Lung Sounds & Auscultation
This lung sound is continuous, high-pitched with musical instrument sound that is polyphonic and occurs mainly during expiration but can be present with inspiration as well
High-Pitched Wheeze
Select all of the following that are considered discontinuous breath sounds
Plueral friction Rub, Fine Crackles, Coarse Crackles
Wheeze -polyphonic
Polyphonic wheezes are loud, musical and continuous, occur in expiration and inspiration and heard over anterior, posterior and lateral chest walls
Wheeze-Expiratory
wheezes are adventitious lung sounds that are continuous with a musical quality, can be high or low pitched , ex. narrowing of the airways
crackles/rales-fluid accumulation
-fine, Hugh pitched, discontinuous -heard @ end of inspiration
Bronchophony
- the spoken voice sound heard through the stethoscope, which sounds soft, muffled, and indistinct over normal lung tissue Ex. Have patient say "99"
whispered pectoriloquy
-a whispered phrase heard through the stethoscope that sounds faint and inaudible over normal lung tissue Ex. patient whispers 1,2,3
Egophony
-abnormal change in tone of voice that is heard when auscultating the lungs Ex. Have patient say "e" if it sounds like "a" this is abnormal
These type of breath sounds are found at the site of the bronchi and are located anteriorly at the 1st and 2nd intercostal space & posteriorly in between the scapulae?
Bronchovesicular
The right middle lobe is auscultated with the stethoscope where?
Anteriorly on the right at the 4th intercostal space
When auscultating the posterior part of the chest the upper lobes are found?
Between C7 to T3
True or False: Low-pitched wheezes are polyphonic sounds that can be cleared when coughing
False
True or False: The left lung has 3 lobes: left upper lobe, left middle lobe, and left lower lobe.
False
You are auscultating a patient's lung sounds. During your assessment, you note there is a low-pitched harsh, grating sound that sounds like a pleural friction rub. However, you're not sure if this is a pleural friction rub or pericardial friction rub. What do you do next to determine the difference?
Have the patient hold their breath and note if the sound is still present
Bronchvisucular breath sounds
Inspiration to expiration are equal , normal sounds in the mid chest area or in the posterior chest of the scapula
While assessing a patient's lung sounds you note bronchial breath sounds in the peripheral lung fields. What could this finding represent?
Lung consolidation like pneumonia
Wheeze -Monophonic
Monophonic wheezes are loud , continuous sounds occurring in inspiration , expiration and throughout the respiratory cycle
vesicular breath sounds
Normal breath sounds made by air , soft and low pitched heard over most of the lung surface
When auscultating the anterior part of the chest, specifically the apex of the lungs, it is best to auscultate where with the stethoscope?
Slightly above the clavicle
On auscultation of a patient in respiratory distress, you hear a high-pitched, harsh sound that is monophonic and is present only during inspiration. This is known as:
Stridor
Stridor
Stridor is caused by upper airway narrowing or obstruction and is often heard w/o a stethoscope
Bronchial Breath Sounds can be auscultated where?
Tracheal area
True or False: During auscultation, the anterior part of the chest mainly provides an assessment of the upper lobes of the right and left lungs, while the posterior part of the chest provides mainly provides an assessment of the lower lobes of the right and left lungs.
True
These breath sounds are found anteriorly and posteriorly throughout the peripheral lung fields?
Vesicular
What is adventitious breath sounds?
abnormal breath sounds
diminished vesicular sounds
are lower in intensity and are less full or robust than vesicular sounds
crackles , late inspiratory (rales)
begin in late inspiration and increase in intensity, higher in pitch and can vary in loudness , adventitious sounds like a hook and loop faster being separated , heard over the posterior bases of the lungs, do not clear with coughing
Pleural Friction Rub
deep, low-pitched snoring sound associated with partial airway obstruction, heard on chest auscultation
crackles , coarse (rales)
discontinuos , brief popping lung sounds , louder in pitch and last longer
crackles , early inspiratory (rales)
heard during the early part of inspiration, and end during inspiration, cough can decrease or lower , characteristic of COPD
bronchial breath sounds
hollow, tubular sounds that are low pitched, normally auscultated over the trachea
Rhonchi
low pitched wheezes continuous both inspiratory and expiratory, strong , gurgling or rattle like , rhonchi usually clears after coughing