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DPT 760 - Cardiopulmonary I > Auscultations: Heart and Lung Sounds > Flashcards

Auscultations: Heart and Lung Sounds Flashcards

1
Q

What is the purpose of the diaphragm and bell on a stethoscope?

A

a) Diaphragm: Identify high-pitched sounds.

b) Bell: Used to identify lower-frequency sounds such as atrial and ventricular gallops.

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2
Q

What are the main steps in heart auscultation?

A
  • listen over the 4 designated areas systematically
  • assess rate, rhythm, and for extra sounds or murmurs
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3
Q

What is the S1 heart sound and what does it signify?

A

S1 is the ‘lub’ sound, signifying the closure of the mitral and tricuspid valves and the onset of ventricular systole.

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4
Q

What is the S2 heart sound and what does it signify?

A

S2 is the ‘dub’ sound, signifying the closure of the aortic and pulmonary valves and the onset of ventricular diastole.

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5
Q

What causes the S1 heart sound?

A

The closure of the mitral and tricuspid valves.

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6
Q

What causes the S2 heart sound?

A

The closure of the aortic and pulmonary valves.

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7
Q

What is the characteristic difference between S1 and S2?

A
  • S1 has a lower pitch and longer duration.
  • S2 has a higher pitch and shorter duration.
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8
Q

What is an S3 heart sound?

A

S3 - An extra heart sound heard during early diastole, associated with increased ventricular compliance (can be normal in children).

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9
Q

What is an S4 heart sound?

A

S4 - An extra heart sound heard before S1, associated with atrial contraction into a stiff ventricle.

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10
Q

What conditions are associated with an S4 heart sound?

A
  • hypertension
  • hypertrophic heart disease
  • pulmonary disease
  • myocardial infarction
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11
Q

What is a ventricular gallop?

A

An S3 (lub-dub-dub / Ken-Tu-Cky)
heart sound, commonly found in ventricular failure.

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12
Q

What is an atrial gallop?

A

An S4 (la-lub-dub / Ten-Ne-See)
heart sound, associated with a stiff or hypertrophic ventricle.

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13
Q

What is a heart murmur?

A
  • A longer-duration sound caused by the disruption of blood flow, such as through a stenotic or regurgitant valve.
  • “Soft, blowing, or swishing”
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14
Q

What causes a systolic murmur?

A
  • Typically due to ejection or regurgitation between S1 and S2, heard as a ‘swishing’ sound.
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15
Q

What causes a diastolic murmur?

A

Caused by aortic or pulmonary regurgitation or mitral stenosis, heard immediately following S2.

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16
Q

What is a mitral valve prolapse?

A

A condition where the mitral valve does not close properly, causing a clicking sound during systole.

17
Q

What are vesicular breath sounds?

A

Soft, low-pitched sounds heard during inspiration over distal airways.

18
Q

What are bronchial breath sounds?

A

Loud, tubular sounds normally heard over the trachea, with a shorter inspiratory phase.

19
Q

What are bronchovesicular breath sounds?

A
  • softer than bronchial sounds
  • heard over the mainstem bronchi
  • continuous between inspiration and expiration
20
Q

Differences between diminished and absent breath sounds?

A

a) Diminished breath sounds: Breath sounds that are less intense than expected, often due to conditions like hyperinflation or obesity.

b) Absent breath sounds: No audible breath sounds, often due to lobectomy, morbid obesity, or pneumothorax.

21
Q

What does it mean when bronchial breath sounds are heard outside their normal location?

A

This indicates consolidation or compression of lung tissue, facilitating sound transmission.

22
Q

What are adventitious breath sounds?

A

Abnormal sounds such as crackles, wheezes, and pleural friction rubs.

  • Adventitious - “added sounds”
23
Q

What are crackles (rales)?

A

Discontinuous, high-pitched popping sounds, often associated with fluid or secretions in the lungs.

24
Q

What causes wet and dry crackles?

A
  • Wet: Conditions like pulmonary edema or pleural effusion, where fluid is present in the lungs.
  • Dry: Caused by the sudden opening of closed airways, seen in atelectasis or pulmonary fibrosis.
25
Q

What are wheezes?

A

Continuous high- or low-pitched sounds, often heard during exhalation, indicating airway obstruction.

26
Q

What are Rhonchi and Stridor?

A
  • Rhonchi: Low-pitched continuous sounds associated with mucus, common in chronic bronchitis or pneumonia.
  • Stridor: A severe, high-pitched wheeze heard in the upper airway, often due to obstruction and considered an emergency.
27
Q

What is pleural friction rub?

A

A sound resembling two pieces of leather rubbing together, associated with pleural inflammation.

28
Q

What is bronchophony?

A

Increased vocal resonance with greater clarity and loudness, indicating lung consolidation.

29
Q

What is egophony?

A

A form of bronchophony where the ‘E’ sound changes to a nasal ‘A’, indicating consolidation.

30
Q

What is whispered pectoriloquy?

A

Clearer, louder recognition of whispered words, indicating lung consolidation.

31
Q

How do you auscultate the lungs?

A
  • place the diaphragm on the chest wall
  • start at the apices
  • compare symmetrical points
  • listen to at least one full breath cycle
32
Q

What precautions should you take when performing lung auscultation?

A

Prevent patient dizziness, drape appropriately, and ensure deep breaths through the mouth.

33
Q

What are normal vesicular breath sounds?

A
  • soft, low-pitched sounds during inspiration with a 3:1 inspiration to expiration ratio.
34
Q

What are abnormal bronchial breath sounds?

A

Heard outside of the tracheal area, indicating conditions like consolidation or compression.

35
Q

What is the significance of diminished or absent lung sounds?

A

Diminished: Sounds less then what you would expect in the area

  • pain
  • not taking deep enough breath
  • hyperinflation/emphysema (lesser)
  • obesity (further away from chest wall d/t adipose tissue and harder to breath)

Absent: don’t hear anything

  • Lobectomy, nothing to hear
  • morbid obesity
  • mucus plugging has blocked airway completely
  • pneumothorax with air in space
36
Q

How can abnormal voice sounds help in diagnosis?

A

Increased vocal resonance, as in bronchophony or egophony, indicates consolidation or atelectasis.

37
Q

What is the significance of stridor in lung auscultation?

A

It indicates a life-threatening upper airway obstruction and requires immediate intervention.

38
Q

What is the difference between wet and dry crackles?

A
  • Wet crackles are due to fluid in the lungs
  • Dry crackles result from sudden airway opening.
39
Q

What is the purpose of lung auscultation?

A
  • to confirm findings from the chart
  • rule out dysfunction
  • assess ventilation after treatment

DPT 760 - Cardiopulmonary I (22 decks)

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