Ausculation

Question 1

What are normal breath sounds?

Answer 1

• Transmission of sound created by passage of air in and out of the lungs.
• Inspiration 2x as long as expiration
• Upper lobes are lounder than bases

Question 2

What are the abnormal breath sounds?

Answer 2

1. Bronchial
2. Quiet
3. Stridor
4. Pleural Rub
5. Vocal resonance

Question 3

What is bronchial breathing?

Answer 3

Harsh noises, loud and high pitched.
produced by passage of air in and out of larger bronchi, transmitted through solid tissue.

Question 4

What can the cause of bronchial breathing be?

Answer 4

1. Consolidation: air-filled spaces are replaced by products of disease e.g. water, pus, blood
2. Mass
3. Collapsed lung if bronchus patient

Question 5

What are quiet breath sounds?

Answer 5

Diminished sound may occur over a chest of a person breathing quietly.
Local reduction: likely to indicate disease.
This occurs when there is an abnormal barrier between normal lung and stethoscope

Question 6

What are the possible causes of quiet breath sounds?

Answer 6

1. reduced air entry
2. reduced transmission: localised accumulation of air/fluid in pleural space will block sound transmission so that breath sounds are absent

Question 7

What is Stridor?

Answer 7

sound of an upper airway obstruction, may be due to collapse of the floppy tracheal wall, inflammation or an inhaled foreign body

Question 8

What is pleural rub?

Answer 8

cracking/rubbing sound occurs with each breath when the pleural surfaces are roughed by inflammation/infection.
- heard equally during inspiration and expiration

Question 9

What is vocal resonance?

Answer 9

transmission of voice through the airways and lung tissue to the chest wall
consolidated lung tissue transmits all sounds better.

Question 10

What are the added breath sounds?

Answer 10

1. Crackle
2. Wheeze

Question 11

What are crackles?

Answer 11

Inspiratory: discontinuous popping sounds created by a sudden opening of a closed section of airway
Expiratory: often sputum
Can be early/late fine/coarse insp/exp

coarse, early insp crackles- opening of bronchioles— bronchitis

Question 12

What are the possible causes of Crackles?

Answer 12

1. atelectasis
2. pulmonary oedema- fine and late
3. Fibrosis- COPD/ARDs/interstitial

Question 13

What is a wheeze?

Answer 13

Musical continuous sound of varying length and pitch
- audible on inspiration (more severe) and/or expiration (first heard)
- created by narrowing of the airway

Question 14

What are the possible causes of a Wheeze?

Answer 14

1. Bronchospasm
2. Swollen mucosa
3. Sputum
4. Mass