Chapter Two: Auscultation and Olfaction Flashcards
What is auscultation?
It means listening the patient’s voice, breathing, belching, borborygmi, coughing, hiccups, sighing, sneezing, vomiting and language.
What is the clinical significance of auscultation?
Listening to the sounds and changes in the voice and breathing can help identify the thermal nature of pathogens as well as the excessive or deficient nature.
What does a loud volume with strong force generally indicate?
Heat, excess
What does a voice with soft volume and weak force indicate?
Cold, deficiency
What are the two aspects within the scope of listening?
- Listening to changes in speech and breathing. This includes listening to the volume (loud or soft), strength (strong or weak), clarity (clear or turbid), and rate (rapid or slow).
- Listening to abnormal sounds such as coughing or vomiting which are caused by pathological changes in the zang-fu organs.
Which parts of listening pertain to physiology?
Speech
Respiration
Which parts of listening pertain to pathology?
- Belching
- Borborygmi
- Coughing
- Hiccups
- Sighing
- Sneezing
- Vomiting
The normal voice reflects the _________ of Zang Fu organs and the sufficiency of ____ and ________.
Harmony; qi; blood
What are the phonic organs?
Lung (including larynx and vocal cords in TCM), throat, epiglottis, lips, tongue, teeth and nose.
Which Zang Fu organs are most closely related to the production of vocal sounds?
Lung and Kidney
What creates sound? What causes changes in voice? What is the Lung’s relation to the voice?
- Movements of qi create sound.
- Abnormal changes in qi result in changes of the voice.
- The lung is the gateway of the voice.
What organ is the root of source qi and also the root of the voice?
Kidney
What about the voice is directly related to the function of the kidney?
The volume of the voice.
Kidney is called the _____ of the ______.
root; voice
Stomach and Spleen are the _________ _____ of teh ___. The Stomach channel passes through the _____ and influences __________.
acquired; root; qi; throat; vocalization
What controls speech and the strength of the voice?
Gathering (zong) qi. Therefore SP/ST are related to the strength of the voice as they are responsible for gu qi which combines with qing qi to create zong qi.
Normal vocal sounds differ in what ways?
Volume, tone and clarity
What is the definition of pathological vocal sounds?
The voice loses its clarity and smoothness, leading to acute or chronic hoarseness, raspiness or a complete loss of voice (aphonia).
Abnormal vocalization is causes by a disorder of the ______ and ______ _____.
larynx, vocal cords
What are the three possible causes of pathological vocal sounds and what is their pathogenesis?
- Loss of moisture in the larynx and vocal cords may be due to an attack of exogenous dryness or a deficiency of Lung and Kidney yin. Yin deficiency can arise from chronic illness, aging, smoking, profuse sweating, bleeding or improper treatment.
- Loss of force and power to produce sound is caused by stagnation or qi and yang deficiency, which may result from emotional stress or chronic illness.
- Pathogens obstructing or lodged in the larynx and vocal cords, such as phlegm or blood stasis, which result from dysfunctions of the zang fu organs; or exogenous pathogens such as wind-heat or wind-cold.
What does a voice with loud volume indicate?
heat, excess
What does a voice with low volume that has a vague sound to it indicate?
exterior wind cold, dampness invasion
What does a voice with low volume indicate?
cold, deficiency
What are the two main categories of pathological vocalization?
- Hoarseness
- Aphonia
What are the four main TCM categories of hoarseness?
- Exterior syndrome
- Blood stagnation
- Phlegm heat
- Lung and Kidney Yin Xu
What are the primary and accompanying symptoms of hoarseness caused by exterior syndrome?
- Sudden onset, voice is low in ptich and raspy
- Chills and fever, sore or itchy throat, cough, floating pulse
What are the main and accompanying symptoms of hoarseness caused by blood stagnation?
- Chronic hoarseness with gradually increasing intensity
- Dry and sore throat, mass or nodule on neck, dry mouth without desire to drink, purple tongue
What are the main and accompanying symptoms of hoarseness caused by phlegm heat?
- Hoarseness with plum pit sensation, coughing
- Cough with thick yellow phlegm, severe sore throat or plum pit sensations, fever, red tongue with slippery rapid pulse
What are the main and accompanying symptoms for hoarseness caused by Lung and Kidney yin Xu?
- Chronic onset, gradually increasing intensity, worse in evenings
- Dry itchy throat with slight soreness, night sweats, dry cough without phlegm, thready pulse
