Respiratory Exam Flashcards
What are the clinical terms for: normal breath sounds, abnormal breath sounds and added breath sounds?
Normal: vesicular
Abnormal: diminished breath sounds, bronchial breathing
Added: wheeze, crackles/crepitations, pleural rub, stridor
What do vesicular breath sounds sound like?
Longer on inspiration, normal sounds, soft
What does bronchial breathing sound like?
Abnormal in peripheral lung
Loud and tubular, sounds forced
Inspir/expir are equal length
Gap between phases
In which diseases would you hear bronchial breath sounds?
Consolidation
Lobar Collapse
Lung Cavity
What does wheeze sound like?
Heard on expiration.
High pitch wheeze is called “sibilant wheeze”. Monophonic if obstruction is localised, polyphonic if variable obstruction
Low pitch wheeze is called “rhonchi”
What does wheeze indicate?
Narrowing of airways either due to bronchospasm e.g. in asthma (sibilant wheeze), or secretions in small airways e.g in chronic bronchitis (rhonchi)
What are crackles?
Interruptions of breathing - usually heard on inspiration because peripheral collapsed airways are being forced open.
What can crackles at different times indicate?
Early inspiratory = small airway disease like bronchitis
Mid inspiratory = pulmonary oedema
Late inspiratory = pulmonary fibrosis, pulmonary oedema, COPD, resolving pneumonia, lung abscess, TB
Biphasic = bronchiectasis
What are the two types of crackles?
Fine = broncholitis, pulmonary oedema, pulmonary fibrosis Coarse = COPD, resolving pneumonia, lunch abscess, TB, bronchiectasis
What does pleural rub sound like?
Low pitched, grating, like walking on snow.
Heard during inspiration.
What does pleural rub indicate?
Inflammation of pleura.
In diseases such as consolidation, pulmonary infarction, uremia
What is the difference between pleural rub and pericardial rub?
Pericardial rub continues even when holding breath after inspiration.
What is stridor?
Occurs during inspiration, “musical wheezing”
