LUNG SOUNDS

Question 1

o Discontinuous, nonmusical

o Can be heard early inspiratory (COPD); late inspiratory (Pulmonary Fibrosis); or biphasic (Pneumonia)

Answer 1

Crackles

Question 2

name this type of crackle?

▪ Softer, higher pitched, shorter duration and more frequent per breath than coarse crackles
▪ Usually mid to late inspiration
▪ Change according to body position
▪ Causes include: pulmonary fibrosis, interstitial lung diseases (interstitial fibrosis & interstitial pneumonitis)

Answer 2

Fine Crackles

Question 3

name this type of crackle?

▪ Appear early in inspiration and last throughout expiration (biphasic)
▪ Can be heard over any lung region, and do not change with body position (unlike fine crackles)
▪ Longer duration and lower frequency than fine crackles
▪ Change or disappear with coughing and are transmitted to the mouth
▪ Causes include: COPD, asthma, bronchiectasis, pneumonia and heart failure

Answer 3

Coarse Crackles

Question 4

o Discontinuous, low frequency, grating sound
o Comes from inflammation and roughening of visceral pleura as it slides along parietal pleura
o Biphasic (heard in inspiration and expiration).
o Best heard in axilla and base of lungs

Answer 4

Pleural Rub

Question 5

o Series of precordial crackles that are synchronous with heart beat (not respiration)
o Best heard in left lateral position
o Comes from air entering mediastinum → mediastinal emphysema (pneumomediastinum)
o Causes severe chest pain
o Has been reported with: tracheobronchial injury, blunt trauma, pulmonary disease, recreational drugs, childbirth and rapid ascent from
scuba diving

Answer 5

Mediastinal Crunch

Question 6

o Continuous musical sounds
o Occur during rapid airflow when bronchial airways are narrowed almost to closure
o Can be inspiratory expiratory, or biphasic
o May or may not be localized depending on cause
o Typical of asthma and common in multiple pulmonary diseases

Answer 6

Wheeze

Question 7

▪ Variant of a wheeze, but lower pitched

▪ Unlike wheeze, may disappear with cough so secretions may be involved

Answer 7

Rhonchi

Question 8

o Continuous, high frequency, high pitched musical sound
o Produced by airflow through narrowing in upper respiratory tract
o Best heard over neck during inspiration, but can be biphasic
o Causes include: trachea stenosis from intubation, airway edema after device removal, epiglottis, foreign body, and anaphylaxis
o Immediate Intervention is warranted

Answer 8

Stridor