Dr. Z lung sounds Flashcards
Crackles?
- Intermittent non-musical
- short successive or overlapping clicks
- Fine like velcro or coarse like fabric tearing
Wheezes and Rhonchi?
- Musical quality
- prolonged
- sinusoidal sound wave
- Wheezes sound like “heeeeee”
- Rhonchi low pitch snoring quality
What causes fine crackles or rales?
- opening of alveoli, traction by surrounding parenchyma pulling open the passage
- Pneumonia
- ILD
- PF
- Atelectasis
- HF
Where do you hear fine crackles in heart failure?
- posterior inferior lung fields (dependant fluid)
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What causes Coarse Crackles
- Boluses of gas passsing through small airways as they open and close
- caused by:
- COPD
- asthma
- bronchiectasis
- pneumonia
- HF
- think of mucus
What is one way to tell rhonchi and wheezes apart?
- Rhonchi may dissapear with coughing so seceretions may be involved
Lack of wheezing or mininmnal wheezing may be a very ominous sign, why?
- airways become more narrowed making wheezes quieter resulting in the “silent chest” of severe asthma requiring immediate intervention
Stridor?
- continuous high frequency high pitched musical sound produced during airflow through narrowing in uppper respiratory tract
- immediate intervention needed
Where is stridor heard the loudest?
Neck
What causes stridor?
- anaphylaxis
- epiglottitis
- foreign body
- tracheal stenosis from intubation
- airway edema after devicce removal
What is mediastinal crunch?
- precordial crackles synchronous with heartbeat not respiration
- aka Mediastinal epmhysema
Pleural friction rub?
Discontinuous low frequency coarse grating biphasic sounds heard during expiration in the axilla and base of lungs
L side HF percussion, breath sounds, adventitious sounds and tactile fremitus and voice sounds?
- resonant
- vesicular breath sounds
- late inspiratory crackels in dependent portions of lungs
- normal special tests
Bronchitis percussion, trachea, breath sounds, adventitious sounds oand specialty test?
- resonant
- Midline
- vesicular to harsh
- no adventitious sounds, but possible scattered corarse crackles in early inspiration and expiration possible wheezes or rhonchi
- normal specialty tests
Lobar pneumonia percussion, trachea, breath sounds, adventitious sounds oand specialty test?
- Dull over airless area
- midline
- bronchial over invovled area
- late inspiratiory crackles over area
- increased sounds in specialty tests over area
