Basecamp: Breath Sounds and Voices

What do abnormal bronchial sounds represent?

consolidation or compression of lung tissue

What is Stridor?

continuous, high-pitched wheeze-like noise during insp or exp. originating in the upper airways laryngeal or large airway narrowing heard best of the trachea

Where are Tracheal and Bronchial Sounds typically heard?

normally heard over the trachea

Where are Vesicular Sounds normally heard?

over the distal airways

Which abnormal breath sound is best described as a dry, crackling sound heard during both inspiration and expiration? pleural friction rub crackle rhonchi stridor

pleural friction rub A pleural friction rub occurs when inflamed visceral and parietal pleurae rub together.

Abnormal Bronchial Breath sounds may be produced by what?

pneumonia

Crackles may be associated with what pathology?

restrictive OR obstructive disorders

What is more valuable when detecting pulmonary consolidation, infarction, and atelectasis, breath sounds or Voice sounds?

Whispered and spoken voice sounds

Crackles

(rales) abnormal, discontinuous, high pitched adventitious lung sounds heard on inspiration

Egophony

A change in vocal resonance in the presence of a lung consolidation condition in which the transmission of the "eee" sound becomes a nasal "ay" sound.

What causes Rhonchi?

air passing through an airway which is obstructed by inflammatory secretions or liquids, bronchial spasms, or neoplasms in the smaller or larger airways.

What are crackles typically located?

at the bases of lungs with interstitial lung disease, atelectasis, pneumonia, bronchiectasis, and pulmonary edema

Which lung sound may indicate a Pneumothorax? Crackle Pleural Friction Rub Diminished Absent

Absent

When crackles occur during the latter half of respiration they typically represent what?

atelectasis fibrosis pulmonary edema or pleural effusion

Listening to a patient's body sounds with a stethoscope is known as: auscultation inspection palpation percussion

auscultation Auscultation involves using a stethoscope to listen for sounds made by internal organs such as the heart and lungs. It is used to aid in the diagnosis of certain cardiopulmonary disorders.

Which voice sound is describe as increased vocal resonance with greater clarity and loudness of spoken words? Bronchophony Egophony Whispered pectoriloquy

Bronchophony

What is a Wheeze?

Continuous "musical" or whistling sound composed of a variety of pitches during both insp and exp but variable from minute to minute.

What are Rhonchi

Continuous, low-pitched, nonmusical sound, like snoring or gurgling that may be heard during both inspiration and expiration.

Match the following: High-pitched popping sound

Crackle

What are the different abnormal breath sounds?

Crackles (Rales) Pleural Friction Rub Rhonchi Stridor Wheeze Bronchial Breath Sounds Decreased or diminished sounds Absent breath sounds

What is Pleural Friction Rub?

Dry crackling sound heard during both inspiration and expiration

(T/F) There are typically twelve areas on the anterior chest wall to auscultate for lung sounds.

False - seven

(T/F) Bronchial Breath sound auscultated over the distal airway are considered normal

False -abnormal

Pulmonary edema may produce what type of crackles?

Fine crackles (like air bubbles)

What are characteristics of Vesicular sounds?

High pitched, breezy sounds with longer inspiratory phases than expiratory and NO pause inbetween

What is the procedure for listening to lung breath sounds?

Listen to at least one breath sound in each bronchopulmonary segment comparing the sounds from the left and right sides. Start at the apices and work downward, comparing symmetrical points sequentially. Have the patient breath in and out through the mouth. Listen to at least one full cycle of breathing at each location.

What are characteristics of Tracheal and Bronchial sounds?

Loud, tubular sounds that have a shorter inspiratory phase than expiratory phase and a slight pause inbetween.

Crackles due to the movement of secretions are usually _____ pitched

Low

What are breath sounds?

Movement of air in the tracheobronchial tree produces sounds that can be heard with a stethoscope

Where does Pleural Friction Rub usually occur?

Over the spot where the patient feels the pleuritic pain

What would a absent breath sound be indicative of?

Pneumothorax or lung collapse

What will cause a Wheeze?

Turbulent airflow and the vibrations of the walls of small airways due to narrowing by bronchospasm, edema, collapse, secretions, neoplasms or foreign bodies.

