Lung sounds Flashcards

(39 cards)

1
Q

where do lung sounds come from

A
  • Normal breath sounds are generated turbulent airflow in the trachea and large airways.
  • These sounds are comprised of high, medium and low frequencies
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2
Q

what are normal breath sound characteristics

A
  • heard all over chest wall
  • quieter at bases than apices
  • muffled due to filtering by the air in alveoli
  • expiration is shorter and quieter than inspiration with no pause in between
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3
Q

what are abnormal bronchial breath sounds

A

are tracheal and large airway sounds that have been transmitted though non-aerated (airless) lung tissue which does not attenuate the higher frequencies
-Bronchial Breath sounds (Br Br) are loud and high pitched, with a harsh quality

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4
Q

what are bronchial breath sounds heard

A
  • heard over an area of consolidated or collapsed lung

- are similar to those heard over the trachea itself

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5
Q

what do crackles sound like

A

Crackles are clicking sounds heard during inspiration

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6
Q

what causes crackles

A

-caused by the spanning-open of alveoli and small airways during inspiration or by air being forced through airways narrowed by oedema, secretions

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7
Q

what type of crackles would you hear in bronchiectasis

A

Coarse, early inspiratory crackles are heard in cases like bronchiectasis and bronchitis when bronchioles opens

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8
Q

what type of crackles are heard in pulmonary oedema/fibrosis

A

Fine, late crackles occur when alveoli and respiratory bronchioles open such as in pulmonary oedema and pulmonary fibrosis

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9
Q

what is a wheeze

A
  • sounds produced by airways on expiration primarily because the pressure gradient causes greater narrowing (inspiration too if more severe)
  • sound is made by airflow vibration in a narrow or compressed airway
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10
Q

how does obstruction affect wheeze

A
  • pitch of wheeze is directly proportional to degree of obstruction (higher pitch= more obstruction)
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11
Q

what is a polyphonic wheeze

A

many different sounds/pitches

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12
Q

What does a polyphonic wheeze indicate

A

indicates widespread airway narrowing/obstruction

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13
Q

what is a monophonic wheeze

A

caused by a single obstructed airway

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14
Q

what is whispering pectoriloquy

A

when you can hear the person’s whisper clearly though auscultation

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15
Q

what is whispering pectoriloquy indicative of

A
  • Associated with bronchial breath sounds
  • likely indicates an area of consolidation
  • Whispered speech lacks the lower frequencies and is normally not transmitted through the chest wall
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16
Q

what is a percussion note

A
  • elicited by tapping the chest wall

- resonant over normal tissue and dull over solid tissue

17
Q

what are percussion notes used to evaluate

A
  • density of underlying disease

- Hyper-resonance indicates excess air, a stony, dull sound indicates pleural effusion

18
Q

what are diminished breath sounds

A
  • Reduced sound generation due to increased attenuation (filtering)
  • Localised or global
19
Q

what could be the reason for globally diminished breath sounds

A
  • could be due to pain
  • muscle weakness
  • obesity
  • accumulation of fluid/air in the pleural space (increase in filtering)
  • emphysema
20
Q

what could be the reason for localised diminished breath sounds

A
  • sputum plugging with distal hyperinflation -

- obstruction of an airway by a tumour or sputum

21
Q

what is a pleural rub sound

A
  • sound made by inflamed pleural (visceral and parietal) rubbing together with friction
  • caused by infection or non-inflammatory via neoplasm
  • localised or generalised and ranges in volume
  • heard equally during inspiration and expiration, which helps differentiate pleural rub from crackles
22
Q

what are stridor lung sounds

A

o Loud, high pitch sound heard on inspiration
-heard on inspiration because the extra-pulmonary airways are subject to opposite pressure gradients than the intrapulmonary airways

23
Q

what are stridor breath sounds indicative of

A
  • Sign of upper airway obstruction.
  • Caused by turbulent airflow through a partially obstructed airway at the level of the supraglottis, glottis, subglottis or trachea
24
Q

anatomy of auscultation

A

LOOK AT NOTES FOR DIAGRAM

25
what are some limitations to auscultation
 Inter-and intra-therapist/practitioner interpretation of lung sounds is poor  Needs practise and a good quality stethoscope  Not infallible; sounds may change very quickly  Needs patient co-operation to generate sufficient flow rate
26
what is the clinical significance of breath sounds/adventitious sounds
- auscultation is one method of pre treatment | - abnormal breath sounds and adventitious sounds (wheeze etc) are indicative of pathology
27
what sounds can be heard in asthma
• likely to hear expiratory and possibly inspiratory wheeze if severe, stridor
28
what sounds can be heard in pneumonia
• may hear crackles, diminished breath sounds
29
what sounds can be heard in pleuritis
-pleural rub
30
what sounds can be heard in pneumothorax
• diminished breath sounds, bronchial breath sounds, hyper-resonant percussive sound
31
what sounds can be heard in bronchitis
• crackles, diminished breath sounds, wheeze, occasionally stridor
32
what sounds can be heard in bronchiectasis
crackles, wheeze
33
what sounds can be heard in fracture
crunching
34
Auscultation
READ NOTES
35
when do you hear gurgling sounds
massive pulmonary oedema
36
when do you hear crunching sounds
#'s or dislocations
37
causes of large airway noises
- usually mucus in larger airways which clears after coughing - may be audible without auscultation - very loud sound heard all over chest - heard on inspiration and expiration
38
how might a crackle vary (features of crackles)
pitch--> gives a clue to site and pathology time--> very early crackles = coarse and loud- originate in large airways and usually clear with an effective cough. late crackles are from small airways and alveoli number--> proportional to severity of disease (diffuse/widespread/scant)
39
when might crackles occur
aged patient--> due to loss of elastic recoil and subsequent early airway closure during expiration normal--> if preson breathes down to RV and airway closure occurs -pulmonary oedema -pulmonary fibrosis--> due to increased elastic recoil -presence of expirations