Pathology of the Pulmonary System

Question 1

Rhonchi

Answer 1

abnormal breath sounds on expiration

• course, rattling, low-pitched, continuous
• occur when there is mucous or inflammatory secretions in the bronchi
• sounds are usually very clear but can change w/ coughing

Question 2

Stridor

Answer 2

abnormal breath sounds on insp or expiration

• high pitched, “orca whale”, continuous
• occurs when there is an upper airway obstruction

Question 3

Rales (crackles)

- what is it associated w/

Answer 3

abnormal breath sound heard on inspiration; sometimes late inspiration and right before they begin to exhale

• high pitched, non-continuous, fine crackles
• caused by fluid movement in the alveoli or bronchioles
• more often heard at the BASE of the lung
• associated w/ atelectasis, pulmonary edema, pneumonia, bronchiectasis

Question 4

Wheezes

Answer 4

abnormal breath sound heard on inspiration

• high pitched, continuous “musical” sounds
• due to vibrations of the walls of small airways due to a constricted or partially obstructed airway
  (bronchospasm, edema, collapse, secretions, neoplasm or foreign body)

Question 5

Pleural friction rub

Answer 5

abnormal breath sound heard during insp and expiration

• sounds are scratchy, dry and crackling (often described as walking on fresh snow)
• due to the inflamed pleural surfaces rubbing together
• heard over the area where the patient feels pleuritic pain

Question 6

Bronchial breath sound over normal/distal lung tissue

Answer 6

considered abnormal

due to consolidation or compression of lung tissue that facilitates transmission of sound

could be due to pneumonia

Question 7

Egophony

Answer 7

Abnormal voice sound where the spoken long “E” sound turns into a long, nasal-sounding “A”

• this is a form of bronchophony

Question 8

Bronchophony

Answer 8

Abnormal voice sound when you can clearly auscultate w/ greater clarity and loudness “99” when the patient says “99”
(or any spoken words for that matter)

this indicates consolidation, atelectasis, or fibrosis which all will improve the transmission of sound

Question 9

Whispering pectoriloquy

Answer 9

recognition of whispered words

Question 10

Obstructive lung disease

-FEV/FVC

Answer 10

characterized by decreased expiratory flows
- COPD

FEV/FVC about 42% or less

Question 11

Restrictive lung disease

-FEV/FVC

Answer 11

characterized by reduced lung volumes and relatively normal expiratory flow rates
- due to interstitial lung disease, tumor, pleural disease, chest wall deformities, obesity, pregnancy, neuromuscular disease

FVC is reduced, FEV/FVC is normal or > 80%