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40 Cards in this Set

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Resonant Percussion Note is produced when

Percussing over normal lung tissue
= distribution of air & tissue
A Dull percussion note is produced when
a solid or liquid substance has replaced some of the normal air in the lungs
>proportion of tissue or fluid than of air
A flat percussion note is produced when
airless tissue
contains a > proportion of tissue than of air
A tympanic percussion note is produced when
percussing over an enclosed, air-filled chamber or cavity
Lung disorders or diseases in which a dull sound is heard upon percussion
pneumonia, atelectasis, pulmonary edema, lung tumors, pleural effusion, pleural thickening or fibrosis and pulmonary fibrosis
Lung disorders or diseases in which a flat note is heard upon percussion
massive pleural effusions, pneumonectomy and massive atelectasis
Lung disorders or diseases in which a tympanic note is heard upon percussion
tension pneumothorax, large pulmonary cavity, and emphysematous bullae under tension
Describe a resonant sound
low in pitch and has a "muffled drum" sound
Describe a hyperresonant sound
low pitch and has a "hollow drum" sound
Describe a dull percussion note
moderately high pitched and has a "dull thud" sound
Describe a flat percussion note
relatively high pitched and has a "soft thud" sound
Describe a tympanic percussion note
usually highest in pitch when compared to other percussion notes and has a pure musical sound
Four classifications of normal breath sounds
1. vesicular
2. bronchial
3. bronchovesicular
4. tracheal
Vesicular Breath sounds
low pitched, soft
I phase longer than E phase
Heard over majority of lung periphery - excluding right apex
Bronchial Breath Sounds
Higher pitched
Sounds like blowing through a tube; Loud
E phase longer than I phase w/short pause between
Heard over manubrium
Bronchovesicular Breath Sounds
combination of vesicular and bronchial breath sounds w/out pause
I & E phases are about =
Tracheal Breath Sounds
very harsh & high pitched
heard over trachea above clavicular notch
E phase longer than I phase
Four common Adventitious Breath Sounds
crackles
wheezes
ronchi
rubs
Crackles
described as coarse or fine
produced by sudden opening of alveoli or sections of the lung
Wheezes
High pitched continuous sound
generated by air passing through a narrowed lumen
Rhonci
low pitched continuous sounds
described as "wet"
produced by fluids or secretions vibrating in the airways
Pleural Rub
Sounds like creaking leather
occurs when the visceral & pleural membranes rub w/more friction then normal
Stridor
loud, high pitched musical wheeze heard primarily over the larynx & trachea on I
Indicates partial obstruction of structures
Describe normal voice sounds
if underlying tissue is normal (air-filled) the sound heard will be muffled and indistinct
Reduction of voice sounds occurs when
excessive amt. of air in lungs and/or pleural space
Louder & clearer voice sounds are a result of:
normally air-filled lung structures are filled with a liquid or solid
(there must be a patent airway to conduct the sounds)
Diminished lung sounds can be due to:
1. partial loss of ventilating tissue
2. hyperinflated lung tissue
3. abnormality that reduces sound transmission
4. Absence of functioning structures
What is tactile fremitus
the feeling of vibrations on the chest wall with the hand
What are the three forms of tactile fremitus?
1. vocal fremitus
2. pleural rub fremitus
3. rhonchal fremitus
Decreased or absent vocal fremitus indicates
that there is an increase in the amount of air in the lungs
collapsed or obstructed airways also prevent the transmission of sound
Plerual Rub Fremitus
feel a grating sensation
indicates that the pleural surface is inflamed or roughened by disease.
Diseases/disorders associated w/a partial loss of ventilating lung tissue
resulting in decreased/absent lung sounds
pneumonia
partial airway obstruction
atelectasis
Abnormalities that reduce sound transmission
pleural effusion
pleural thickening
pneumothorax
Conditions that can lead to absent lung sounds
pneumonectomy
atelectasis
pneumothorax
pleural effusion
severe pleural fibrosis
empyema
diaphragmatic paralysis
airway narrowing accompanied by wheezing may occur from:
1. Mediator release of bronchoactive substances (Asthma, Carcinoid Tumor)
2. Excess fluid in the lungs or edematous airways (Cardiogenic or Noncardiogenic pulmonary edema;
3. Airway inflammation & mucus secretion. (pneumonia, bronchitis, Bronchiolitis, Bronchiectasis, Asthma)
4. Partial Airway Obstruction (large lung tumor, foreign object, mucus plug)
Crackles are indicative of
airway collapse
alveolar collapse
fluid or mucous in airways
fluid or mucous in alveoli
Diseases or disorders that may present with Fine Crackles
high pitched - on I
atelectasis, interstitial fibrosis, early pulmonary edema, early left ventricular failure, CHF, interstitial pneumonia
Characteristics of Fine Crackles
high pitched cracling or popping noises on I
caused by seperation of alveolar walls that are mildly adhered to each other due to fluid or mucus w/in the alveoli;
Also result from sudden "popping open" of alveoli that collapsed on previous E.
Medium Crackles Characteristics
medium pitched w/a wet moist quality, usually occur early to mid I but may occure throughout E.
Result of fluid/mucus filled bronchial or bronchiolar walls that are separated by the passage of air during lung expansion.
Coarse Crackles Characteristics
low pitched w/a loud bubbly quality
Result of air bubbling through fluid or mucus in the larger, more proximal airways