general inspection (palpation, percussion,ausculation)

Question 1

decreased TF

Answer 1

obstruction, pneumothorax, emphysema, hydrothorax / pleurisy

Question 2

increased TF

Answer 2

compression or consolidation of lung. pneumonia TB pul.fibrosis, pneumosclerosis thick chest wall

Question 3

three basic medical percussion sounds

Answer 3

resonant (pul over lung tissue): loud low pitched long non tympanic
tympanic (abdominal cavity) : loud low/high pitched long
dull( solid organs): quite high pitched short nontympanic

Question 4

decreased resonant

Answer 4

by decreased amount of air in lungs
gentler, shorter and higher than normal resonant
pneumosclerosis, stage and 1 3 of lobar pneumonia, pul.edema atelectasis

Question 5

dull resonant sound

Answer 5

consolidation of lungs
stage 2 of lobar pneumonia
tumor lung abscess before perforation infarction
fluid collection( pleural effusion empyema)

Question 6

hyperresonance

Answer 6

air collection in lung or chest
emphysema
louder lower longer

Question 7

tympanic sound over chest

Answer 7

pneumothorax big lung cavities in lung abscess / TB

Question 8

Breath sounds

Answer 8

produced by turbulent air flow
can be vesicular breath sound : soft low pitched gentle rustling quality. letter (F)
insp without pause into exp and fades away one third way. I>E
over lungs
bronchial breath sounds: louder longer higher
letter A
sharp gap between exp and insp. E>I
over manubrium trachea and neck

Question 9

factors influencing loudness of vesicular breath sounds

Answer 9

elasticity 
amount of alveoli 
speed of air filling the alveoli
duration of insp and exp
changes in the side of the chest wall, pleura and pleural cavity

Question 10

physiological decrease of vesicular breath sounds

pathological decrease of vesicular breath sounds

Answer 10

->thick chest wall in obesity(physiological)
-> increased air filled lungs:( emphysema ) flexibility and quantity of alveoli decreased
lung consolidation : when alveoli filled with fluid. pneumonia lung edema
decrease in air flow: chronic bronchitis and bronchial asthma and tumor
pneumofibrosis
normal lung displaced with air/fluid: pneumothorax pleural effusion
path of muscles, fracture of ribs dry pleurisy

Question 11

physiological and pathological increase of vesicular breath sound

Answer 11

physiological: thin chest, asthenic ,children, physical exertion
rough harsh breathing: louder higher exp longer than insp
due to partial obstruction of bronchus in acuute bronchitis bronchiectasi acute pneumonia

Question 12

pathological bronchial breath sound

Answer 12

heard over places where it is supposed be vesicular
airless lungs
consolidation of lungs: lobar pneumonia pneumothorax Tb lung cancer lung abscess

Question 13

adventitious sounds

Answer 13

extra additional sounds that are heard over normal breath sounds.
crackles (coarse, fine, atelectatic )
wheezes 
rhonchi
pleural rub
stridor

Question 14

crackles

Answer 14

fluid in small airways or atelectasis 
discontinuous sounds 
intermittent non musical brief 
more common in insp
popping sound when air forced through narrowed airways 
congestive HF
fibrotic lung disease 
obstructive lung disease 
pneumonia
bronchitis 
bronchiectasis 
healthy older person 
if does not clear after cough = ARSD +pul.edema

Question 15

atelectatic crackles

Answer 15

only in periphery disappear after cough
congestive- elderly
non infl fluid in alveoli

Question 16

fine crackles

Answer 16

soft high pitched brief
sudden opening and closing of airways
on alveoli
stage 1 3 of lobar pneumonia

Question 17

coarse crackles

Answer 17

louder low pitched last longer 
bubbling sound related to secretion in small bronchi 
infl. fluid in small bronchi
heard over both exp and insp
congestive HF

Question 18

wheezes

Answer 18

high pitched hissing musical wistling
insp +exp
cough may increase decrease or disappear
forced air through narrowed airways 
two types: diffused COPD
localized: bronchial obstruction 

bronchial asthma bronchitis COPD early stages of HF

Question 19

Rhonchi

Answer 19

low pitched continuous tonal
rupture of fluid films and airway wall vibrations 
disorders with increased secretions and decreased clearance of fluid 
ususally clears with cough
bronchitis 
bronchiectasis 
bronchocarcinoma 
bronchial asthma

Question 20

pleural rub

Answer 20

discrete sometimes numerous sounds
often in insp
cough does not change sound
infl pleural surfaces rubbing because of dry pleurisy or dehydration

Question 21

stridor

Answer 21

high pitch continuous heard over trachea

Question 22

increase bronchophony

Answer 22

lung infarctions
TB
compression atelectasis
lobar pneumonia

Question 23

decreased bronchophony

Answer 23

emphysema
pneumothorax
pleurisy
effusion

Question 24

egophony

Answer 24

e to a

consolidation, fluid filled, compressed lungs