(T/F) The inspiratory phase of vesicular breath sounds is longer than the expiratory phase

Ture

Match the following: Low pitched snoring or gurgling sound

Rhonchi

Which abnormal breath sound is caused by air passing through an airway that is obstructed by inflammatory secretions or liquid? Crackle Pleural Friction rub Rhonchi Wheeze

Rhonchi

Match the following: Continuous snoring or gurgling sound

Stridor

Which term describes normal breath sounds that are heard during auscultation over the trachea, above the sternal notch? bronchial vesicular bronchovesicular adventitious

bronchial Bronchial breath sounds are described as loud, hollow, high-pitched tubular sounds, often heard over the trachea.

(T/F) Pulmonary edema may produce fine crackles as air bubbles through fluid in the distal small airways

True

Match the following: Continuous musical or whistling sound

Wheeze

When are bronchial sounds abnormal?

When heard over the distal airways

Bronchophony

abnormal increase in clarity of transmitted voice sounds heard when auscultating the lungs (e.g. 99)

An increase in loudness and distinctness of voice sounds during auscultation indicate what?

consolidation atelectasis or fibrosis all of which improve the transmission of vibrations through lung tissue.

What pulmonary test is conducted by auscultating over the patient's thorax while the patient repeats "99"? bronchophony egophony whispered pectoriloquy focal fremitus

bronchophony Bronchophony refers to the abnormal transmission of sounds from the lung or bronchi. Bronchophony is most commonly assessed by asking the patient to say "99." If the therapist is unable to distinguish the sounds, it is considered a normal test. If the therapist can clearly hear the words "99," the test is considered positive and may be indicative of increased lung density.

How are lung and breath sounds characterized?

by pitch, intensity, quality, and the duration of the inspiratory and expiration phase

If abnormal sounds are suspected what should the examiner do?

compare the intensity, pitch, and quality of the sounds heard on one side with other side at same location. Identify breath sounds as vesicular, bronchovesicular, bronchial, or absent

What term describes smooth, normal airflow through the respiratory tracts? laminar flow low flow turbulent flow normal flow

laminar flow Laminar airflow consists of isolated layers of air with different velocities. This type of airflow occurs when the resistance to airflow is proportional to the airflow rate throughout the airways. This is considered an optimal airflow and is generally not heard upon auscultation.

Wet Crackles

movement of fluid or secretions during inspiration

Which of the following adventitious breath sounds is characterized by a low-pitched or "snoring" sound that may be heard during both inspiration and expiration? rhonchi wheeze stridor crackles

rhonchi Rhonchi are caused by air passing through small or large airways that are typically obstructed by secretions lining the airways. Rhonchi are continuous, low-pitched sounds that resemble snoring.

What would a diminished or decrease breath sound be indicative of?

severe congestion emphysema hypoventilation

What are adventitious lungs sounds?

sounds heard with inspiration and/or expiration that can be continuous or discontinuous

What are voice sounds?

spoken word that is heard as muffled Whispered words that are faint and syllables that are not distinct except over the main bronchi

Which breath sound is most consistent with an extremely high pitched wheeze? crackles rales rhonchi stridor

stridor Stridor refers to a continuous high-pitched wheeze heard with inspiration or expiration. Stridor is a type of adventitious breath sound that occurs from alterations or turbulence in airflow.

Dry Crackles

sudden opening of closed airways

What does Stridor indicate?

upper airway obstruction

Normal breath sounds heard over the distal airways in healthy lung tissue is best termed: bronchial vesicular adventitious rales

vesicular Normal breath sounds heard over distal airways are also known as vesicular sounds. Bronchial sounds are louder, more hollow, and echoing. Abnormal breath sounds are referred to as adventitious and there are two types: crackles (rales) and wheezes.

Which of the following adventitious breath sounds is characterized by a continuous, high-pitched whistling sound? rhonchi wheeze stridor crackles

wheeze Wheezes are characterized by high pitched whistling sounds and are often associated with obstructive lung disorders such as asthma. Stridor sounds are most prominent on inspiration and can typically be heard without a stethoscope.

Adventitious breath sounds that are musical in nature would be classified as: bronchial vesicular wheezes crackles

wheezes Wheezes are adventitious breath sounds that are characterized by being musical. Wheezes are caused by a decrease in the size of the lumen of the airway.

When does a Pleural Friction Rub usually occur?

when inflamed visceral and parietal pleurae rub together

Whispered Pectoriloquy

whispered sounds heard loudly and clearly upon thoracic auscultation