week 1 Flashcards
describe normal breath sounds
soft non-musical
heard over the entire lung fields
muffled in quality
normal to get quieter the further from the trachea
inspiration is louder than expiration
inspiration is heard longer than the expiration
no pause between inspiration and expiration
describe decreased breath sounds
much lower intensity with a soft, distant quality
what are the causes of decreased breath sounds
decreased in ability to generate sound
decreased transmission of the sound to the chest wall
combination of both
describe increased/bronchial breath sounds
inspiration and expiration are equal pitch, equal intensity, equal duration
it is a louder, harsher and more brassy sound
definite pause between inspiration and expiration
when do bronchial/increased breath sounds occur
occurs when the lung tissue around a large airway is more dense due to pathology such as consolidation or collapse and the main airway is still patent
name some causes of increased breath sounds
consolidation
collapse
at the fluid line of a pleural effusion
large mass
name some causes of decreased/absent breath sounds
shallow breathing/drowsiness/pain
poor position
atelectasis/collapse
collapse with complete obstruction of a large airway
hyperinflation e.g. emphysema
obesity/very muscular patients
pleural effusion
pneumothorax/haemothorax
ankylosing spondylitis
what are crackles on auscultation due to
the explosive equalisation of gas pressure and sudden opening and closing of the airways
when are coarse crackles normally heard
early inspiration and throughout expiration
when are fine crackles heard
mid-to-late inspiration and occasionally on expiration
what are the clinical causes of fine crackles
interstitial lung fibrosis
early congestive heart failure
pneumonia
can be the earliest signs or diseases such as idiopathic pulmonary fibrosis and asbestosis
what are the clinical causes of course crackles
most indicative of secretions
present in COPD, pneumonia, asthma, bronchiectasis
also present in congestive cardiac failure with severe pulmonary oedema
what airways do early inspiratory crackles indicate
proximal airways
what airways do late inspiratory crackles indicate
peripheral airways
what airways do early expiratory crackles indicate
proximal airways
what airways do late expiratory crackles indicate
peripheral airways
describe a wheeze
whistling musical high-pitched sound, heard on both inspiration and expiration
what is a wheeze caused by
oscillations of the bronchial wall as air passes through narrowed airways
what are the two types of wheeze
monophonic and polyphonic
what is a monophonic wheeze generated by
one airway, single note, same position in the respiratory cycle
what is a polyphonic wheeze generated by
several airways giving different notes and is more likely to be widespread
describe a stridor
a high-pitched, musical sound (darth vadar)
what produces a stridor
it is produced as turbulent flow passes through a narrowed segment of the upper respiratory tract
name some clinical causes of stridor
epiglottitis
airway oedema after removal of artificial airway
anaphylaxis
vocal cord dysfunction
inhalation of foreign body
laryngeal tumour
thyroiditis
tracheal carcinoma
describe a pleural rub
creaky leathery sound or boot crunching down snow
name the cause of pleural rub
inflammation of the pleura
name some causes of a wheeze
bronchospasm
airway oedema
sputum
tumour
foreign body
