Breath and Lung Sounds

Question 1

What to do when listening to breath sounds?

Answer 1

• compare bilaterally

- auscultate full respiratory cycle at each site

Question 2

Normal Breath Sounds

Answer 2

• bronchial
• bronchovesicular
• vesicular

Question 3

Normal Breath Sounds: Bronchial

Answer 3

produced by air moving through the trachea
-Heard Best:
> Anteriorly: over the trachea
> Posteriorly: below the nape of the neck
-Description: blowing, hallow sounds; inspiration is shorter than expiration and lower pitched

Question 4

Where are Bronchial Sounds are heard best?

Answer 4

• Anteriorly: over the trachea

- Posteriorly: below the nape of the neck

Question 5

Description of Bronchial Sounds

Answer 5

blowing, hallow sounds

-inspiration is shorter than expiration and lower pitched

Question 6

Normal Breath Sounds: Bronchovesicular

Answer 6

produced by air moving through the bronchial airways
-Heard Best
>Anteriorly: over the 1st and 2nd ICS adjacent to the sternum anteriorly
>Posteriorly: over the scapula posteriorly
-Description: medium pitched, medium intensity, blowing sounds; inspiration and expiration are equal length and similar pitch

Question 7

Where are Bronchovesicular sounds heard best?

Answer 7

• Anteriorly: over the 1st and 2nd ICS adjacent to the sternum anteriorly
• Posteriorly: over the scapula posteriorly

Question 8

Description of Bronchovesicular Sounds

Answer 8

medium pitched, medium intensity, blowing sounds

-inspiration and expiration are equal length and similar pitch

Question 9

Normal Breath Sounds: Vesicular

Answer 9

produced by air moving through the smaller airways

• Best heard: over the lung fields
• Description: soft, low-pitched, breezy sounds; inspiration is longer, louder, and higher-pitched than expiration

Question 10

Where is Vesicular Sounds heard best?

Answer 10

over the lung fields

Question 11

Description of Vesicular Sounds

Answer 11

soft, low-pitched breezy sounds

-inspiration is longer, louder, and higher-pitched than expiration

Question 12

Abnormal Breath Sounds (Adventitious)

Answer 12

• Crackles/ Rales
• Rhonchi
• Wheezes
• Stridor
• Friction Rub
• Grunting

Question 13

Adventitious Breath Sounds: Crackles/Rales

Answer 13

caused by air bubbling through moisture in alveoli

• characteristics: bubbling, crackling, popping, soft, high-pitched, and very brief sounds
• usually heard through inspiration

Question 14

Crackles/ Rales Characteristics

Answer 14

bubbling, crackling, popping, soft, high-pitched, and very brief sounds
-usually heard through inspiration

Question 15

What Conditions would you find Crackles/ Rales?

Answer 15

-pneumonia, congestive heart failure (CHF), bronchitis, and emphysema

Question 16

Adventitious Breath Sounds: Rhonchi

Answer 16

caused by mucous secretions in the large airways

• characteristics: coarse, snoring, continuous low-pitched sounds heard during inspiration and expiration
• may clear with coughing

Question 17

Rhonchi Characteristics

Answer 17

coarse, snoring, continuous low-pitched sounds heard during inspiration and expiration
-may clear with coughing

Question 18

What Conditions would you find Rhonchi?

Answer 18

bronchitis, emphysema, narrowed airways, and fibrotic lungs

Question 19

Adventitious Breath Sounds: Wheezes

Answer 19

caused by narrowing of small airways by spasm, inflammation, mucous, or tumor
-characteristics: high-pitched musical or squeaking sounds heard during inspiration or expiration

Question 20

Wheezes Characteristics

Answer 20

high-pitched, musical or squeaking sounds heard during inspiration or expiration

Question 21

What Conditions would you find Wheezes?

Answer 21

acute asthma, emphysema

Question 22

Adventitious Breath Sounds: Stridor

Answer 22

caused by a partial upper airway obstruction or tracheal or laryngeal spasm

• need immediate medical examination
• characteristics: high-pitched, continuous honking sounds heard throughout the respiratory cycle but most prominent on inspiration

Question 23

Stridor Characteristics

Answer 23

high-pitched, continuous honking sounds heard throughout the respiratory cycle but most prominent on inspiration

Question 24

What Conditions would you find stridor?

Answer 24

acute respiratory distress, foreign body in airway, epiglottitis

Question 25

Adventitious Breath Sounds: Friction Rub

Answer 25

caused by rubbing together of inflamed pleural layers

• characteristics: a high-pitched grating or rubbing sound that may be heard throughout the respiratory cycle
• loudest over lower lateral anterior surface

Question 26

Friction Rub Characteristics

Answer 26

high-pitched grating or rubbing sound that may be heard throughout the respiratory cycle
-loudest over lower lateral anterior surface

Question 27

What Condition would you find Friction Rub?

Answer 27

pleuritis

Question 28

Adventitious Breath Sounds: Grunting

Answer 28

retention of air in the lungs

-characteristics: a high-pitched tubular sound heard on expiration

Question 29

Grunting Characteristics

Answer 29

a high-pitched tubular sound heard on expiration

Question 30

What Condition would you find Grunting?

Answer 30

emphysema

Question 31

Stertor

Answer 31

“death rattle”

• labored breathing that produces a snorting sound
• common with mouth breathing due to nasal congestion