Auscultation

Question 1

what is auscultation

Answer 1

sounds over chest

stethoscope has 2 sides - diaphragm - sensitive to high freq - lung sounds
bell - detects cardiac sounds - lower frequency

Question 2

advantages of stethoscope

Answer 2

cheap
lightweight
portable

Question 3

disadvantages

Answer 3

subjective - skill of clinician
attenuates frequencies above 120 Hz
Low frequency sounds below human hearing range

Question 4

Breath sounds norms described as …. and are categorized as normal if

Answer 4

Vesicular sounds produced by turbulance in the airways.

Healthy lungs filter most of the high frequency sounds

inspirations are more prolonged than expiration.

NB sounds harsher over upper lobes

differences in regional flow rates, the breath sounds at apex in an upright position become fainter as inspiration progresses.

Base = breath sounds are faint at the beginning of inspiration but increase throughout inspiration.

Question 5

Paradoxically quiet breath sounds (limited expiration) are due to

Answer 5

loss of elastic tension in the lung
compression of the central bronchi
no bronchial narrowing
normal inspiratory flow velocity

Question 6

Crackles are produced by…. and are most often heard in …

Answer 6

opening of previously closed bronchioles

inspiration phase

Question 7

What do early inspiratory crackles indicate?

Answer 7

diffuse airflow limitation

Question 8

What do late inspiratory crackles occur in?

Answer 8

pulmonary oedema, fibrosis of the lung and bronchiectasis

Question 9

Coarse crackles are heard more in..

Answer 9

obstructive disease

Question 10

Fine crackles are heard more in

Answer 10

fibrotic lung diseases

Question 11

What do Bronchial sounds sound like?

Answer 11

hollow sounding and have a higher pitch than vesicular sounds

Question 12

Bronchial breathing are …

Answer 12

abnormal sounds heard over consolidation or collapsed lung and sometimes over areas of fibrosis.

Question 13

Wheeze are heard during……result from…..

Answer 13

expiration

vibrations in collapsed airways

Question 14

Monophonic

Answer 14

single large airway obstruction

Question 15

polyphonic

Answer 15

narrowing of many smaller airways

Question 16

Wheeze is often heard in

Answer 16

Asthma and COPD

Question 17

Pleural rub is

Answer 17

creaking or groaning sound

indicative of inflammation or thickening of pleural surfaces

Question 18

stridor is

Answer 18

inspiratory musical type of noise caused by rapid airflow due to obstruction in the upper respiratory tract.

Question 19

Typical lung sounds in Asthma (4)

Answer 19

decreased breath sounds due to diminished airflow
expiratory wheeze singnifyinf bronchospasm
prolonged expiration phase
crackles (if sputum present)

Question 20

Lung sounds in COPD (4)

Answer 20

inspiratory and expiratory wheeze (bronchospasm)

Prolong expiration

Coarse Crackles - airway closure due to mucus

Prolonged forced expiration - prevent airway walls collapsing during expiration
- paradoxical quiet breath sounds

Question 21

bronchiectasis (1)

Answer 21

abnormal dilation of the bronchi after obstruction and infection
insp and exp crackles - pus in lung

Question 22

Pulmonary Odema

Answer 22

crackles heard in bases - fluid accumulation in base of lungs
wheeze - obstruction of airways by fluid
end-inspiratory crackles heard in half of cases
thickening of airways causes obstruction, producing crackles

Question 23

Lung Cancer

Answer 23

tumours - obstruction and atelectasis

stridor - narrowing of airways by tumour

Question 24

Cystic fibrosis

Answer 24

hypertrophy and hyperplasia of mucous secreting glands.

insp and exp wheeze - obstruction
crackles (fine) secretions

Question 25

Origin of
wheeze
crackles

Answer 25

wheeze - airway wall flutter, vortex shedding

Crackles - airway wall stress relaxation