2. Breath sounds and differentials for asthma Flashcards
what is the term for normal breaths
vesicular breathing
Describe vesicular breaths
normal sound on most of the lung
soft, low pitch
inspiration is longer than expiation and no gap between the phases
what are diminished breath sounds
absent breath sounds
Describe bronchial breath sounds
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
name 3 conditions in which you would hear bronchia; breath sounds
Consolidation
Lobar collapse with a patent bronchus
lung cavity
what does consolidation mean
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.
what are pulmonary cavities
abnormal gas filled spaces within the lung
name some common added/adventitious breath sounds
wheeze
crackles/crepitations
pleural friction rub
Describe a wheeze, which part of breathing it occurs in and what it indicates
a continuous musical quality sound
usually occurs in expiration
it indicates a narrowing of airways due to bronchospasm or secretions in the small always
What does a high pitch ‘sibilant’ wheeze sound like and why do you hear it
sounds like whistling
heard due to smaller airway narrowing in bronchospasm (like in asthma )
what does a low pitch ‘sonorous’ wheeze (aka rhonchi) show
heard when smaller airways are narrow due to secretions
name some other conditions in which a wheeze can be heard in
eosinophilic lung disease cardiac failure COPD foreign body aspiration pulmonary disease
Describe a crackle/crepitation, which part of breathing it occurs inn and what it indicates
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
peripheral airway collapse on expiration is due to what
either interstitial fibrosis or secretions/fluid
If crackle is head in early inspiration what does it suggest
a small airway disease like bronchiolitis
if crackle is heard mid inspiratory what does it suggest
Pulmonary odema (fluid accumulation in the tissue and air spaces of the lungs)
if crackle is heard in late inspiration what does it suggest
pulmonary fibrosis pulmonary odema COPD resolving pneumonia lung abscess tuberculous lung cavities
if crackle is biphasic what does it suggest
bronchiectasis (permanent enlargement of parts of the airways of the lung. Symptoms typically include a chronic cough with mucus production)
Crackles can either be fine or coarse;
what conditions would you hear a fine crepitation
bronchiolitis
pulmonary odema
pulmonary fibrosis
Crackles can either be fine or coarse;
what conditions would you hear a coarse crepitation
COPD resolving pneumonia lung abcess tuberculous lung cavity bronchiectasis
what is pleural friction rub caused by
inflammation of either the visceral and/or the parietal pleura
what does pleural friction rub sound like
low pitched, grating sound similar to the sound of walking on snow
what conditions is pleural friction rub caused in
consolidation
pulmonary infarction
uraemia
when is pleural friction rub heard
during inspiration when the 2 pleura slide over each other
How would COPD present differently to asthma
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
how would a PE present differently to asthma
would have SOB and pleuritic pain
