Heart and Lung sounds (exam 1) Flashcards
Where do u auscultate the superior lobes?
Bilat. chest, above nipples
or on sides right under bilat. armpits
where do u auscultate the middle lobe?
on the R side just lateral to nipple
on the R chest wall just medial to nipple
where do u auscultate the inferior lobes
on the middle back, bilaterally
on the bilateral sides towards the posterior around ribs 6-10ish area
how do u ask the patient to breath when ausculating?
open mouth
deeper and more forceful than normal
seated position
listen to one full breath at each location
what are normal breath sounds?
vesicular
bronchial
where do u hear vesicular sounds
all over lungs, not over trachea or manubrium or interscap. region
what do vesicular sounds sound like?
Looooong INHALE, short EXHALE
low pitch,
soft expiration
where do you hear bronchial sounds?
only over the trachea
what do bronchial sounds sound like?
short INHALE, Looooooooong Exhale
louder
higher pitched and
loud expiration
what do rhonchi sound like?
course rattling with EXHALATION
very clear, low pitched
abnormal
causes of rhonchi?
mucous
pneumonia, bronchitis, cystic fibrosis
what do rales sound like?
crackles fine rattling, non-continuous high pitched with INHALE abnormal like hair being rubbed together over your ear
causes of rales
fluid
PE, pneumonia, asthma
what does coughing do to rales?
makes them louder
What do wheezes sound like?
HIGH pitched whistle during INHALATION
abnormal
causes of wheezing
COPD
what does a pleural friction rub sound like?
saran wrap, LOUD
what is egophony?
have the patient say E, sounds like A to you as u aucultate
what is bronchophony?
patient says 99, u hear it very clearly while auscultating- u shouldn’t be able to hear it at all- sound is transmitted easily, denoting excess fluid on lungs
what is whispering pectorilquy?
patient whispers and u hear it plain as day, amplified in their lungs, denotes fluid.
hyperinflation causes auscultated sounds to be….?
softer than normal- air= poor conductor of sound
where can u listen to the apex of the heart beat?
patient lies on L side, place thumb on sternum and fingers across 5th intercostal
S1 heart sound
start of systole, AV valves closing and Semilunar valves opening
low pitched LUB
heard best at mitral area
S2 heart sound
End of sytole, Semilunar valves closing, AV valves open
high pitched DUB
heard best at aortic or pulmonary areas
S3 heart sound
abnormal!
vents filling up produce vibrations
lub-dub-da (tenn-e-see)
causes of S3 heart sound
CHF, lack of elasticity in already overstretched heart mm
what position can u put the patient in to accentuate S3 heart sound if you think you hear it but want to make sure?
L side lying
S4 heart sound
abnormal!
atrial contraction and accelerated rush of bllod into vents
ta-lub-dub (Ken-tuck-y)
causes of S4 heart sound?
L vent. hypertrophy
other abnormal heart sounds
heart murmor-da-ta-ta
pericarditis rub- rubbing, leather sound
