CARDIO - Breath Sounds & Voice Sounds

Stridor

- Continuous high-pitched wheeze heard with inspiration or expiration - indicates upper airway obstruction

Bronchial Breath Sounds (abnormal)

- abnormal when heard in locations where vesicular sounds are normally present (distal airways) - pneumonia may produce these sounds

Characteristic of tracheal and bronchial breath sounds

- loud, tubular sounds, normally heard over trachea - inspiratory phase is shorter than expiratory phase (with slight pause between the two) NOTE: bronchial sounds heard over distal airways are abnormal and represent consolidation or compression of lung tissue that facilitates transmission of sound

What are 3 typical breath sounds

1. tracheal 2. bronchial 3. vesicular

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? a. rhonchi b. wheeze c. stridor d. crackles

A 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.

Crackles/Rales

- Abnormal/discontinuous - High pitched popping sound heard more during inspiration - May be associated with restrictive or obstructive lung disorders - represent movement of fluid or secretions during inspiration (wet crackles) or occurs from sudden opening of closed airways (dry crackles) - often heard in bases of lungs with interstitial lung disease, atelectasis, pneumonia, bronchiectasis, and pulmonary edema

Wheeze

- Continuous "musical" or whistling sound composed of a variety of pitches - heard during both inspiration and expiration, but variable from min-to-min and area-to-area - arise from turbulent airflow and the vibrations of the walls of small airways d/t narrowing by bronchospasm, edema, collapse, secretions, neoplasm, or foreign body

Rhonchi

- Continuous low-pitched sounds of "snoring" or "gurgling" quality - Can be heard during inspiration or expiration - Caused by air passing through an airway which is obstructed by inflammatory secretions of liquid, bronchial spasm or neoplasm in the smaller (sibilant) or larger (sonorous) airways

Pleural friction rub

- Dry, crackling sound heard during both inspiration and expiration - Occurs when inflamed visceral and parietal pleurae rub together - Heard over spot where pt. feels pleuritic pain

Characteristics of vesicular breath sounds

- high pitched, breezy sounds normally heard over the distal airways in healthy lung tissue - inspiratory phase is longer than expiratory phase and there is no pause between the two

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

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

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

A 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 term describes normal breath sounds that are heard during auscultation over the trachea, above the sternal notch? a. bronchial b. vesicular c. bronchovesicular d. adventitious

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

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

A 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.

What term describes smooth, normal airflow through the respiratory tracts? a. laminar flow b. low flow c. turbulent flow d. normal flow

A 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.

Normal breath sounds heard over the distal airways in healthy lung tissue is best termed a. bronchial b. vesicular c. adventitious d. rales

B 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? a. rhonchi b. wheeze c. stridor d. crackles

B 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: a. bronchial b. vesicular c. wheeze d. crackles

C 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.

Which breath sound is most consistent with an extremely high pitched wheeze? a. crackle b. rale c. rhonchi d. stridor

D 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.

T or F: there are typically 12 areas on the anterior chest wall to auscultate for lung sounds

FALSE 7

T or F: bronchial breath sounds auscultated over the distal airways are considered normal

FALWE vesicular

Bronchophony

Increased vocal resonance with greater clarity and loudness of spoken words ("99")

T or F: pulmonary edema may produce fine crackles as air bubbles through fluid in the distal small airways

TRUE

T or F: the inspiratory phase of vesicular breath sounds is longer than expiratory phase

TRUE

Adventitious breath sounds

abnormal breath sounds heard with inspiratory and/or expiration that can be continuous or discontinuous

Which lung sound may indicate a pneumothorax? - crackle - pleural friction rub - diminished - absent

absent

which voice sound is described as increased vocal resonance with greater clarity and loudness of spoken words? - bronchophony - egophony - whispered pectoriloquy

bronchophony

Match the abnormal breath sound with its description: stridor

continuous high pitched wheeze

Match the abnormal breath sound with its description: wheeze

continuous musical or whistling sound

Egophony

form of bronchophony in which the spoken long "E" sounds changes to a long, nasal-sounding "A"

Match the abnormal breath sound with its description: crackle

high-pitched popping sound

Match the abnormal breath sound with its description: rhonchi

low-pitch snoring or gurgling sound

How should voice sounds typically sound in a healthy lung?

muffled and faint - increases in loudness and distinctness indicate consolidation, atelectasis or fibrosis - voice sounds are somewhat more valuable than breath sound sin detecting pulmonary consolidation, infarction, and atelectasis

Whispered pectoriloquy

recognition of whispered words "1, 2, 3"

which abnormal breath sound is caused by air passing through an airway that is obstructed by inflammatory secretion or liquid? - crackle - pleural friction rub - rhonchi - wheeze

rhonchi