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Cardiopulmonary > Lung sounds > Flashcards

Lung sounds Flashcards

1
Q

where do lung sounds come from

A
  • Normal breath sounds are generated turbulent airflow in the trachea and large airways.
  • These sounds are comprised of high, medium and low frequencies
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2
Q

what are normal breath sound characteristics

A
  • heard all over chest wall
  • quieter at bases than apices
  • muffled due to filtering by the air in alveoli
  • expiration is shorter and quieter than inspiration with no pause in between
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3
Q

what are abnormal bronchial breath sounds

A

are tracheal and large airway sounds that have been transmitted though non-aerated (airless) lung tissue which does not attenuate the higher frequencies
-Bronchial Breath sounds (Br Br) are loud and high pitched, with a harsh quality

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4
Q

what are bronchial breath sounds heard

A
  • heard over an area of consolidated or collapsed lung

- are similar to those heard over the trachea itself

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5
Q

what do crackles sound like

A

Crackles are clicking sounds heard during inspiration

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6
Q

what causes crackles

A

-caused by the spanning-open of alveoli and small airways during inspiration or by air being forced through airways narrowed by oedema, secretions

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7
Q

what type of crackles would you hear in bronchiectasis

A

Coarse, early inspiratory crackles are heard in cases like bronchiectasis and bronchitis when bronchioles opens

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8
Q

what type of crackles are heard in pulmonary oedema/fibrosis

A

Fine, late crackles occur when alveoli and respiratory bronchioles open such as in pulmonary oedema and pulmonary fibrosis

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9
Q

what is a wheeze

A
  • sounds produced by airways on expiration primarily because the pressure gradient causes greater narrowing (inspiration too if more severe)
  • sound is made by airflow vibration in a narrow or compressed airway
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10
Q

how does obstruction affect wheeze

A
  • pitch of wheeze is directly proportional to degree of obstruction (higher pitch= more obstruction)
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11
Q

what is a polyphonic wheeze

A

many different sounds/pitches

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12
Q

What does a polyphonic wheeze indicate

A

indicates widespread airway narrowing/obstruction

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13
Q

what is a monophonic wheeze

A

caused by a single obstructed airway

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14
Q

what is whispering pectoriloquy

A

when you can hear the person’s whisper clearly though auscultation

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15
Q

what is whispering pectoriloquy indicative of

A
  • Associated with bronchial breath sounds
  • likely indicates an area of consolidation
  • Whispered speech lacks the lower frequencies and is normally not transmitted through the chest wall
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16
Q

what is a percussion note

A
  • elicited by tapping the chest wall

- resonant over normal tissue and dull over solid tissue

17
Q

what are percussion notes used to evaluate

A
  • density of underlying disease

- Hyper-resonance indicates excess air, a stony, dull sound indicates pleural effusion

18
Q

what are diminished breath sounds

A
  • Reduced sound generation due to increased attenuation (filtering)
  • Localised or global
19
Q

what could be the reason for globally diminished breath sounds

A
  • could be due to pain
  • muscle weakness
  • obesity
  • accumulation of fluid/air in the pleural space (increase in filtering)
  • emphysema
20
Q

what could be the reason for localised diminished breath sounds

A
  • sputum plugging with distal hyperinflation -

- obstruction of an airway by a tumour or sputum

21
Q

what is a pleural rub sound

A
  • sound made by inflamed pleural (visceral and parietal) rubbing together with friction
  • caused by infection or non-inflammatory via neoplasm
  • localised or generalised and ranges in volume
  • heard equally during inspiration and expiration, which helps differentiate pleural rub from crackles
22
Q

what are stridor lung sounds

A

o Loud, high pitch sound heard on inspiration
-heard on inspiration because the extra-pulmonary airways are subject to opposite pressure gradients than the intrapulmonary airways

23
Q

what are stridor breath sounds indicative of

A
  • Sign of upper airway obstruction.
  • Caused by turbulent airflow through a partially obstructed airway at the level of the supraglottis, glottis, subglottis or trachea
24
Q

anatomy of auscultation

A

LOOK AT NOTES FOR DIAGRAM

25
Q

what are some limitations to auscultation

A

 Inter-and intra-therapist/practitioner interpretation of lung sounds is poor
 Needs practise and a good quality stethoscope
 Not infallible; sounds may change very quickly
 Needs patient co-operation to generate sufficient flow rate

26
Q

what is the clinical significance of breath sounds/adventitious sounds

A
  • auscultation is one method of pre treatment

- abnormal breath sounds and adventitious sounds (wheeze etc) are indicative of pathology

27
Q

what sounds can be heard in asthma

A

• likely to hear expiratory and possibly inspiratory wheeze if severe, stridor

28
Q

what sounds can be heard in pneumonia

A

• may hear crackles, diminished breath sounds

29
Q

what sounds can be heard in pleuritis

A

-pleural rub

30
Q

what sounds can be heard in pneumothorax

A

• diminished breath sounds, bronchial breath sounds, hyper-resonant percussive sound

31
Q

what sounds can be heard in bronchitis

A

• crackles, diminished breath sounds, wheeze, occasionally stridor

32
Q

what sounds can be heard in bronchiectasis

A

crackles, wheeze

33
Q

what sounds can be heard in fracture

A

crunching

34
Q

Auscultation

A

READ NOTES

35
Q

when do you hear gurgling sounds

A

massive pulmonary oedema

36
Q

when do you hear crunching sounds

A

’s or dislocations

37
Q

causes of large airway noises

A
  • usually mucus in larger airways which clears after coughing
  • may be audible without auscultation
  • very loud sound heard all over chest
  • heard on inspiration and expiration
38
Q

how might a crackle vary (features of crackles)

A

pitch–> gives a clue to site and pathology
time–> very early crackles = coarse and loud- originate in large airways and usually clear with an effective cough. late crackles are from small airways and alveoli
number–> proportional to severity of disease (diffuse/widespread/scant)

39
Q

when might crackles occur

A

aged patient–> due to loss of elastic recoil and subsequent early airway closure during expiration
normal–> if preson breathes down to RV and airway closure occurs
-pulmonary oedema
-pulmonary fibrosis–> due to increased elastic recoil
-presence of expirations

Cardiopulmonary (4 decks)

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