W6: Auscultation Lung Sounds Flashcards
Observations of breathing
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
What is the inspiratory:expiratory ratio
1:2
What is tactile fremitus
the vibration produced by the voice and transmitted to the chest wall, where it is detected by the hand as a tactile vibration
What is auscultation?
the process of listening and interpreting the sounds produced by air movement within the airways and lungs
Which lung is larger?
Right lung
How many lobes does each lung have?
Right lung: 3 lobes - upper, middle, lower
Left lung: 2 lobes - upper and lower
When we auscultate, we divide the lung fields into:
upper, middle and lower zones
Difference between anterior and posterior chest in terms of lobes
Anterior chest: contains upper and middle lobes with little lower lobe
Posterior chest: has almost all lower lobe
Which lobe doesn’t project into the posterior chest
right middle lobe
How to find the upper lobe
C7 to T3
How to find the middle lobe
T3-T6
How to find the lower lobe
T6-T10
What are you looking for during ausculation
normal or abnormal breath sounds
characteristics in the sound frequency, duration, timing, intensity and quality
Fine crackles: description, pathology, when is it heard?
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
Coarse crackles: description, pathology, when is it heard?
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
Wheeze (rhonchi): description, pathology, when is it heard?
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
Stridor: description, pathology, when is it heard?
Sibilant rhonchi
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
When would you expect sibilant rhonchi
heard during bronchospasm from airway narrowing in an acute asthma attack
Sonorous rhonchi
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
When would you expect sonorous rhonchi
relates to mucous within the larger airways, heard in populations with bronchitis
Crackles sound like…
popping sounds heard during inspiration or expiration
What does a wheeze sound like, when is it heard and why is it caused?
Whistling sound heard during expiration caused by the narrowing of airways
What is stridor and when is it heard
high pitched sound heard during inspiration
