Breath sounds

Question 1

Normal breath sounds

Answer 1

• Bronchial: over manubrium
  
  • Vesicular: over lungs
    Bronchovesicular: around 1st and 2nd intercostal space

Question 2

Abnormal breath sounds

Answer 2

1. Decreased or absent breath sounds
2. Bronchial breathing or bronchovesicular sounds in in unexpected areas
3. Extraneous sounds produced over bronchopulmonary screen
   - Crackles
   - Wheezing
   - Rhonchi
   - Pleural friction
   - Stridor

Question 3

Crackles

Answer 3

discontinuous rattling or clicking sounds
i. Early inspiration: indicate air passing through secretion
ii. Late inspiratory crackles: indicate opening or clolsed alveoli and airwyas (atrelectasis)

Question 4

Wheezing

Answer 4

narrowed airways (bronchospasm, secretions)
i. Continuous musical quality sound
ii. Usually high pitched (squeaking)
iii. More so during expiration (inspiration and expiration indicate more severe narrowing)

Question 5

Rhonchi

Answer 5

Similar to wheeze but low pitches (like snoring)
i. Occurring during inspiration and expiration
ii. Indicate obstruction of larger airways

Question 6

Pleural friction

Answer 6

Due to pathology affecting the pleura (inflammation)
i. Creaking or grating sound (like leather rubbing on leather)
ii. Heard at end of inspiration and beginning of expiration
iii. Localized to particular wall of the chest wall

Question 7

Stridor

Answer 7

musical wheeze heard over trachea or larynx during inspiration
i. Indicates obstruction in upper airway
ii. May be medical emergency

Question 8

Charting breath sounds

Answer 8

• Type of breath sounds
  ○ Normal/decreased/absent, bronchial or adventitious
• Timing of respiratory cycle
  ○ E.g. end inspiratory
• Location on the chest wall/side
• Changes after PT treatment