Listening (Auscultation) Flashcards by Jonathan Bench | Brainscape

Q

Auscultation (definition)

A

It means listening to the patient’s voice, breathing, coughing, vomiting, belching, sneezing, and language

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Q

Auscultation

Clinical Signifigance:

A

Listening to the sounds and changes in the voice and breathing can help identify the thermal nature of the pathogens, and the excessive or deficient state of the antipathogenic qi.

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Q

Auscultation

Sound: Loud volume, strong force

Indication:

A

Auscultation

Sound: Loud volume, strong force

Indication: Heat, excess

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Q

Auscultation

Sound: Soft volume, weak force

Indication:

A

Auscultation

Sound: Soft volume, weak force

Indication: Cold, deficiency

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Q

Auscultation

Scope of Listening (list aspects)

A

Speech and Breathing

Abnormal Sounds

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Q

Auscultation

Scope of Listening- Speech and Breathing

A

This means listening to:

Volume (loud or soft)
Strength (strong or weak)
Clarity (clear or turbid)
Rate (rapid or slow)

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Q

Auscultation

Scope of Listening- Abnormal Sounds

A

ex. Coughing or vomiting

Pathological changes in the zang fu organs

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Q

Vocal Sounds - Zang Fu Relationships

Closest Organs Related to Vocalization (list)

A

Lung, Kidney

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Q

Vocal Sounds - Lung

Nickname:

Vocal Function:

A

Vocal Sounds - Lung

Nickname: Gateway of the Voice

Vocal Function: Governs the qi. Larynx and vocal
cords are part of the lung system and directly involved in the production of sound.

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Q

Vocal Sounds - Kidney

Nickname:

Vocal Function:

A

Vocal Sounds - Kidney

Nickname: Root of the Voice

Vocal Function: the root of source qi (yuán qì); controls the reception of qi. The volume of the voice
is directly related to the function of the Kidney.

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Q

Vocal Sounds - Stomach and Spleen

Nickname:

Vocal Function:

A

Vocal Sounds - Stomach and Spleen

Nickname: Strength of the Voice

Vocal Function: the acquired root of the qi.

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Q

Vocal Sounds - Clinical Significance

Voice Sound: Loud Volume

Indication:

A

Vocal Sounds - Clinical Significance

Voice Sound: Loud Volume

Indication: Heat, excess

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Q

Vocal Sounds - Clinical Significance

Voice Sound: Low Volume, Vague

Indication:

A

Vocal Sounds - Clinical Significance

Voice Sound: Low Volume, Vague

Indication: Exterior wind cold, dampness invasion

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Q

Vocal Sounds - Clinical Significance

Voice Sound: Low Volume

Indication:

A

Vocal Sounds - Clinical Significance

Voice Sound: Low Volume

Indication: Cold, deficiency

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Q

Vocal Sounds

Hoarseness (define):

A

Vocal Sounds

Hoarseness (define): voice and cough lose their clear
and smooth qualities

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Q

Vocal Sounds - Hoarseness

Description: Sudden onset, voice is low in pitch and raspy

Symptom:

Indication:

A

Vocal Sounds - Hoarseness

Description: Sudden onset, voice is low in pitch and raspy

Symptom: Chills and fever, sore or itchy throat, cough, floating pulse

Indication: exterior syndrome

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Q

Vocal Sounds - Hoarseness

Description: Chronic, with gradually increasing intensity

Symptom:

Indication:

A

Vocal Sounds - Hoarseness

Description: Chronic, with gradually increasing intensity

Symptom: Dry and sore throat, mass or nodule on neck, dry mouth without desire to drink, purple tongue

Indication: Blood stagnation

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Q

Vocal Sounds - Hoarseness

Description: Hoarseness with plum-pit sensation coughing

Symptom:

Indication:

A

Vocal Sounds - Hoarseness

Description: Hoarseness with plum-pit sensation coughing

Symptom: cough with thick yellow phlegm, severe sore throat or plum pit sensation, fever red tongue with slippery rapid pulse

