W3 - Cardio Auscultation Flashcards
Why do we use auscultation
To listen and interpret sounds produced within the thorax
Used to variety observed and palpated findings before, during & after treatment
What happens if a patient has crackles heard at the mouth
Ask them to clear it by coughing so it doesn’t prevent them from masking other sounds during auscultation
What 2 sounds are we looking for during auscultation
Breath sounds
Added sounds
What are the 3 types of breath sounds
Normal = soft & muffled quality. Louder & longer on inspiration
Bronchial = loud & harsh. Discontinuous sounds heard over the trachea
Decreased/absent = soft distant sounds with lower intensity
What causes a decreased/absent breath sound
Reduced air entry to generate sound (atelectasis)
Lower transmission of sounds (pleural effusion/thuckening/hyperinflation)
Lower chest wall movement (ankylosing spondylitis/ pain/drowsiness/positions)
How are breathe sounds generated
Turbulent air flow
What are the 4 added sounds
Crackles
Wheezing
Pleural rub
Stridor
What causes crackles
Explosive equalisation of gas pressure between 2 components of the lungs , when a closed secretion of airway separating them suddenly opens
What are the 2 types of crackles
Coarse
Fine
What does the timing of crackles tell you about their position in the bronchial tree
Early inspiration = proximal airways
Late inspiration = peripheral airways
Early expiration = proximal airways
Late expiration = peripheral airways
What are the 2 types of wheezing
Monophonic = generated by 1 airway & smae oosition in the respiratory cycle
Polyphonic = generated by several airways
How many lobes do each lung have and why
Right = 3
Left = 2 as it shares its space with the heart
What structure separates the lobes of the lungs
Fissures
What does the right oblique fissure separate
Anteriorly = The right lower and middle lobe
Posteriorly = separates the right upper and lower lobe
What does the right horizontal fissure separate
Right middle lobe and the right upper lobe
Where does the oblique fissure line up with on the rib cage
6th costal cartilage & the 5th intercostal space laterally & finishes at the spinous process of T4
Where does the horizontal line up against on the rib cage
Lines up with the 4th costal cartilage and then meets the oblique fissure
What are we listening for with a stethoscope
Quality &intensity of breath sounds
Presence of any added sounds
How is turbulence noise produced
Air molecules collide with each other and the air walls
Which air ways do not generate breath sounds and why
Small airways due to the airflow being laminar and therefore more silent
What causes bronchial breath sounds
Breathe sounds haven’t been dampened down by air flow in the lungs - usually due to the air being replaced by something more solid
Sólidas transmit sound waves better than air as the molecules are closer together and tightly bonded (louder)
What does high and low pitched wheezing normally indicate
High pitched = Narrowing caused by bronchospasm or oedema
Low pitched = suggests sputum
What do course crackles sound like
Rice crispies in milk
