W6: Auscultation Lung Sounds

Question 1

Observations of breathing

Answer 1

Frequency: respiratory rate, inspiratory:expiratory ratio (1:2)
Drive: depth of breathing (shallow vs lateral basal expansion)
Symmetry: mode of breathing, symmetry of chest wall
Rhythm: regularity of breathing pattern
Accessory muscle use
Audible noises during breathing
Tactile fremitus

Question 2

What is the inspiratory:expiratory ratio

Answer 2

1:2

Question 3

What is tactile fremitus

Answer 3

the vibration produced by the voice and transmitted to the chest wall, where it is detected by the hand as a tactile vibration

Question 4

What is auscultation?

Answer 4

the process of listening and interpreting the sounds produced by air movement within the airways and lungs

Question 5

Which lung is larger?

Answer 5

Right lung

Question 6

How many lobes does each lung have?

Answer 6

Right lung: 3 lobes - upper, middle, lower
Left lung: 2 lobes - upper and lower

Question 7

When we auscultate, we divide the lung fields into:

Answer 7

upper, middle and lower zones

Question 8

Difference between anterior and posterior chest in terms of lobes

Answer 8

Anterior chest: contains upper and middle lobes with little lower lobe
Posterior chest: has almost all lower lobe

Question 9

Which lobe doesn’t project into the posterior chest

Answer 9

right middle lobe

Question 10

How to find the upper lobe

Answer 10

C7 to T3

Question 11

How to find the middle lobe

Answer 11

T3-T6

Question 12

How to find the lower lobe

Answer 12

T6-T10

Question 13

What are you looking for during ausculation

Answer 13

normal or abnormal breath sounds
characteristics in the sound frequency, duration, timing, intensity and quality

Question 14

Fine crackles: description, pathology, when is it heard?

Answer 14

description: soft pitched and brief, usually heard more towards end inspiration. Sounds like rolling two strands of hair between your fingers

Indicative of less viscous material

Pulmonary oedema

Question 15

Coarse crackles: description, pathology, when is it heard?

Answer 15

description: louder, lower pitch and are generally heard earlier in inspiration and remain throughout expiration. Sounds like opening up a velcro fastener or a gurgle

Indicative of viscous sputum

Question 16

Wheeze (rhonchi): description, pathology, when is it heard?

Answer 16

sounds heard continuously during inspiration and expiration.
Caused by air moving through airways narrowed by constriction or swelling of the airway or partial obstruction

2 types: Sibilant rhonchi, Sonorous rhonchi

Question 17

Stridor: description, pathology, when is it heard?

Question 18

Sibilant rhonchi

Answer 18

high pitched wheeze with a shrill or squeaking quality. Heard throughout inspiration and expiration continuously.
Commonly heard during bronchospasm from airway narrowing in an acute asthma attack

Question 19

When would you expect sibilant rhonchi

Answer 19

heard during bronchospasm from airway narrowing in an acute asthma attack

Question 20

Sonorous rhonchi

Answer 20

low pitched wheeze with a snoring or moaning quality. Relates to mucous within the larger airways commonly heard in populations suffering from bronchitis. sounds may clear with coughing and expectoration of phlegm

Question 21

When would you expect sonorous rhonchi

Answer 21

relates to mucous within the larger airways, heard in populations with bronchitis

Question 22

Crackles sound like…

Answer 22

popping sounds heard during inspiration or expiration

Question 23

What does a wheeze sound like, when is it heard and why is it caused?

Answer 23

Whistling sound heard during expiration caused by the narrowing of airways

Question 24

What is stridor and when is it heard

Answer 24

high pitched sound heard during inspiration