Modified from Thibodeau G, Patton K: Structure and function of the human body, ed 14, St. Louis, 2012, Mosby.)

Chest Wall Landmarks

FIGURE 11-3 Chest wall landmarks. (From Potter PA, Perry AG, Stockert PA, Hall A: Fundamentals of nursing, ed 8, St. Louis, 2013, Mosby.)

Systematic Pattern for Palpation and Auscultation

FIGURE 11-4 Systematic pattern for palpation and auscultation—posterior, lateral, and anterior. (From Potter PA, Perry AG, Stockert PA, Hall A: Fundamentals of nursing, ed 8, St. Louis, 2013, Mosby.)

Normal Breath Sounds

Vesicular Soft, low-pitched sighing over bronchiole and alveoli base on inspiration

Bronchial Moderate, high-pitched sound over trachea

Bronchovesicular Moderate sound over first and second intercostal spaces

Tracheal Loudest and highest pitched of normal breath sounds, harsh and tubular

Signs and Symptoms of Hyperventilation

• Tachycardia, chest pain, shortness of breath

• Dizziness, lightheadedness, disorientation

• Paresthesia, numbness

• Tinnitus, blurred vision, tetany

Signs and Symptoms of Hypoventilation

• Dizziness, headache, lethargy

• Disorientation, convulsions, coma

• Decreased ability to follow instructions

• Cardiac arrhythmias, electrolyte imbalance, cardiac arrest

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