week 3

Question 1

Name some things that can interfere with your assessment when auscultating

Answer 1

movement of stethoscope on skin
oral cavity sounds
clothing/sheets
talking
hairy skin
water in tubing
shivering
external sounds

Question 2

What do normal breath sounds sound like in a stethoscope?

Answer 2

sounds are 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 longer than expiration
no pause between inspiration and expiration

Question 3

What are increased breath sounds called?

Answer 3

bronchial

Question 4

What are bronchial breath sounds like?

Answer 4

louder, more coarse sound compared to normal

Question 5

What are inspiration and expiration like with bronchial breath sounds?

Answer 5

equal pitch
equal intensity
equal duration

Question 6

How can we describe bronchial breathing (what does it sound like)?

Answer 6

Darth Vader

Question 7

When do bronchial breath sounds occur?

Answer 7

when the lung tissue is more dense due to a pathology

Question 8

Is there a pause between inspiration and expiration for bronchial breathing?

Answer 8

yes

Question 9

What are decreased breath sounds caused by?

Answer 9

decreased ventilation to generate sound e.g. collapse or consolidation
decreased mechanics of breathing or chest wall movement e.g. scoliosis, rib fracture
decreased transmission of the sound e.g. obesity, pleural effusion

Question 10

What are the 3 types of added sounds?

Answer 10

crackles/crepitus/rales
wheezes
pleural rub

Question 11

What is the primary source of crackling?

Answer 11

It is due to the explosive equalisation of gas pressure between two components of lung, when a closed section of airway separating them opens

Question 12

What are the two types of crackles?

Answer 12

coarse and fine

Question 13

What are crackles mostly indicative of?

Answer 13

sputum

Question 14

What do early inspiratory crackles indicate about their position?

Answer 14

proximal airways

Question 15

What do late inspiratory crackles indicate about their position?

Answer 15

peripheral airways

Question 16

What do early expiratory crackles indicate about their position?

Answer 16

proximal airways

Question 17

What do late expiratory crackles indicate about their position?

Answer 17

peripheral airways

Question 18

What is a wheeze?

Answer 18

whistling sound caused by air passing through narrowed airway

Question 19

What are the two types of wheeze?

Answer 19

monophonic
polyphonic

Question 20

Describe a monophonic wheeze

Answer 20

It is generated by one airway, single note, same position in the respiratory cycle

Question 21

Describe a polyphonic wheeze

Answer 21

It is generated by several airways giving different notes
pitch varies depending on the amount of narrowing: the greater the narrowing the higher the pitch
can occur on inspiration or expiration or both

Question 22

Describe a rub (added breath sound)

Answer 22

creaky leathery sound
pleural surfaces rubbing together
usually heard in later inspiration and early expiration
often identical on inspiration and expiration

Question 23

What is a possible cause of a pleural rub?

Answer 23

inflammation of the pleura

Question 24

Name some possible causes of a wheeze

Answer 24

bronchospasm
airway oedema
sputum
tumour
foreign body

Question 25

Name some causes of crackles

Answer 25

sputum
pulmonary oedema
fibrosis

Question 26

What is a stridor caused by?

Answer 26

turbulent airflow through narrowing/obstruction in the upper airway