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Semester 5 PMCP Exam 2 > Breath Sounds > Flashcards

Breath Sounds Flashcards

1
Q

How do ventilation and airflow rate changes affect breath sound intensity

A

Intensity is increased with a bigger amount of air

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2
Q

With breath sounds, what are we listening to

A

Turbulence of air flowing into and out of the lungs

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3
Q

Louder in larger or smaller airways

A

Larger airways are louder, don’t hear as much in the smaller airways

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4
Q

What is best position for listening to breath sounds

A

Sitting up

Gravity is pressing on the alveoli when on side or laying down

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5
Q

How to have them breathe

A

In and out of mouth to get the most air in and out

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6
Q

Normal breath sounds

A

Bronchial
Bronchovesicular
Vesicular

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7
Q

Bronchial breath sounds are heard where

A

Around the neck/trachea

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8
Q

Bronchovesicular sounds are where

A

Around the main stem bronchi - these are the bigger airways

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9
Q

Vesicular sounds are heard where

A

periphery of the lung

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10
Q

Lungs go up to where and down to where

A

Up above clavice

Down to 7th/8th rib - below that will get bowel sounds

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11
Q

On the back side - what sounds do you hear

A

BV and V

There are no bronchial!

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12
Q

How many sounds on the front

A

11

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13
Q

How many sounds on the back

A

14

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14
Q

Overtime what is the goal with the breath sounds - should be able to get what in one breath

A

sounds 1-4 with one breath in and out because they are the same lobe

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15
Q

Where to start with breath sounds - sequence of it

A

Best to start on R, but dont have to

Would go R - L and then drop down L - R and so on

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16
Q

Which side goes down lower for breath sounds

A

R goes down lower because heart is on the left side

R has 3 lobes

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17
Q

Bronchial - normal breath sound - what will it sound like

A

break between inhalation and exhalation

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18
Q

BV sound - what will it sound like

A

Not as much of a break - equal amounts of time with inhalation and exhalation - little bit lower of a pitch

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19
Q

V sound - what will is sound like

A

Hear more inhalation rather than exhalation - air is not as turbulent coming out because it is more of a passive process to get air out of the lungs

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20
Q

Bronchial - what is the pitch

A

High pitched

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21
Q

Bronchial - sound is described as

A

Tracheal because of the position

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22
Q

Bronchovesicular pitch

A

High pitched - but lower than Bronchial

No pause

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23
Q

BV - heard best when

A

lung tissue is close to the surface - can have pt lean forward a little bit

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24
Q

Where is BV louder

A

Typically louder on the back because the front has girth and stuff

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25
Q

Which is louder BV sound - the right or the left

A

The right because of the main stem bronchi position - more vertical on the R so the air is louder and more turbulent
Remember this is normal for R BV to be a bit louder than L on the back

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26
Q

Vesicular - what is the sound

A 
softer sound (because smaller airways) 
Heard over the remaining peripheral lung
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27
Q

Vesicular - longer inhalation or exhalation

A

longer inhalation

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28
Q

Vesicular - special population

A

Infants and children have louder, harsher breath sounds because of their chest wall and airway being closer to the surface

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29
Q

How does the cardiac cycle affect normal breath sound intensity - louder with systole or diastole

A

Systole

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30
Q

Abnormal sounds

A

Bronchial
Decreased
Absent

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31
Q

Bronchial breath sounds - abnormal - occur in

A

peripheral lung tissue when it becomes airless - either partially or completely

32
Q

Bronchial breath sounds - abnormal - occur because of

A

obstruction from secretions or compression from an extrapulmonary source (fluid or tumor)

33
Q

Bronchial breath sounds - abnormal - AKA

A

tubular

34
Q

If someone has a glob of mucous stuck in their lung - what will happen with the sound

A

The bronchial breath sound will be loudest in that one spot because the consolidation is occupying a space and actually causes sound to be transmitted better

35
Q

What happens to the sounds around the area of consolidation

A

If big area - can lead to the rest of the lung being decreased or absent because it is blocking air from getting to those places
If small - can lead to areas that are decreased and others that are fine because some air is still making it through

