Lungs volume and sounds Flashcards
auscultation of lung sounds
- plcae the diaphragm of tehstethoscope in firm contact with the pt’s unclothed chest wall
- start at the apices and work downward, comparing symmterical points sequentially
- have the patient breathe in and out through the mouth, a little deeper than normal
- listen to at least one cycle of ins[iration and expiration in each pulmonary segment
tracheal and bronchial sounds
- loud tubular sounds normally heard over the trachea
- inspiratory phase is shorter than the expiratory phase and there is a slight pause between them
abnormal bronchial sounds
- heard over distal airways are abnormal and represent consolidation or compression of lung tissue that faciliates transmission of sound
vesicular breath sounds
- high pitched, breezy sounds normally heard over the distal airways in healthy lung tissue
- inspiratory phase is longer than expiratory phase and there is no pause between them
adventitious breath sounds
- abnormal breath sounds heard with inspiration and/or expiration that can be continuous of discontinuous
crackle (formerly rales)
- abnormal, discontinuous high pitched popping sound heard more often during inspiration
- may be associated with restrictive or obstructive respiratory disorders
- often heard in teh bases of lungs with interstitial lung disease, atelectasis pneumonia, bronchiectasis and pulmonary edema
- pulmonary edema may produce fine crackles as air bubbles through fluid in the distal small airways
crackles in later half of inspiration
- typically represent atelectasis, fibrosis pulmonary edema or pleural effusion.
crackles due to movement of secretion
- usually low-pitched and can be heard during inspiration and/or expiration like the sounds of hair being rubbed togetehr between the thumb and forefinger
pleural friction rub
- dry crackling sound heard during both inspiration and expiration
- occurs when inflamed visceral and parietal pleurae rub together
- heard over the spot where the patient feels pleuritic pain
Rhonchi
- continuous low-pitched sounds described as having a “snoring” or “gurgling” quality that may be heard during both inspiration and expiration
- caused by air passing through an airway which is obstructed by inflammatory secretions or liquid, bronchial spasm or neoplpasms in teh smaller or larger airways
stridor
- continuous high-pitched wheeze heard with inspiration or expiration
- indicated upper airway obstruction
wheeze
- continuous “musical” or whistling sound composed of a variety of pitches
- heard during both inspiration and/or expiration, but variable from minute to minute and area to area
- arise from turbulent airflow and teh vibrations of the walls of small airways due to narrowing by bronchospasm, edema, collapse, secretions, neoplasm or foreign body
bronchial breath sounds
- abnormal breath sounds when heard in locations where vesicular sounds are normally present
- pneumonia may produce these sounds
decreased or diminished sounds
- a less audible sound may indicate severe congestion, emphysema or hypoventilation
absent breath sounds
- absent lung sounds may indicate pneumothora or lung collapse
bronchophony
- increased vocal resonance with greater clarity and loudness of spoken words
egophony
a form of bronchophony in which the spoken long “E” sound changes to a long nasal-sounding “A”
whispered pectoriloquy
recognition of whispered words “1,2,3”
anatomic dead space volume (VD)
- the volume of air that occupies the non-respirtaory conducting airways
expiratory reserve volume ERV
- the maximal volume of air that can be exhaled after a normal tidal exhalation
- ERV is approx 15% of total lung volume
forced expiratory volume FEV
- the maximal volume of air exhaled in a pecific period of time: usually the 1st, 2nd, and 3rd second of a forced vital capacity maneuver
Forced vital capacity FVC
the volume of air expired during a forced maximal expiration after a forced maximal inspiration
functional residual capacity FRC
- the volume of air in the lungs after normal exhalation
- FRC = ERV +RV
- FRC is approc 40% of total lung volume
inspiratory capacity IC
- the maximal volume of air that can be inspired after a normal tidal exhalation
IC= TV +IRV - IC is approx 60% of total lung volume
inspiratory reserve volume IRV
- the maximal volume of air that can be inspired after normal tidal volume inspiration
- IRV is approx 50% of total lung volume
minute volume ventilation VE
the volume of air expired in one minute
-VE =TV x respiratory rate
Peak expiratory flow PEF
the max flow of air during teh beginning of a forced expiratory maneuver
residual volume RV
- teh volume of a gas remaining in the lungs at the end of a maximal expiration
- RV is approc 25% of Total lung volume
TLC
- total volume of air in the lungs after a maximal inspiration; teh sum of all lung volumes
TLC = RV +VC or TLC = FRC +IC
vital capacity VC
- teh volume change that occurs between maximal inspiration and maximal expiration
- VC = TV +IRV + ERV
- VC is approx 75% of total lung volume