Indication: phlegm heat

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Q

Vocal Sounds - Hoarseness

Description: Chronic onset, gradually increasing intensity, worse in evening

Symptom:

Indication:

A

Vocal Sounds - Hoarseness

Description: Chronic onset, gradually increasing intensity, worse in evening

Symptom: dry itchy throat with slight soreness, night sweats, dry cough without phlegm, thready pulse

Indication: Lung and kidney yin deficiency

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Q

Vocal Sounds

Aphonia (define):

A

Vocal Sounds

Aphonia (define): a condition in which one is unable to produce vocal sounds, also called “loss of voice”

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Q

Vocal Sounds

Aphonia (general classifications):

A

Tongue disorder- aphonia due to lack of free tongue movement. The voice is normal and can produce sound. This is not true aphonia

Throat disorder- the tongue movement is normal, but vocal sounds cannot be produced

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Q

Vocal Sounds - Aphonia

Classification: Tongue Disorder (Wind Stroke)

Indications:

Prognosis:

A

Vocal Sounds - Aphonia

Classification: Tongue Disorder (Wind Stroke)

Indications: Exogenous or Endogenous Pathogen

Prognosis: –

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Q

Vocal Sounds - Aphonia

Classification: Throat Disorder (Acute)

Indications:

Prognosis:

A

Vocal Sounds - Aphonia

Classification: Throat Disorder (Acute)

Indications: Exopathogenic Factor

Prognosis: Curable

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Q

Vocal Sounds - Aphonia

Classification: Throat Disorder (Chronic)

Indications:

Prognosis:

A

Vocal Sounds - Aphonia

Classification: Throat Disorder (Chronic)

Indications: Endopathogenic Factor

Prognosis: Difficult to Cure

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Q

Vocal Sounds - Aphonia

Classification: Throat Disorder (Remark)

Indications:

Prognosis:

A

Vocal Sounds - Aphonia

Classification: Throat Disorder (Remark)

Indications: Pregnancy Aphonia - temporary condition

Prognosis: –

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Q

Speech

Organ most directly related to speech

A

Heart

Speech is the voice of the heart; the heart controls speech

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Q

Pathological Speech - Dysarthria

Define:

A

Difficult, poorly articulated speech, difficult to understand, e.g., slurring

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Q

Pathological Speech - Aphasia

Define:

A

Impaired expression or comprehension of written or spoken language

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Q

Pathological Speech - Dysarthria

Etiology:

Pathogenesis

A

Pathological Speech - Dysarthria

Etiology: disorder of the tongue

Pathogenesis: pathological changes of the spirit

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Q

Pathological Speech - Aphasia

Etiology:

Pathogenesis

A

Pathological Speech - Aphasia

Etiology: disorder of the tongue

Pathogenesis: pathological changes of the spirit

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Q

Pathological Speech - Variations

Speech: Taciturn (silent or dislike of speaking)

Indication:

A

Pathological Speech - Variations

Speech: Taciturn (silent or dislike of speaking)

Indication: Cold, deficiency

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Q

Pathological Speech - Variations

Speech: Persistent talking

Indication:

A

Pathological Speech - Variations

Speech: Persistent talking

Indication: Excess, heat

Q

Pathological Speech - Abnormal Speech

Categories (list):

A

Indistinct Speech

Incoherent Speech

Q

Pathological Speech - Indistinct Speech

Definition:

Pathogenesis:

Indications:

A

Pathological Speech - Indistinct Speech

Definition: broken speech, a hard, inflexible tongue, or slurred speech with unclear words and a soft voice which makes it difficult to be understood

Pathogenesis: tongue body lacks nourishment due to wind-phlegm or blood stasis obstructing the channels and collaterals of the tongue, or there is an insufficiency of body fluids.

Indications: wind-phlegm or blood stasis obstructing the channels and collaterals; yin impairment due to febrile disease

Q

Pathological Speech - Incoherent Speech

Definition:

Pathogenesis:

Indications:

A

Pathological Speech - Incoherent Speech

Definition: speech that is unable to express or convey thought. It is spoken without thinking and cannot be controlled. It is often found in a patient who also displays abnormal mental behavior (Spirit disturbance), unclear consciousness, or loss of consciousness.

