Auscultation Flashcards

1
Q

Position of Lobes ANTERIORLY

A

Upper lobe - 2-4 ICS
Middle/Lingular - 4-6 ICS
Lower Lobe - 6 ICS LATERALLY ONLY

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2
Q

Position of Lobes POSTERIORLY

A

Lower Lobe - T2-T10

middle lobe is wedge shaped, not present posteriorly

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3
Q

Normal Breath Sounds:

Bronchial Sounds

A

Heard over trachea

  • loud and high pitched
  • heard between inspiration and expiration - PAUSE HEARD
  • expiration sound > inspiration sound
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4
Q

Normal Breath Sounds:

Bronchovesicular Sounds

A

Anterior Chest: 1st and 2nd ICS near sternum

Posterior Chest: Interscap region (mainstem bronchi)

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5
Q

Normal Breath Sounds:

Vesicular Sounds

A

Heard all over areas of the chest distal to the central airways

  • soft, breezy quality
  • heard inspiration and expiration - NO PAUSE
  • inspiration sound > expiration sound
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6
Q

Abnormal Breath Sounds:

Bronchial Breathing

A

absent or diminished:

  • obesity, pleural effusion, pneumothorax, COPD
  • due to a loss of ventilatory power
  • reduced intensity of sound

bronchial heard away from trachea

  • lung consolidation, congestion, atelectasis, fibrosis
  • increased during expiration - harsh blowing
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7
Q

Adventitious Breath Sounds:

Wheezes (rhonchi)

A

heard in asthma, bronchitis (COPD)

  • continuous, musical quality, polyphonic
  • heard over CONSTRICTED lungs and airways
  • mostly heard on exhalation
    - if heard on inhalation - v severe

if heard in one airway only (monophonic) it is an EMERGENCY - there is a blockage

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8
Q

Adventitious Breath Sounds:

Crackles (rales)

A

heard in COPD (bronchitis, emphysema, asthma), interstitial lung dz, pulm edema, pulm effusion

  • discontinuous, intermittent bubbling/crackling
  • hear air bubbling through secretions, small airways as they snap open
  • heard during inspiration
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9
Q

Adventitious Breath Sounds:

Pleural Friction Rub

A

heard when there is pleural inflammation

  • low pitch, non musical, “cracking leather”
  • heard over the lateral lung fields during insp and exp
    - does not move - sound will be heard in the same place bc things are stuck
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10
Q

Voice Sounds:

Bronchophany

A

instruct pt to say “99”

  • normal - inaudible
  • positive - 99 heard loud and clear
  • positive when there is tissue consolidation - sound travels better through denser tissue
    - pulm edema, tumor, pneumonia
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11
Q

Voice Sounds:

Egophany

A

instruct pt to say “ee”

  • normal - muffled
  • positive - hear “ay” loud and clear
  • positive when there is tissue consolidation - sound travels better through denser tissue
    - pleural effusion
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12
Q

Voice Sounds:

Whispered Pectoriloquy

A

instruct pt to whisper “99”

  • normal - inaudible
  • positive - hear 99 loud and clear
  • positive when there is tissue consolidation - sound travels better through denser tissue
    - pulm edema, tumor
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13
Q

Heart Sounds:

Aortic Area

A

2nd ICS on the right - close to the sternum

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14
Q

Heart Sounds:

Pulmonic Area

A

2nd ICS on the left - close to the sternum

S2 heard best here

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15
Q

Heart Sounds:

Erb’s Point

A

3rd ICS on the left - close to the sternum

S1 and S2 heard equally well here

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16
Q

Heart Sounds:

Tricuspid Valve

A

4-5th ICS to the left - close to the sternum

17
Q

Heart Sounds:

Mitral Valve - PMI

A

5th ICS to the left - MCL

S1 heard best here
S3 and S4 heard here in LLDP
left S/L with 1/4 turn downwards use bell of steth