Auscultation

Question 1

What is auscultation?

Answer 1

Process of listening to and interpreting the sounds produced within the thorax

Question 2

What is it used for?

Answer 2

Verify observed and palpated findings before, during and after treatment

Question 3

What are you listening for?

Answer 3

Breath sounds

Added sounds

Question 4

What are the 3 breath sounds?

Answer 4

Normal
Increased (bronchial)
Decreased / absent

Question 5

What do normal breath sounds sound like?

Answer 5

Sounds heard over the entire lung fields
Muffled in quality 
Normal to get quieter further from the trachea 
Inspiration os louder than expiration 
Inspiration is longer than expiration 
No pauses

Question 6

What do increased breath sounds sound like?

Answer 6

Muffled in quality
Pounder, more coarse sound compared to normal
Definite pause between inspiration and exploration

Question 7

Why do increased breath sounds occur?

Answer 7

When lung tissue is more dense due to a pathology

Question 8

What do decreased or absent breath sounds sound like?

Answer 8

Decreased from normal breath sounds or completely absent

Question 9

What causes decreased breath sounds?

Answer 9

A pathology of the underlying lung causing disproportionate reduction in the normal breath sound
Decreased ventilation to generate sound
Decreased mechanics of breathing or chest wall movement
Decreased transmission of sound

Question 10

What are possible caused of increased breath sounds?

Answer 10

Collapse
Fluid
Large mass
Consolidation

Question 11

What are possible causes of decreased / absent breath sounds?

Answer 11

Shallow breathing / drowsiness / pain 
Poor positioning 
Collapse 
Collapse with a complete obstruction of airway 
Hyperinflation 
Obesity / very muscular patient

Question 12

What are the 3 added sounds?

Answer 12

Crackles
Wheezes
Pleural Rub

Question 13

What are the 2 groups of crackles?

Answer 13

Coarse

Fine

Question 14

What do crackles sound like?

Answer 14

Short

Non-musical popping sound

Question 15

What are some of the possible causes of crackles?

Answer 15

Explosive sound from the equalisation of pressure in an obstructed airway 
Collapsed airway 
Sputum 
Pulmonary oedema 
Fibrosis

Question 16

What are the 2 types of wheeze?

Answer 16

Monophonic

Polyphonic

Question 17

What are monophonic wheezes?

Answer 17

The same pitch at the same point in the respiratory cycle

Question 18

What are polyphonic wheezes?

Answer 18

Varying pitch at different points of the respiratory cycle

Question 19

What are some examples of wheezes?

Answer 19

Bronchospasm
Airway oedema 
Sputum 
Tumour 
Foreign body

Question 20

What is a pleural rub?

Answer 20

Pleural surfaces rubbing together

Question 21

What type of sound is a pleural rub?

Answer 21

Creaky leathery sound

Question 22

What can cause a pleural rub?

Answer 22

Inflammation of the pleura

Question 23

What are some things that can interfere with the assessment?

Answer 23

Movement of the stethoscope on the skin 
Oral cavity sounds 
Clothing / sheets 
Talking 
Hairy skin 
Water in tubing 
Shivering 
External sounds