week 3 Flashcards
Name some things that can interfere with your assessment when auscultating
movement of stethoscope on skin
oral cavity sounds
clothing/sheets
talking
hairy skin
water in tubing
shivering
external sounds
What do normal breath sounds sound like in a stethoscope?
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
What are increased breath sounds called?
bronchial
What are bronchial breath sounds like?
louder, more coarse sound compared to normal
What are inspiration and expiration like with bronchial breath sounds?
equal pitch
equal intensity
equal duration
How can we describe bronchial breathing (what does it sound like)?
Darth Vader
When do bronchial breath sounds occur?
when the lung tissue is more dense due to a pathology
Is there a pause between inspiration and expiration for bronchial breathing?
yes
What are decreased breath sounds caused by?
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
What are the 3 types of added sounds?
crackles/crepitus/rales
wheezes
pleural rub
What is the primary source of crackling?
It is due to the explosive equalisation of gas pressure between two components of lung, when a closed section of airway separating them opens
What are the two types of crackles?
coarse and fine
What are crackles mostly indicative of?
sputum
What do early inspiratory crackles indicate about their position?
proximal airways
What do late inspiratory crackles indicate about their position?
peripheral airways
What do early expiratory crackles indicate about their position?
proximal airways
What do late expiratory crackles indicate about their position?
peripheral airways
What is a wheeze?
whistling sound caused by air passing through narrowed airway
What are the two types of wheeze?
monophonic
polyphonic
Describe a monophonic wheeze
It is generated by one airway, single note, same position in the respiratory cycle
Describe a polyphonic wheeze
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
Describe a rub (added breath sound)
creaky leathery sound
pleural surfaces rubbing together
usually heard in later inspiration and early expiration
often identical on inspiration and expiration
What is a possible cause of a pleural rub?
inflammation of the pleura
Name some possible causes of a wheeze
bronchospasm
airway oedema
sputum
tumour
foreign body
Name some causes of crackles
sputum
pulmonary oedema
fibrosis
What is a stridor caused by?
turbulent airflow through narrowing/obstruction in the upper airway
