Assessment of the Respiratory System Flashcards
5 most common abnormal breath sounds
Wheezing
Rhonchi (Course Crackles)
Rales
Stridor
Pleural Rub
identify which of the 5 most common abnormal breath sounds is being described
- caused by airway obstruction
- occur during asthma
- occur during COPD
- occur during interstitial lung disease
- occur during infections
- occur during pulmonary embolism
- occur during aspiration
Wheezing
identify which of the 5 most common abnormal breath sounds is being described
- continuous high pitched sound
- whistling sound
- worse on expiration
Wheezing
identify which of the 5 most common abnormal breath sounds is being described
- caused by
COPD
Bronchitis
Bronchiectasis
Pneumonia
Chronic Bronchitis
Cystic Fibrosis
Rhonchi or Course Crackles
identify which of the 5 most common abnormal breath sounds is being described
- makes low pitched bubbling or rattling sound during inspiration and expiration
- occur in the bronchi
Rhonchi or Course Crackles
identify which of the 5 most common abnormal breath sounds is being described
- caused by
Pulmonary edema
Pneumonia
Atelectasis
- occur in alveoli
Rales or Fine Crackles
identify which of the 5 most common abnormal breath sounds is being described
- Brief discontinuous popping or cracking sound
- sounds like fire crackling, hair between fingers, and cellophane being crumpled
Rales or Fine Crackles
identify which of the 5 most common abnormal breath sounds is being described
- caused by
upper airway narrowing
Obstruction of airway like
Epiglottis, Pertussis, Aspiration, Croup
Stridor
identify which of the 5 most common abnormal breath sounds is being described
- loud high pitched whistling or crowing sound
- occurs usually on inspiration
Stridor
identify which of the 5 most common abnormal breath sounds is being described
- caused by
inflammation in the pleura
Pleural Effusions
Empyema
Hemothorax
Pleural Rub
identify which of the 5 most common abnormal breath sounds is being described
- symmetrical continuous leather creaking localized sound
- Does not change location when a person’s cough
Pleural Rub
Where does do they insert needle for tension pneumothorax?
2nd ICS
Where do they insert a chest tube
4th ICS
large air collection in the pleural space compromises respiration and cardiac function
tension pneumothorax
most important examination technique for assessing air flow through the tracheobronchial tree
Auscultation
3 Voice sounds
Bronchophony
egophony
Whisper Pectoriloquy
Identify which of the 3 breath sounds is being described
- ask the client to repeat the letter “E”
- present when e sound changes to A sound
Egophony
Identify which of the 3 breath sounds is being described
- ask the client to repeat the phrase “ninety-nine”
- loud voice heard clearly
Bronchophony
Identify which of the 3 breath sounds is being described
- ask the client to whisper the phrase “one-two-three” or “ninety-nine”
- present when whispered sounds are loud and clear
Whispered Pectoriloquy
Characteristics of Percussion sounds: Flat
Intensity: Soft
Pitch: High
Duration: Short
Example Location: Thigh
Characteristics of Percussion sounds: Dull
Intensity: Medium
Pitch: Medium
Duration: Medium
Example Location: Liver
Characteristics of Percussion sounds: Resonant
Intensity: Loud
Pitch: Low
Duration: Long
Example Location: Healthy Lung
Characteristics of Percussion sounds: Hyper resonant
Intensity: Very Loud
Pitch: Lower
Duration: Longer
Example Location: Usually None
Characteristics of Percussion sounds: Tympanic
Intensity: Loud
Pitch: High
Duration: Longer
Example Location: Gastric Air bubble or puffed out cheek
ratio of anteroposterior diameter to transverse diameter
1:2
What to note when inspecting
Tracheal deviation
Chest wall deformities
Kyphosis – curvature of the spine (anterior/posterior)
Scoliosis – curvature of the spine (lateral)
Barrel Chest – increased anterior/posterior chest wall
Pectus excavatum
Pectus carinatum
Signs of Respiratory Distress
Tachypneic (>25/bpm)
Cyanosis (hypoxia) or pallor (heart failure)
Pursed-lip breathing
Accessory muscle use
Diaphragmatic paradox
Intercostal indrawing
Emphysema Dominant
Bronchitis Dominant
Paradoxical Breathing
Accessory muscles of ventilation
- scalene
- sternocleidomastoid
- pectoralis major
- trapezius
- external intercostals.
Characteristics of Breath Sounds
Vesicular
Broncho Vesicular
Bronchial
Tracheal
Identify Characteristics of Breath Sounds
- inspiratory sound longer than expiratory
- Intensity: soft
- Pitch Low
- Location: over most lungs
Vesicular
Identify Characteristics of Breath Sounds
- Inspiratory and Expiratory almost equal
- Intensity: Intermediate
- Pitch: Intermediate
- Location: 1st and 2nd ICS
Broncho Vesicular
Identify Characteristics of Breath Sounds
- expiratory lasts longer than inspiratory
- Intensity: Loud
- Pitch: High
- Location: over manubrium
Bronchial
Identify Characteristics of Breath Sounds
- inspiratory and expiratory sounds almost equal
- Intensity: Very Loud
- Location: over trachea in the neck
tracheal
Continuous Adventitious Breath sounds
Wheezing
Rhonchi
Stridor
Identify Continuous Adventitious Breath sounds
- high pitched with snoring quality
Wheezing
Identify Continuous Adventitious Breath sounds
- Low pitched with snoring quality
Rhonchi
Identify Continuous Adventitious Breath sounds
- continuous high-frequency high pitch musical sound
- best heard over neck during inspiration
- caused by airway obstruction
Stridor
Discontinuous Adventitious Breath sounds
Fine Crackles
Coarse Crackles
Pleural Rub
Identify Discontinuous Adventitious Breath sounds
- soft high pitched sound
- very breif
Fine Crackles
Identify Discontinuous Adventitious Breath sounds
- loud low pitched sound
Coarse Crackles
Identify Discontinuous Adventitious Breath sounds
- low frequency grating sound
- results from inflammation and roughening of visceral pleura
Pleural Rub
