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