Lung Auscualtion Flashcards
Describe the characteristics of bronchial breath sounds
- Relatively high pitch, which makes them more easier to hear
- The expiratory phase is long (as long as inspiration)
- There’s a teeny gap between inspiration and expiration
What are bronchial breath sounds?
The sound air makes when flowing through a tube
What are vesicular breath sounds?
They are filtered sounds due to the little air-filled vesicles (alveoli)
Describe the characteristics of vesicular breath sounds.
- lower frequency, which makes them harder to hear
- The expiratory phase is short
- There is no silent pause
True or False: It is normal to hear bronchial sounds in the neck and over the lungs.
False; bronchial breath sounds are only to be heard over the neck. They’re not supposed to be heard anywhere else. Remember, the normal chest is supposed to contain alveolar air that transform the sound into vesicular breath sounds.
If you hear bronchial breath sounds over the lungs, what does this indicate?
The alveolar sacs have either collapsed or have filled with fluid (e.g. blood, pus, or pulmonary edema)
True or False: Crackles are very important findings. Their presence is always significant.
True.
Describe crackle sounds.
- “Discontinuous”
- Does not have any musical characteristics; they’re just noises
- Normally heard on inspiration
What are the 3 different types of crackles and their possible indication?
- Early inspiratory crackles- bronchitis
- Mid inspiratory crackles- Bronchiectasis
- Late inspiratory crackles- There’s either scarring of the lung tissue (pulmonary fibrosis) or there is fluid (blood, pus, or serum).They can indicate pulmonary hemorrhage, pneumonia, or pulmonary edema.
What is the mechanism of early inspiratory crackles?
Generalized by air flowing through large central bronchi covered in secretions. The mixing go the air and secretion creates a bubbling noise. They are low pitched and typically called “course” crackles. These often clear with coughing.
What is the mechanism of mid inspiratory crackles?
These are neither high- nor low- pitched. They come from inflamed, partiality dilated medium sized bronchi.
What is them mechanism of late inspiratory crackles?
These come from small, distal airways that are partially collapsed. They are collapsed because of high interstitial pressure. When the client takes a deep breath, the pressure in the airway increases and pushes open the bronchiole, causing a popping or crackling noise. These sounds resemble the undoing of velcro. They are fine and high-pitched.
Describe a wheeze.
Wheezes are high-pitched, typically expiratory, and are longer than 250 milliseconds.
What causes wheezes?
When air flows rapidly through a narrow airway a sucking effect is created on the airway wall. This causes the airway to flutter
Why is it said to “Beware the silent asthmatic”
It’s not necessarily the diameter of the airway that causes wheezes, it’ the speed of the air.
This is why asthmatics on the brink of respiratory might not wheeze. It may mean that air isn’t moving.
Is wheezing sensitive and specific? Why or why not?
It is not. Normal clients may wheeze while you auscultate their lungs if you have them exhale with too much force. So if you not everyone that wheezes has asthma
True or False: Wheezes are only on expiratory.
False; wheezes can be heard on inspiratory and expiratory or just expiratory. They never just inspiratory.
What do you call a wheeze that you hear just on inspiration?
Stridor
What causes stridor?
It is the result of closing (adduction) of the vocal cords.
What are the characteristics of rhonchi?
- Similar to a wheeze
- They last longer than 250 milliseconds and have a musical quality
- Lower pitch than a wheeze.
- They have a snoring (sonorous) quality to them
What is rhonchi caused by?
They are often caused by thick secretions that narrow the airway.
*They can be diffuse (heard over several places of the lungs) but often times they are localized
