2. Breath sounds and differentials for asthma

Question 1

what is the term for normal breaths

Answer 1

vesicular breathing

Question 2

Describe vesicular breaths

Answer 2

normal sound on most of the lung
soft, low pitch
inspiration is longer than expiation and no gap between the phases

Question 3

what are diminished breath sounds

Answer 3

absent breath sounds

Question 4

Describe bronchial breath sounds

Answer 4

abnormal in majority of the lung that is far from the main air way
loud and tubular quality
high pitched
inspiratory and expiratory phases are equal and there is a definitive gap between the phases

Question 5

name 3 conditions in which you would hear bronchia; breath sounds

Answer 5

Consolidation
Lobar collapse with a patent bronchus
lung cavity

Question 6

what does consolidation mean

Answer 6

when the air that usually fills the small airways in your lungs is replaced with something else
Depending on the cause, the air may be replaced with: a fluid, such as pus, blood, or water.

Question 7

what are pulmonary cavities

Answer 7

abnormal gas filled spaces within the lung

Question 8

name some common added/adventitious breath sounds

Answer 8

wheeze
crackles/crepitations
pleural friction rub

Question 9

Describe a wheeze, which part of breathing it occurs in and what it indicates

Answer 9

a continuous musical quality sound
usually occurs in expiration
it indicates a narrowing of airways due to bronchospasm or secretions in the small always

Question 10

What does a high pitch ‘sibilant’ wheeze sound like and why do you hear it

Answer 10

sounds like whistling

heard due to smaller airway narrowing in bronchospasm (like in asthma )

Question 11

what does a low pitch ‘sonorous’ wheeze (aka rhonchi) show

Answer 11

heard when smaller airways are narrow due to secretions

Question 12

name some other conditions in which a wheeze can be heard in

Answer 12

eosinophilic lung disease
cardiac failure
COPD
foreign body aspiration
pulmonary disease

Question 13

Describe a crackle/crepitation, which part of breathing it occurs inn and what it indicates

Answer 13

it is interrupted and non-musical sound
usually heard during inspiration
the rapid air entry abruptly opens collapsed small airways and alveoli producing the sound

Question 14

peripheral airway collapse on expiration is due to what

Answer 14

either interstitial fibrosis or secretions/fluid

Question 15

If crackle is head in early inspiration what does it suggest

Answer 15

a small airway disease like bronchiolitis

Question 16

if crackle is heard mid inspiratory what does it suggest

Answer 16

Pulmonary odema (fluid accumulation in the tissue and air spaces of the lungs)

Question 17

if crackle is heard in late inspiration what does it suggest

Answer 17

pulmonary fibrosis
pulmonary odema 
COPD
resolving pneumonia 
lung abscess 
tuberculous lung cavities

Question 18

if crackle is biphasic what does it suggest

Answer 18

bronchiectasis (permanent enlargement of parts of the airways of the lung. Symptoms typically include a chronic cough with mucus production)

Question 19

Crackles can either be fine or coarse;

what conditions would you hear a fine crepitation

Answer 19

bronchiolitis
pulmonary odema
pulmonary fibrosis

Question 20

Crackles can either be fine or coarse;

what conditions would you hear a coarse crepitation

Answer 20

COPD
resolving pneumonia 
lung abcess
tuberculous lung cavity 
bronchiectasis

Question 21

what is pleural friction rub caused by

Answer 21

inflammation of either the visceral and/or the parietal pleura

Question 22

what does pleural friction rub sound like

Answer 22

low pitched, grating sound similar to the sound of walking on snow

Question 23

what conditions is pleural friction rub caused in

Answer 23

consolidation
pulmonary infarction
uraemia

Question 24

when is pleural friction rub heard

Answer 24

during inspiration when the 2 pleura slide over each other

Question 25

How would COPD present differently to asthma

Answer 25

would have a history of smoking or long-term asthma
dyspnoea occurs with or without wheezing and coughing
examination will show barrel chest, hyper resonance to percussion and distant breath sounds

Question 26

how would a PE present differently to asthma

Answer 26

would have SOB and pleuritic pain