Ausculatation Flashcards
Bowel Auscultation
Why do it and how to do it?
Why? To assess bowel motility and to determine causes of abdominal complaints
or Searching for renal stenosis
How?
– supine position
– place the stethoscope on the abdomen
Normal bowel sounds?
Normal sounds = clicks and gurgles 5-30/min
Abnormal sounds? Give examples of why you would have increased intensity, decreased intensity
Increased intensity and frequency: diarrhea or intestinal obstruction=obstructive ileus
Decreased intensity and frequency, or no sounds at all: paralytic ileus,
peritonitis
Splash in ileus (lot of air and liquid)
What are Bruits?
Bruit- french for noise
aka vascular murmur.
It is the abnormal sound generated by turbulent flow of blood in an artery due to a partial obstruction; or a localized high rate of blood flow through an unobstructed artery.
Why do we hear Bruits over the abdomen?
Normally there shouldn’t be any
Reason- Renal artery stenosis
Where? upper quadrants of epigastrium & costovertebral angles
Sounds like vascular murmurs
Position for lung auscultation
Arms crossed in front of the chest
Ask the patient not to speak and to breathe deeply through the mouth
•Compare two sides at the identical locations
•At least one full breath at each location
Use Diaphragm of the stethoscope
What are normal breath sounds?
Tracheal or bronchial breath sounds
Vesicular breath sounds
Tracheal/ Bronchial breath sounds
The turbulent airflow in central airways
Loud, high pitched sound (like over trachea, scapula)
Normally not heard
as not transmitted in air filled lung
Can be heard: pneumonia, large pleural effusions
when lung tissue loses air
Vesicular airsounds
Distal to trachea & proximal to alveoli
Normally over the lung
Soft & low pitched
Severe asthma bronchiale (how does it affect the sounds heard)
Decreased sounds
Emphysema (effect of sound)
Decreased sounds
PTX (effect of sounds)
Absent or decreased sounds
Bronchial sounds heard with what 2 conditions?
Pneumonia
effusion
6 Conditions causing crackles
- pneumonia
- ARDS
- bronchiectasis
- early CHF
- interstitial lung disease
- pulmonary edema
What type of sound is a wheeze?
A continuous, high pitched, hissing sound
When do we normally hear wheezing/ wheezes?
heard normally on expiration but also sometimes on inspiration
What produces the wheezing sounds?
Produced when air flows through airways narrowed by secretions, foreign bodies, or obstructive lesions.
What are crackles and when do we hear them?
Discontinuous, non musical brief sounds
More commonly heard on inspiration
Describe two types of crackles?
Fine: High pitched, soft and v brief
Coarse: low pitched, louder, less brief
What is the mechanical basis behind the two types of crackles?
The collapse of small airways during expiration (fine crackles)
or
air bubbles through secretions or incompletely closed airways during expiration (coarse crackles)
What conditions cause wheezes?
- asthma bronchiale
- CHF
- chronic bronchitis
- COPD
- pulmonary edema
What is stridor? Where and when do we hear it?
inspiratory musical wheeze heard loudest over the trachea during inspiration
What does stridor suggest?
stridor suggests an obstructed trachea or larynx
• constitutes a medical emergency that requires immediate attention
• foreign body
What is pleural rub?
creaking or brushing sounds produced when the pleural surfaces are inflamed and rub against each other
may be discontinuous or continuous sounds
usually localised at a particular place on the chest wall