Pathogenesis: failure of the Heart to store the Spirit.

Indications: Lack of Spirit, or Spirit been disturbed

Q

Classified Abnormal Speech

List:

A

Raving (kuáng yán)
Muttering (diän yû)
Soliloquies (dú yû)
Wrong speech (cuò yû)
Delirium (zhän yû)
Faint murmuring (zhèng shëng)

Q

Respiration

Description:

A

Process by which the human body exchanges turbid qi (zhuó qì) for clear qi (qïng qì) through the act of exhalation and inhalation.

Respiration exchanges and renews qi to ensure the proper functioning of all the body’s physiological processes, which require qi.

Q

Pathological Respiration

Definition:

Pathogenesis:

Indications:

A

Pathological Respiration

Definition: Abnormal respiration is the external manifestation of pathological changes in the Lung. Respiration changes in rate, rhythm, smoothness, strength, and sound quality (clear or turbid)

Pathogenesis: Exopathogens obstruct the Lung qi; Lung and Kidney qi deficiency

Indications: –

Q

Pathological Respiration

Clinical Significance:

A

Listening to the sound of respiration can help identify the thermal nature (hot or cold) of the pathogens and the excessive or deficient nature of the antipathogenic qi.

Q

Pathological Respiration

Respiration Sound: Loud, Harsh, Rapid

Indications:

A

Pathological Respiration

Respiration Sound: Loud, Harsh, Rapid

Indications: Heat Excess

Q

Pathological Respiration

Respiration Sound: Weak, Deep, Slow

Indications:

A

Pathological Respiration

Respiration Sound: Weak, Deep, Slow

Indications: Cold, Deficiency

Q

Pathological Respiration

Respiration Sound: Deep Breathing

Indications:

A

Pathological Respiration

Respiration Sound: Deep Breathing

Indications: Excess qi in the Heart and Lung

Q

Pathological Respiration

Respiration Sound: Weak Breathing

Indications:

A

Pathological Respiration

Respiration Sound: Weak Breathing

Indications: Deficiency of both the Liver and Kidney

Q

Pathological Respiration

Respiration Sound: Rough Respiration with Rapid Exhalation and Slow Inhalation

Indications:

A

Pathological Respiration

Respiration Sound: Rough Respiration with Rapid Exhalation and Slow Inhalation

Indications: Heat, excess, exogenous disease due to excessive pathogen

Q

Pathological Respiration

Respiration Sound: Faint Respiration with Slow Exhalation and Inhalation

Indications:

A

Pathological Respiration

Respiration Sound: Faint Respiration with Slow Exhalation and Inhalation

Indications: Deficiency, chronic endogenous disease

Q

Abnormal Respiration

List:

A

Asthma
Wheezing
Upper stifling breath
Shortness of breath
Shortage of qi

Q

Abnormal Respiration - Asthma

Define:

Pathogenesis:

A

Abnormal Respiration - Asthma

Define: also called “panting,” respiration is difficult, short, and rapid. There is a sense of tightness, congestion, breathlessness, or constriction in the chest with difficulty inhaling. In severe cases, the patient gasps for breath with his mouth open, lifting his shoulders and flaring his nostrils to assist in respiration. During an attack, the patient is unable to lie flat.

Pathogenesis: Lung qi failure to descend

Q

Abnormal Respiration - Asthma
Acute Onset

Symptom:

Indication:

A

Abnormal Respiration - Asthma
Acute Onset

Symptom: deep and long breathing, relieved by exhalation; harsh and loud sound of breath. Patient prefers supine position when laying down, protruding eyes, accompanied with cough and phlegm, strong body movements and breathing, forceful pulse

Indication: Excess

Q

Abnormal Respiration - Asthma
Chronic and Gradual Onset

Symptom:

Indication:

A

Abnormal Respiration - Asthma
Chronic and Gradual Onset

Symptom: short, shallow, and difficult breathing, relieved by inhalation; soft and weak voice, induced or aggravated by exertion

Indication: Deficiency

Q

Abnormal Respiration - Wheezing

Define:

Pathogenesis:

A

Abnormal Respiration - Wheezing

Define: respiration is rapid and makes a whistling sound. Recurrent attacks are likely. This condition is difficult to cure.

