Breath Sounds

Question 1

What are the three types of normal breath sounds?

Answer 1

Tracheal
vesicular
Bronchial

Question 2

Describe trachael breath sounds

Answer 2

Very loud and relatively high pitched.
Inspiration and expiration are equal in length.
Sounds are heard over trachea.

Question 3

Describe vesicular breath sounds

Answer 3

Soft and low pitched.
Inspiration sounds longer than expiration.
Heard over lungs

Question 4

Describe bronchial breath sounds?

Answer 4

Loud, high pitched, sounds close to stethoscope. There is a gap between inspiration and expiration.
Expiration sounds longer than inspiration and this is abnormal if heard elsewhere.
Heard over manubrium.

Question 5

Name the four abnormal/added breath sounds

Answer 5

Crackles
Wheeze
Pleural rub
Voice sounds

Question 6

Describe the abnormal sound of crackles

Answer 6

Sudden opening of small airways/alveoli that are stuck together by fluid.
There are fine crackles and coarse crackles
Crackles heard during early inspiration=large airways=?COPD.
Crackles heard during later inspiration=pneumonia, fibrosis and pulmonary odema.
Bubbly/gurgling sounds= air movement through secretions in larger airways.

Question 7

Describe the abnormal sound of a wheeze

Answer 7

High pitched and continous which is caused by the vibration of the walls of narrowed airway as air rushes through.
Wheeze is a sign of bronchospasm and increased WOB.
Monophonic wheeze (one single wheeze sound in breath)=single obstructed airway.
Polyphonic wheeze= (wheeze comes and goes within the breath) widespread disease: asthma, COPD, PE.

Question 8

Describe the abnormal sound of pleural rub

Answer 8

Inflammation of the pleural surface occurs in pleurisy which produces the sound of roughened surfaces rubbing on each other (boots crunching on the snow).
Important considerations:
- Chest drains on suction can affect sounds.
- Water in ventilator tubing or tube kinking can cause added sounds

Question 9

Describe the abnormal sound/added sound of voice sounds.

Answer 9

Vibrations of the spoken word can be felt by the hands (tactile fremitus).
Vibrations heard through stethoscope (say 99=vocal resonance).
If lung is consolidated or there is an atelectasis, they are heard more clearly through a denser medium (whisper 99).
Decreased voice sounds occur when there is an atelectasis with a blocked airway/pneumothorax/PE.