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Questions and Answers
What is the characteristic of crackles during inspiration?
What is the typical cause of crackles in its early stages?
What is the effect of gravity on the location of crackles in the lungs?
How can crackles be classified?
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What can be done to make crackles more audible during auscultation?
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What is the characteristic of crackles in relation to louder respiratory sounds?
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What is the characteristic of a pleural friction rub sound?
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What can vocal resonance help evaluate during auscultation?
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In what condition may vocal sounds become louder than usual over a distinct area?
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What is the purpose of the bronchophony test?
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What is the characteristic of an egophony test?
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What does the presence of a pleural friction rub often indicate?
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What is the characteristic of a normal vocal sound during auscultation?
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What is the purpose of auscultation in evaluating respiratory disorders?
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What is the characteristic of wheezes in terms of pitch?
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What is the main cause of wheezes in a localized area?
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What is the characteristic of rhonchi in terms of pitch?
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What is the typical timing of stridor in relation to breathing?
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What is the main characteristic of crackles?
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What is the significance of stridor in terms of airway compromise?
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What is the typical cause of rhonchi?
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What is the characteristic of wheezes in terms of loudness?
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Study Notes
Chest Auscultation
- Continuous breath sounds:
- Wheezes (sibilant wheezes): high-pitched musical noises, usually louder during expiration, caused by high-velocity air through narrowed airways, may occur due to asthma or congestive heart failure
- Classified as mild, moderate, or severe, and described as occurring on inspiration or expiration or both
- Rhonchi:
- Also known as sonorous wheezes
- Continuous, low-pitched, rumbling sounds usually heard on expiration
- Caused by passage of air through airway obstructed by thick secretions, muscular spasm, new tissue growth, or external pressure
- May result from any condition that increases secretions
Stridor
- Usually an inspiratory, crowing-type sound that can be heard without a stethoscope
- Indicates significant narrowing or obstruction of the larynx or trachea
- May be caused by epiglottitis, viral croup, anaphylaxis, or foreign body aspiration
- Heard best over the site of origin, usually the larynx or trachea
- Often indicates airway compromise that may be life-threatening, especially in children
Discontinuous Breath Sounds
- Crackles:
- High-pitched, discontinuous sounds usually heard during end of inspiration
- Sound similar to hair being rubbed between fingers
- Caused by disruptive passage of air in small airways or alveoli or both
- Most typical causes are pulmonary edema and pneumonia in its early stages
- Classified as coarse crackles (wet, low-pitched sounds) or fine crackles (dry, high-pitched sounds)
Pleural Friction Rub
- Low-pitched, dry, rubbing or grating sound
- Caused by movement of inflamed pleural surfaces as they slide on one another during breathing
- May be auscultated on inspiration and expiration, usually loudest over the lower lateral anterior surface of the chest wall
- Presence may indicate pleurisy, viral infection, tuberculosis, or pulmonary embolism
Vocal Resonance and Bronchophony
- Vocal sounds heard on auscultation should be assessed to evaluate presence of lung consolidation
- Usually indicates pneumonia or pleural effusion
- Any change in character of spoken voice that is higher pitched and less muffled than normal during auscultation should be noted
- Bronchophony: vocal sounds will be louder where consolidation is present
- Egophony: vocal sounds resemble the letter "a" more closely when consolidation is present
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Description
This quiz covers the basics of chest auscultation, including continuous breath sounds, wheezes, and their causes. Test your knowledge of respiratory medicine!
