Term
Inspiratory sounds last longer than expiratory
Intensity soft
Pitch relatively low
Heard over most of lung fields |
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Definition
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Term
| vesicular: insp/exp longer. intensity. pitch. position. |
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Definition
Inspiratory sounds last longer than expiratory
Intensity soft
Pitch relatively low
Heard over most of lung fields |
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Term
| broncho-vesicular: insp/exp longer. intensity. pitch. position. |
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Definition
Inspiratory and expiratory about equal
Intermediate intensity
Intermediate pitch
Heard over 1st and 2nd interspaces anteriorly and between scapulae posteriorly |
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Term
| Bronchial: insp/exp longer. intensity. pitch. position. |
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Definition
Expiratory sounds slightly longer than inspiratory
Loud
High pitched (tubular)
Heard over manubrium if at all |
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Term
| trachial: insp/exp longer. intensity. pitch. position. |
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Definition
Inspiration and expiration about equal
Very loud
High pitched (tubular)
Heard over trachea in neck |
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Term
| Can these normal lung sounds ever be abnormal? |
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Definition
YES - if sounds heard in unusual locations - Also, if significantly different side to side
If bronchovesicular or bronchial sounds are heard in locations distant from expected sites, suspect that air filled lung has been replaced by fluid-filled or solid lung tissue |
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Term
| rales or crackles. when are they heard? ask pt to what? can be sign of what? |
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Definition
Brief discontinuous sounds, most often at end of inspiration
If heard, ask pt to cough. If they clear with cough, due to mucous in airways (not rales)
Can be sign of consolidation, fibrosis, early heart failure |
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Term
| rhonchi. how are they described? what do they indicate? |
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Definition
Essentially described as rales that clear with cough (similar, usually coarse sound)
Also can have a snoring or gurgling quality
Indicate mucous in larger airways, as in bronchitis |
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Term
| Wheezes. when are they heard? what do they indicate? |
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Definition
Musical sounds created when air flows rapidly through bronchi that are narrowed significantly
Heard in expiration and sometimes on inspiration
Can be evidence of asthma, bronchitis, COPD, allergic response |
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Term
| stridor. when is it heard? what can it indicate? |
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Definition
Wheeze heard primarily during inspiration and mainly over larger airways
Can be sign of airway obstruction - foreign body - croup - epiglottitis |
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Term
| Pleural Rub. to what is it related? how does it sound? what does it evidence? |
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Definition
Related to inflammation of pleural surfaces (pleurisy, pleuritis)
Coarse grating sound like sandpaper or Velcro, timed with lung movement
Evidence of local inflammation |
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Term
| Ask pt to say “99” or “1,2,3” when is it increased/decreased? |
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Definition
Sound increased in consolidation - solid or fluid inside alveoli
Sound decreased when fluid or air pushes lung away from chest wall - fluid or air outside alveoli |
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Term
| Egophony. what does it mean? |
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Definition
It is determined by having the patient say the letter "E", while you're listening through the stethoscope to a suspected area of involvement.
If you are listening for an "E", and it comes through like "A", then egophony is present.
Referred to as “e to a” change
What is happening is that the pure sound has become louder and more nasal in quality.
It can be heard directly above an area of pleural effusion due to compression atelectasis of the lung |
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Term
| bronchophony. what does it mean? |
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Definition
The technique is to have the patient verbalize "99".
As a vocal sound is transmitted from the larynx down through the trachea, the bronchi, the alveoli and then to the chest wall, the sound becomes less distinct and much softer than if you heard it externally.
However, if bronchophony is present, the sound is very distinct, very clear and very loud.
Bronchophony occurs over areas of the lung in which the alveoli are filled with fluid or replaced by solid tissue. It can be heard in pneumonia, atelectasis, or tumors. |
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Term
| Whispered Pectoriloquy. what does it mean? |
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Definition
| It is the same as bronchophony, but now the patient whispers "99". In the normal chest, it is going to be almost unintelligible, but in areas of the lung that are filled with fluid it comes through very distinctly. It is the same as bronchophony, but it is a much more sensitive indicator. |
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Term
| Evaluation of the Thorax. 6 parts. |
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Definition
Skin
Muscle
Ribs
Spine
Lungs
Trachea |
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Term
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Definition
| vertebral line - scapular line |
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Term
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Definition
| peri-scapular - infra-scapular - supra-scapular - inter-scapular |
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Term
| anterior lines Locations - |
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Definition
| mid-sternal - mid-clavicular - anterior axillary - costal angle. infra-mammary - nipple line - costal margin - supra-clavicular - epigastric |
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Term
| landmark for post upper and lower lobe division |
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Definition
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Term
| Chest Wall Expansion Asymmetry |
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Definition
| Asymmetry - pain (splinting) - paralysis muscles diaphragm - pneumothorax - hemothorax - pleural effusion |
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Term
| 4 things for which to inspect thorax |
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Definition
Chest wall configuration
Symmetry
Muscle mass
Skin lesions |
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Term
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Definition
Increased A/P diameter
Decreases chest wall movement
Aging
Emphysema |
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Term
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Definition
Funnel Chest
Can compress mediastinal structures |
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Term
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Definition
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Term
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Definition
| When severe, can limit chest wall expansion and compromise breathing |
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Term
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Definition
Body position
“tri-pod position”
Retractions
Pursed lips |
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Term
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Definition
| Fingers - cyanosis - clubbing |
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Term
| normal, bradypnea, tachypnea, hyperpnea, cheyne-stokes |
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Definition
Normal: 12 to 20/min
Bradypnea: < 12/min
Tachypnea: > 20/min, normal depth
Hyperpnea (hyperventilation): > 20/min, and very deep
Cheyne-Stokes: grad increasing depth with periods of apnea. |
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Term
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Definition
Compress ribs - tenderness - deformity
Muscle mass
Temperature
Diaphoresis |
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Term
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Definition
Best over interspaces
Resonance - normal lung
Tympany - hyperinflated emphysema pneumothorax
Dullness - bone - fluid - solid organ |
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Term
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Definition
Strike DIPJ of one finger, pressed firmly against chest wall, with middle finger of other hand
Sharp strike needed to produce sufficient sound
No long nails! |
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Term
| percussion: pleximeter v. plexor |
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Definition
Strike briskly 2 or 3 times to produce sound
Pleximeter - finger pressed against chest
Plexor - “tapping” finger |
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Term
| what are you assessing in tactile fremitus |
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Definition
| What you are assessing is a change from side to side. |
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Term
| tactile fremitus which aspect of hand |
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Definition
3 or 4 paired locations anteriorly
Ulnar aspect of hands
Ask patient to say “99” |
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