Auscultation

Question 1

Wheeze

Answer 1

Airway obstruction:
- COPD = bronchiole constriction (chronic bronchitis)/ sputum build up
- Asthma = narrowed airways/ sputum build up

A wheeze during expiration indicates less obstruction than a wheeze on both Insp and Exp

Monophonic = small notes starting and finishing at different times (local pathology)
Polyphonic = multiple notes starting and ending at the same time (larger more central airways)

Question 2

Crackles

Answer 2

The popping sounds produced are created when air is forced through respiratory passages that are narrowed by fluid, mucus, or pus.

Sputum retention/ exudate/ fluid
- infection
- sudden opening and closing of airways (atelectasis)

Coarse crackles indicate more excessive fluid in the airways
The difference between fine and coarse is believed to be from the size of the airways (coarse being the larger airways)

Question 3

Reduced breath sounds

Answer 3

Slightly reduced:
Large areas of air reduce breath sounds
- emphysema or reduced inhalation due to pain or weakness

Quiet base sounds:
No air movement at all
- consolidation
- atelectasis