Respiratory Checkout Flashcards
Abnormal breath sounds
bronchial (where they shouldn’t be)
absent/decreased
bronchial breathing normal locations vs abnormal
normal - over trachea/larynx
abnormal - anywhere else, above clavicle, interscap space, peripheral areas
If breath sounds are bronchial in other areas, it indicates
areas of consolidation
if breath sounds are decreased or absent, patient may have
asthma, atelectasis, emphysema, pleural effusion, ARDS, pneumothorax
Adventitious breath sounds
crackles (rales)
wheezing/Rhonchi
stridor
pleural rub
fine versus coarse crackles
fine: soft, high pitch due to CHF or pulmonary fibrosis
coarse: loud, low pitch due to airway obstruction
wheezes versus rhonchi
wheezes: musical, higher pitch - suggestive of ashthma
rhonchi: snoring, lower pitch - suggestive of secretions in large airways
stridor
crowing sound during inspiration suggesting obstruction or laryngospasm
- often heard WITHOUT stethoscope
crackles are continuous/discontinuous whereas wheezing is
crackles - discontinuous
wheezing - continuous high pitch
where do you here vesicular sounds
over the lungs
where do you hear bronchovesicular sounds
1st and 2nd intercostal space anteriorly and between scaps
crackles are heard on the ______ and indicate what
inhale
accumulation of fluid secretions or exudate within airways or inflammation and edema in pul tissue
early inspiratory and expiratory crackles are the hallmark of ________
chronic bronchitis
late inspiratory crackles may mean
pneumonia, CHF or atelactasis
wheezing is heard more during the ____ and may indicate
expiration
narrowed airways, bronchoconstriction, secretions
asthma,
Stridor is heard during _____ and suggests
early inspiration
upper airway obstruction or laryngospasm
if patient has decreased breath sounds what technique would you use next?
fremitus
increased fremitus may indicate
atelectasis
consolidation
pulmonary edema
more dense = more vibration (atelectasis is partial collapse so shape is still there)
decreased fremitus may indicate
pneumothorax or pleural effusion
complete collapse of lung = more air
pleural effusion, sound gets muffled before reaching chest wall
Examination findings in pleural effusion: tracheal deviation
contralateral
Examination findings in pleural effusion: fremitus
decreased
Examination findings in pleural effusion: percussion
dull
Examination findings in pleural effusion: pectoriloquy
decreased
Examination findings in pleural effusion: breath sounds
decreased
