Auscultation Flashcards
Before listening with a stethoscope
Listen to what you can hear from the mouth - noisy breathing indicates increased airflow tubulence due to obstructed upper airways
Crackles, wheezes or snored may be heard from bedside
A monophonic wheeze in the upper airways called stridot is a serious sign denoting larygngeal or tracheal narrowing to a diameter as small as 5mm.
Patient preperation and position
- Clothing
- Position of patient
- Patient comfort
- Instructions to the patient
How many auscultation points
10 points anteriorly
12 points posteriorly
Access will vary between male and female patients
Normal breath sounds
Louder on inspiration and faded/minimal on expiration
Inspiratory sounds heard for longer
Pleural rub
Cracking/rubbing sound
Like walking on fresh snow
Sounds same throughout
Usually localised
Pleural rub is a result of…
As a result of inflamed pleura and decreased production of pleural fluid
Pleurisy/pleuritis
Usually as a result of infection
Often associated with pleuritic chest pain
Fine crackles
Like rubbing hair next to your ear
Re-opening of airways due to atelactasis or secretions
End inspiratory: opening of smaller airways and suggests fibrosis or pulmonary oedema
Coarse crackles
Like pouring milk on rice krispies
Suggests obstruction due to sputum in more proximal, larger airways
Early expiratory: more central airways
Late expiratory airways: more peripheral airways
Wheezes
Musical sounds due to vibration of the wall of narrowed or compressed airways
Primarily during expiration
Expiratory phase can therefore be prolonged
Mono-phonic wheeze
Same note (usually lower pitched)
Due to compression or obstruction of a large, central airway
Poly-phonic wheeze
Multiple notes simultaneosly (usually higher pitched
Added sounds
wheezes
crackles
Pleural rub
