Pulmonary Auscultation and Breath Sounds

Question 1

Who invented the first stethoscope?

Answer 1

Theophile Laennec

Question 2

Rales/Crackles

Answer 2

Due to abnormalities in the lung

• pneumonia
• fibrosis
• CHF

Seem to begin at the end of inspiration; as worsens, will spread throughout inspiration and then into expiration.

Think obstruction of alveoli opening, i.e. fluid

Question 3

Rhonchi

Answer 3

May be continuous or intermittent

May have some musical qualities

Might sound like “snoring” of airways

Suggestive of secretions in larger airways

Change in character with cough?

May occur in bronchial infections or inflammation

Question 4

Wheezing

Answer 4

May be continuous or intermittent

Musical or whistling quality

Suggestive of partial airway obstruction from secretions, tissue inflammation, or a foreign body

At onset will typically begin at end of expiration. As worsens will spread throughout expiration and into inspiration

Question 5

Friction Rubs

Answer 5

Crepitant or squeaky sounds heard through inspiration and expiration

Usually loudest at base of the lungs on the affected side

Differentiate between pleural and pericardial friction rub by listening while patient holds their breath

Underlying lung pathology that may cause:

• pneumonia
• pleuritis
• tumor