36
Q

Pneumothorax - what happens

A

air pressing in - so it will be absent

37
Q

Pleural effusion - what happens

A

decreased or absent - now there is fluid in the lung

38
Q

Fluid in the lung and Increased air in the lung can both lead to

A

decreased or absent breath sound

But whatever is compressed will be louder n that one spot

39
Q

Decreased or absent breath sounds - can be caused by what

A

Internal pulmonary pathology or can be secondary to a nonpulmonary condition

40
Q

Examples of internal pulmonary pathology

A

Emphysema

Pulmonary fibrosis

41
Q

Examples of extrapulmonary pathology

A

Tumor

Neuromuscular weakness and deformities

42
Q

What happens with COPD patients - breath sounds

A

The alveoli in the bottom of the lung are collapsed so they are airless - absent breath sounds
Barrel chest
Nothing is pressing on it - so now bronchial sounds - it is just completely collapsed so sounds are absent

43
Q

Pulmonary fibrosis - what happens to breath sounds

A

Ca comes up and has fibrosed now so you might have the bronchial sounds, but if it is blocking something then it will be absent where the air is not getting to

44
Q

If blocking something - more solid =

A

transmitting your sound better in that specific area - bronchial sound

45
Q

If creating more air - or is airless =

A

absent or diminished

46
Q

Diaphragm paralysis - what happens

A

The diaphragm and lungs wont come down like they should when the pt inhales so you will have absent sounds there too - and because the lung is not expanding

47
Q

What happens with kyphosis

A

Kyphosis will squish the bottom so might have absent sounds at the bottom

48
Q

Absent or diminished breath sounds - related to

A 
Shallow breathing
Diaphragmatic paralysis
Airway obstruction
Pneumothorax
Pleural effusion
Obestiy
Hyperinflated lungs (COPD/Emphysema)
49
Q

Voice transmission - used when

A

need for further evaluation after having heard abnormal breath sounds either due to increased or decreased transmission

50
Q

Types of voice transmission

A

Egophany
Bronchophany
Whispered Pectoriloquy

51
Q

Egophany - having the patient say

A

e but it comes out a

This one is said to be good for pleural effusion detection

52
Q

Bronchophany - having the patient say

A

99 - hear 99 if abnormal, but if normal will sound muffled and low pitched

53
Q

Whispered pectoriloquy - having the patient

A

whisper 1, 2, 3

54
Q

Can you have more than one of the voice transmission sounds at a time

A

YES

55
Q

Adventitious breath sounds are what

A

extraneous noises produced over the bronchopulmonary tree

They are superimposed on normal breath sounds

56
Q

Adventitious breath sounds are indicative of what

A

an abnormal process or condition

57
Q

Classification of adventitious breath soudns

A

Crackle (rales)
Ronchi
Wheezes

58
Q

Crackles - description

A

Discontinuous, low pitched

59
Q

Crackles - heard primarily during

A

inhalation

60
Q

Crackles - thought that the sound is coming from the

A

airways snapping open

61
Q

Crackles - usually heard where

A

peripheral vesicular airway

62
Q

Rhonchi - description

A

low pitched, but continuous

63
Q

Rhonchi - occur during

A

inspiration and expiration

64
Q

Rhonchi - sounds like

A

snoring

65
Q

Rhonchi - associated with

A

obstructive process in the larger, more central airways

66
Q

Rhonchi compared to Crackles - location

A

Rhonchi more in bigger airway spots, crackles in smaller alveoli spots

67
Q

Wheezes - description

A

continuous but high pitched

68
Q

Wheezes occur during

A

expiration

69
Q

Wheezes are indicative of

A

bronchospasms

70
Q

Wheezes - if heard on inspiration might be from

A

air moving through secretions

71
Q

Example of when might hear wheezing

A

Asthmatic patient

Trouble getting air in

72
Q

What does wheezing sound like

A

Musical on expiration

73
Q

Pleural Friction Rub - heard where

A

lower lateral chest areas

74
Q

What does pleural friction rub sound like

A

Sounds like two pieces of leather being rubbed together

75
Q

Pleural friction rub occurs when

A

with each inspiration and expiration

76
Q

What is the sound with pleural friction rub coming from

A

the rubbing of the outer portion of the lung tissue with the pleural cavity - inflammatory process
Can be spontaneous, can come and go, can have it for long time

77
Q

Why is this information helpful to us

A

Exercise tolerance
Tx itnerventions
Reassessment
Goal setting

Semester 5 PMCP Exam 2 (6 decks)

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