Pathogenesis: Lung qi fails to descend, with phlegm obstruction.

Q

Abnormal Respiration - Wheezing
Wheezing with Rapid Respiration

Symptom:

Indication:

A

Abnormal Respiration - Wheezing
Wheezing with Rapid Respiration

Symptom: Loud heavy and rough sound. occurs during summer or fall, and is induced by hot and dry weather.

Indication: Heat

Q

Abnormal Respiration - Wheezing
Wheezing with Short Inconsistent Respiration

Symptom:

Indication:

A

Abnormal Respiration - Wheezing
Wheezing with Short Inconsistent Respiration

Symptom: Aggravated by exertion. Occurs during winter or spring, and is induced by cold and damp weather

Indication: Cold

Q

Abnormal Respiration - Upper Stifling Breath

Define:

Pathogenesis:

A

Abnormal Respiration - Upper Stifling Breath

Define: Respiration is rapid, exhalation more evident than inhalation, and may be accompanied by shortness of breath and edema of the face and eyes.

Pathogenesis: Lung qi rises upward to the throat and obstructs the air tract.

Q

Abnormal Respiration - Upper Stifling Breath
Harsh, Rapid Respiration

Symptom:

Indication:

A

Abnormal Respiration - Upper Stifling Breath
Harsh, Rapid Respiration

Symptom: Difficult breathing with rattling sound in throat. stifling sensation in chest, relieved with exhalation or sitting, worse when lying down

Indication: Excess

Q

Abnormal Respiration - Upper Stifling Breath
Short and Rapid Respiration

Symptom:

Indication:

A

Abnormal Respiration - Upper Stifling Breath
Short and Rapid Respiration

Symptom: Dry cough or phlegm that is difficult to expectorate

Indication: Deficiency

Q

Abnormal Respiration - Shortness of Breath

Define:

Pathogenesis:

A

Abnormal Respiration - Shortness of Breath

Define: Respiration is inconstant, shallow, and rapid without sounds. It is like asthma, but without lifting the shoulders to breathe.

Pathogenesis: Lung qi deficiency.

Q

Abnormal Respiration - Shortness of Breath

Symptom: Cough with white water sputum, stifling
sensation in the chest

Indication:

A

Abnormal Respiration - Shortness of Breath

Symptom: Cough with white water sputum, stifling
sensation in the chest

Indication: Water retention in the chest

Q

Abnormal Respiration - Shortness of Breath

Symptom: Low energy, spontaneous sweating, frequent cold, teeth mark tongue

Indication:

A

Abnormal Respiration - Shortness of Breath

Symptom: Low energy, spontaneous sweating, frequent cold, teeth mark tongue

Indication: Lung qi deficiency

Q

Abnormal Respiration - Shortage of Qi

Define:

Pathogenesis:

A

Abnormal Respiration - Shortage of Qi

Define: respiration is feeble and short. It is difficult to produce the sound required for speech, but otherwise the breathing sounds normal.

Pathogenesis: antipathogenic qi insufficiency is a systemic deficiency in which all of the zang fu organs are in a state of hypofunction.

Q

Abnormal Respiration - Shortage of Qi

Symptom:

Indication:

A

Abnormal Respiration - Shortage of Qi

Symptom: –

Indication: antipathogenic qi insufficiency

Q

Cough

Define:

A

Cough is a common symptom arising from pathological changes of the Lung. Expelling air from the Lung suddenly and noisily keeps the respiratory passages free of irritating material (phlegm or other).

Therefore, cough not only suggests pathological changes, but is also a response for self-protection.

Q

Cough

Pathogenesis:

Clinical Significance:

A

Cough

Pathogenesis: spasmodic contraction of the thoracic cavity causes the Lung qi to ascend, leading to a sudden closing of the glottis which produces the sound of coughing

Exopathogens attack
Internal organs dysfunction
Lung qi and yin deficiency

Clinical Significance: the sound of the cough can help one determine the cause (etiology) and thermal nature of the disease.

