Topic 21 - Adventitious respiratory sounds. Flashcards
When can we hear adventitious respiratory sounds?
Can never be heard under normal conditions !!
Name Adventitious sonds:
- Non-musical ronchi
Crepitation
Crackling sound
Rattling sound - Musical ronchi
Whistling
Wheezing
Description of non-musical ronchi:
Sudden arising and stopping sounds
Sounds like: crackles or rales
Previously called Moist(wet) ronchi
What can be a cause of hearing non-musical ronchi?
The sound occur on areas where it is filled with fluid instead of gasses
Description of crepitation
Sound like: coarse crackles
Similar sound to crepitation
Hair-rubbing
What can be a cause of crepitation sound?
It affects the Bronchioli opening and closing
Can be:
- emphysema
- broncho- pneumonia
- Chronic bronchitits
Sound similar to crackling sound:
Burning wood
What can be a cause of crackling sound?
It affects the Bronchiole opening and closing
Can be:
- emphysema
- Broncho- pneumonia
- Chronic bronchitis
Description of rattling sound:
sound like fine crackles
Similar sound of rattling:
Sucking coke with a straw
What can be a cause of rattling sound:
Moving fluid in trachea or bronchi
Can be:
Lung edema
Description of musical ronchi:
Continuous sound
Sounds like wheezes
Previously named: Dry bronchi
What can be a cause of muscial ronchi?
Narrowed airways
Description of whistling sound:
High muscical sound, a whistling sound
What can be a cause of whistling sound:
Accelerated ariflow
Description of wheezing:
Low musical sound, “fog-horn” sound
What can be a cause for wheezing sound?
Vibration of the airway walls
Can be: COPD
Name other abnormal sounds heard over the thorax:
- Stridor
- Rubbing
- Splashing
- Metallic sound
Description of stridor:
Stong stenotic sound, heard during inspiration
Cause of stridor:
Upper airway stenosis
Description of rubbing sound:
Sounds like hand scratching or snow cracking
Cause for rubbing sound:
Rubbing of pleural surfaces
Can be:
Dry pleuritis
Description of splashing:
Due to gas and fluid movement, sounds like someone shaking a water bottle
Cause for splashing sound:
gas/fluid in cavities
Can be:
Ichorous pericarditis
Pleuritis
Description for metallic sound:
Fluid drops on fluid, have a “plom-plom” sound
Cause for metallic sound:
Ichorous exudate in
cavernss
Can be:
aspiration pneumonia
Which paramters do we use to describe the adventitious respiratiry sounds:
- Place
- Strengt
- Type
- Respiratory phase when heard
- Temporary or permanent
Name the different types of adventitious respiratory sounds:
- Non-musical ronchi
- Muscial ronchi
Describe non-musical ronchi:
Sudden arising or stopping sound
What causes non-musical ronchi?
Caused by an abrupt opening of bronchi and also vibration of the small bronchial wall
Which sounds belong to the non-musical ronchi?
- Crepitation
- Crackling
- Rattling sound
Non-musical ronchi is further divided into subgroups, name them:
- Early inspiratory or expiratory crepitation and crackling
- Late inspiratory crepitation and crackling
Cause for Early inspiratory or expiratory crepitation and crackling:
Obstruction of bronchi that are bigger then 2mm
- Bronchopneumonia
- COPD
Cause for Late inspiratory crepitation and crackling:
Compressio of the bronchi less than 2 mm
- Pulmonary edema
- interstitial oedema
- Neoplasms
Describe musical ronchi:
Continuous sound
What causes musical ronchi?
Occur in patients with obstructive lung disease
The walls begin to vibrate between inspiration and expiration and produce a musical tone
Which sounds belong to musical ronchi?
Whistling
Wheezing
Depending on when we hear musical ronchi, it can have different causes. Name the situations we can hear musical ronchi:
- During inspiration: extrathoracal
- During late inspiration: Intrathoracal resonant sound
- During expiration: Intrathoracal resonant sound
what causes musical ronchi during inspiration?
caused by upper airway
obstruction - laryngeal paralysis
what causes musical ronchi during late inspiration?
originate from bronchial compression caused by „enlarged” lung parenchyma
what causes musical ronchi during expiration?
originate from obstruction (inflammatory fluid, tissue thickening) of the bronchi and
bronchioli
Can be:
- COPD
- Bronchopneumonia
