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cardio pulmonary hell > asculation > Flashcards

asculation Flashcards

1
Q

breath sounds at mouth
normal
if obstruction

A
  1. should be barely audible during inspiration and expiration
  2. high pitch sound if obstruction
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2
Q

where do we listen to bronchial breath sounds?

quality/ type of sound compared to vesicular sounds

A
  1. listen over large airways - *at carinal (sternal angle) of trachea
  2. hollow/ tubular sounds which are louder and higher pitched than vesicular
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3
Q

bronchovesicular breath sounds
sound
where we listen (anterior and posterior)

A
  1. intermediate sounds btwn bronchial and vesicular sounds
  2. anterior: heard in upper lung, ~2 IC space, mid clavicular
  3. posterior: between shoulder blades
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4
Q

vesicular breath sounds
what they sound like (2)
where we listen (ant and post)

A
  1. sounds like leaves rustling
  2. on chest wall they are faint, low pitched* and barely audible during latter half of expiration
  3. hear over most of the lung surface => anterior and posterior, not btwn shoulder blades
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5
Q

what is pulmonary consolidation?

what is an indication of consolidation?

A
  1. a region of normally compressible lung that is filled with fluid and it hard or swollen
  2. hearing bronchial sounds where they don’t belong indicates consolidation
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6
Q

abnormal breath sounds:

bronchial breath sounds (2)

A
  1. bronchial breath sounds- a.k.a. tubular breath sound soccur in peripheral lung tissue when they become airless, the sounds you hear is from adjacent bronchi which is enhanced
  2. decreased breath sounds - transmission is diminished
  3. absent breath sounds- no sounds audible
    these may simply be due to depth of penetration (ie obesity)
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7
Q

definition of adventitious breath sounds (2)

A
  1. breath sounds which are extraneous noises produced over bronchopulmonary tree
  2. generally indicate abnormal process or condition
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8
Q

rales/crackles
what they sound like
what they indicate
what it means if they can be cleared with a cough

A
  1. abnormal breath sound which is discontinuous, low pitched and occurs during inspiration - sound like rustling hair
  2. indicate peripheral airway that have been closed but are now popping open
  3. if can clear with a cough much less significant (maybe just because alveoli had mucus)
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9
Q

ronchi (low pitch wheezes)
sound and quality (2)
attributed to…

A
  1. low pitched sounds (snoring) which occur during both inspiration and expiration.
  2. can be very loud so hard to determine location
  3. attributed to obstructive process (secretions) in more central airways
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10
Q 
wheezes
 what they sound like
 what airways do we hear them in?
 what are they caused by?
 what are they associated with when heard on expiration and inspiration?
A
  1. continuous high pitches sound which occur during expiration
  2. can be on peripheral or proximal airways
  3. caused by narrowing of airway (obstruction!)
  4. expiration = associated with bronchospasm
  5. inspiration = associated with secretions
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11
Q

disease processes - wheezing
when do we hear it with…
asthma
stridor

A
  1. asthma- hear wheezing on inspiration and expiration, not changing
  2. stridor- wheeze from trachea (which is our main airway) => *medical emergency
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12
Q

extra-pulmonary sounds; pleural friction
what it sounds like
what produces it
can the pt feel it? why?

A
  1. sounds like rubbing or leathery
  2. produced by visceral pleura rubbing on parietal pleura due to inflammatory process
  3. painful- because parietal is innvervated
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13
Q

normal breath sounds heard during asculation

A
  1. travelled down bronchial tree and are soft and barely audible
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14
Q

bronchophany
what is it?
why do we hear it?
technique

A
  1. increased vocal transmission- words or letters are louder and clearer
  2. from increased lung density, ie pneumonia
  3. ask pt to repeat “blue moon” or “1,2,3” while asculating lung segment thought to be consolidated
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15
Q

egophany
what it is
technique

A
  1. increased transmission of vocal vibrations, usually along with bronchophany
  2. ask pt to say “eeeeee” sounds like “aaaaa”
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16
Q

whispered pectoriloquy
what it is
technique

A
  1. in pt with patchy areas of lung consolidation, whispered voice sounds become more clear and distinct
  2. have the pt whisper “99” or “1,2,3” and it will be clear and distinguishable
17
Q

why we do mediate percussion?

sounds we hear (4)

A 
1. we do this to asses the density of lungs or underlying organs
sounds we hear:
2. resonant
3. dull (flat)
4. tympanic
5. hyper-resonant
18
Q

resonant percussion
description of sound
when we normally hear it

A
  1. loud, low in pitch

2. hear in healthy aerated lung tissue

19
Q

dull (flat) percussion sounds
description of sound
4 reasons why we hear it
when we normally hear it

A
  1. soft intensity, medium pitch
  2. airless lung (consolidation, collapse, fibrosis, tumor) or if lung is seperated from chest wall by pleural fluid or thickened pleura
  3. normally heard over liver or heart
20
Q

tympanic percussion sounds
description of sound
why we hear it (abnormal)
when we normally hear it

A
  1. clear hollow tone
  2. hear in tension pneumothorax or air under pressure
  3. normally heard over stomach
21
Q

hyperresonant percussion sounds
description of sound
why we hear it (abnormal)

A
  1. very loud, lower pitch than resonant

2. amt of air in thorax in increased from emphysema or pneumothorax

22
Q

what is tactile fremitus?

what can it tell us?

A
  1. vibrations felt over chest wall during speaking

2. can indicated density of underlying lungs

23
Q

subcutaneous emphysema
2 causes
what it feels like

A

causes

  1. if sudden onset- from airleak in lung (pneumothorax*) don’t do anything!
  2. caseous gangrene
  3. puffed up space, feels like rice krispies under skin
24
Q

normal diaphragm excursion
during rest
during hard exercise

A
  1. during rest = 3-5 cm

2. during hard exercise = 8-10 cm

25
Q

where is most chest expansion during breathing

A
  1. bottom, decreases as you go superior
26
Q

testing for tracheal deviation
why it happens
3 possible causes

A
  1. place index finger in suprasternal notch, and see if trachea is equal distance btwn clavicles
  2. results from unequal intrathoracic pressure within the chest cavity
  3. causes:
    a. traumatic pneumothorax
    b. atelectasis
    c. pleural effusion
27
Q

6 diseases associated with rales (crackles)

A
  1. atelectasis
  2. bronchiectasis
  3. chronic bronchitis
  4. pneumonia
  5. pulmonary fibrosis
  6. CHF
28
Q

2 diseases associated with wheezing

A
  1. asthma

2. bronchiectasis (ronchi with mucus retention)

cardio pulmonary hell (7 decks)

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