Q

Cough
Acute onset

Symptom:

Indication:

A

Cough
Acute onset

Symptom: harsh, coarse, or hacking, choking cough, and loud cough, daytime worse than night time

Indication: Exterior

Q

Cough
Chronic Recurrent Onset

Symptom:

Indication:

A

Cough
Chronic Recurrent Onset

Symptom: chronic recurrent onset, cough with loud coarse sound, cough may worse in the morning of after meal with rattling loose sound

Indication: Interior (Excess)

Q

Cough
Chronic Cough

Symptom:

Indication:

A

Cough
Chronic Cough

Symptom: feeble and weak sound, worse in the afternoon and evening

Indication: Interior (Deficiency)

Q

Sneezing

Define:

A

Sneezing

Define: a sneeze is an autonomic, convulsive expulsion of air from the nose and mouth. In TCM theory, sneezing is the sound caused by Lung qi suddenly flowing upward through the throat and nose. It is a clinical manifestation of yang qi that is stimulated to brace up to pathogens. Sneezing is not only a pathological change, but a response for self-protection.

Q

Sneezing

Pathogenesis:

Clinical Significance:

A

Sneezing

Pathogenesis: the Lung qi suddenly flows upward through the nose and throat, causes sneezing

Exogenous pathogens attacking the Lung
Insufficient Lung qi.

Clinical Significance: the sound of the sneezing can help one assess the thermal nature of the pathogenic factor as well as the state of the antipathogenic qi. It also helps in forming a prognosis for the disease.

Q

Sneezing

Symptom: Acute onset, constant loud sound

Indication:

A

Sneezing

Symptom: Acute onset, constant loud sound

Indication: Heat, Excess

Q

Sneezing

Symptom: Chronic frequent attack, soft volume

Indication:

A

Sneezing

Symptom: Chronic frequent attack, soft volume

Indication: Lung qi deficiency

Q

Sneezing

Symptom: Sudden sneezing in critical stage of chronic illness

Indication:

A

Sneezing

Symptom: Sudden sneezing in critical stage of chronic illness

Indication: yang qi recovery, improvement in disease state

Q

Sneezing

Symptom: Sneezing due to external stimulation

Indication:

A

Sneezing

Symptom: Sneezing due to external stimulation

Indication: Normal

Q

Vomiting

Define:

A

Vomiting

Define: vomiting (or emesis) is the forceful expulsion of the contents of the stomach through the mouth.

Q

Vomiting (Define):

Vomiting:

Silent Vomiting:

Retching:

A

Vomiting (Define):

Vomiting: emesis with sound and vomitus

Silent Vomiting: emesis without sound but with vomitus

Retching: emesis with sound but no vomitus or scanty fluid

Q

Vomiting

Pathogenesis:

Clinical Significance:

A

Vomiting

Pathogenesis: rebellious Stomach qi forces the Stomach contents out through the mouth.

Qi, food or phlegm obstruct the Stomach
Spleen and stomach deficiency

Clinical Significance: the sounds accompany the vomiting can help one determine the thermal nature of the pathogen or disease, and whether it is excessive or deficient.

Q

Belching

Define:

A

Belching

Define: also known as eructation, burping, or rectus. It is a normal process to relieve distention from the air that accumulates in the Stomach.

Q

Belching

Pathogenesis:

Clinical Significance:

A

Belching

Pathogenesis: rebellious Stomach qi makes a sound when flowing through the throat.

Qi, food or phlegm obstruct the Stomach
Spleen and stomach deficiency

Clinical Significance: the sound of the belching can help one distinguish whether the pattern is excessive or deficient in nature.

Q

Belching

Symptoms: long, loud, and tight sound

Indication:

A

Belching

Symptoms: long, loud, and tight sound

Indication: Excess

Q

Belching

Symptoms: Low volume, feeble, short sound

Indication:

A

Belching

Symptoms: Low volume, feeble, short sound

Indication: Deficiency