Topic 21 - Adventitious respiratory sounds.

Question 1

When can we hear adventitious respiratory sounds?

Answer 1

Can never be heard under normal conditions !!

Question 2

Name Adventitious sonds:

Answer 2

1. Non-musical ronchi
   Crepitation
   Crackling sound
   Rattling sound
2. Musical ronchi
   Whistling
   Wheezing

Question 3

Description of non-musical ronchi:

Answer 3

Sudden arising and stopping sounds

Sounds like: crackles or rales

Previously called Moist(wet) ronchi

Question 4

What can be a cause of hearing non-musical ronchi?

Answer 4

The sound occur on areas where it is filled with fluid instead of gasses

Question 5

Description of crepitation

Answer 5

Sound like: coarse crackles

Question 6

Similar sound to crepitation

Answer 6

Hair-rubbing

Question 7

What can be a cause of crepitation sound?

Answer 7

It affects the Bronchioli opening and closing

Can be:
- emphysema
- broncho- pneumonia
- Chronic bronchitits

Question 8

Sound similar to crackling sound:

Answer 8

Burning wood

Question 9

What can be a cause of crackling sound?

Answer 9

It affects the Bronchiole opening and closing

Can be:
- emphysema
- Broncho- pneumonia
- Chronic bronchitis

Question 10

Description of rattling sound:

Answer 10

sound like fine crackles

Question 11

Similar sound of rattling:

Answer 11

Sucking coke with a straw

Question 12

What can be a cause of rattling sound:

Answer 12

Moving fluid in trachea or bronchi

Can be:
Lung edema

Question 13

Description of musical ronchi:

Answer 13

Continuous sound

Sounds like wheezes

Previously named: Dry bronchi

Question 14

What can be a cause of muscial ronchi?

Answer 14

Narrowed airways

Question 15

Description of whistling sound:

Answer 15

High muscical sound, a whistling sound

Question 16

What can be a cause of whistling sound:

Answer 16

Accelerated ariflow

Question 17

Description of wheezing:

Answer 17

Low musical sound, “fog-horn” sound

Question 18

What can be a cause for wheezing sound?

Answer 18

Vibration of the airway walls

Can be: COPD

Question 19

Name other abnormal sounds heard over the thorax:

Answer 19

1. Stridor
2. Rubbing
3. Splashing
4. Metallic sound

Question 20

Description of stridor:

Answer 20

Stong stenotic sound, heard during inspiration

Question 21

Cause of stridor:

Answer 21

Upper airway stenosis

Question 22

Description of rubbing sound:

Answer 22

Sounds like hand scratching or snow cracking

Question 23

Cause for rubbing sound:

Answer 23

Rubbing of pleural surfaces

Can be:
Dry pleuritis

Question 24

Description of splashing:

Answer 24

Due to gas and fluid movement, sounds like someone shaking a water bottle

Question 25

Cause for splashing sound:

Answer 25

gas/fluid in cavities Can be: Ichorous pericarditis Pleuritis

Question 26

Description for metallic sound:

Answer 26

Fluid drops on fluid, have a "plom-plom" sound

Question 27

Cause for metallic sound:

Answer 27

Ichorous exudate in cavernss Can be: aspiration pneumonia

Question 28

Which paramters do we use to describe the adventitious respiratiry sounds:

Answer 28

1. Place 2. Strengt 3. Type 4. Respiratory phase when heard 5. Temporary or permanent

Question 29

Name the different types of adventitious respiratory sounds:

Answer 29

1. Non-musical ronchi 2. Muscial ronchi

Question 30

Describe non-musical ronchi:

Answer 30

Sudden arising or stopping sound

Question 31

What causes non-musical ronchi?

Answer 31

Caused by an abrupt opening of bronchi and also vibration of the small bronchial wall

Question 32

Which sounds belong to the non-musical ronchi?

Answer 32

1. Crepitation 2. Crackling 3. Rattling sound

Question 33

Non-musical ronchi is further divided into subgroups, name them:

Answer 33

1. Early inspiratory or expiratory crepitation and crackling 2. Late inspiratory crepitation and crackling

Question 34

Cause for Early inspiratory or expiratory crepitation and crackling:

Answer 34

Obstruction of bronchi that are bigger then 2mm - Bronchopneumonia - COPD

Question 35

Cause for Late inspiratory crepitation and crackling:

Answer 35

Compressio of the bronchi less than 2 mm - Pulmonary edema - interstitial oedema - Neoplasms

Question 36

Describe musical ronchi:

Answer 36

Continuous sound

Question 37

What causes musical ronchi?

Answer 37

Occur in patients with obstructive lung disease The walls begin to vibrate between inspiration and expiration and produce a musical tone

Question 38

Which sounds belong to musical ronchi?

Answer 38

Whistling Wheezing

Question 39

Depending on when we hear musical ronchi, it can have different causes. Name the situations we can hear musical ronchi:

Answer 39

- During inspiration: extrathoracal - During late inspiration: Intrathoracal resonant sound - During expiration: Intrathoracal resonant sound

Question 40

what causes musical ronchi during inspiration?

Answer 40

caused by upper airway obstruction - laryngeal paralysis

Question 41

what causes musical ronchi during late inspiration?

Answer 41

originate from bronchial compression caused by „enlarged” lung parenchyma

Question 42

what causes musical ronchi during expiration?

Answer 42

originate from obstruction (inflammatory fluid, tissue thickening) of the bronchi and bronchioli Can be: - COPD - Bronchopneumonia