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51 Cards in this Set

  • Front
  • Back
How does vesicular breathing sound?
Swishing noise, blowing air with letter "f"
Vesicular breathing originate from?
Inspiration air --> Narrower bronchioles --> Wide alveolar sacs --> Eddies (whirl)
When do we hear vesicular breathing?
Only inspiration
--> During expiration air goes from wide alevoli to narrow bronchioles --> No sound
Ratio of normal insp/exp RR?
3:1
What does tubular breathing sound like? (bronchial)
A throaty "kh"
Tubular breathing comes from?
Air through larynx & bronchial tree
Ratio of insp/exp in tubular breathing?
Longer expiratory
Physiological tubular breathing may be heard where?
1. Over larynx & trachea
2. C7 vertebra
3. Th4 vertebra to the right (R bronchus nearby)
4. In axillae
Increased vesicular breathing may be a sign of?
Increased air hunger
- Kussmaul´s acidotic breathing
Unilateral hyperventilation
Lobar pneumonia
Pneumothorax
Pleural effusion
Decreased vesicular breathing may be a sign of?
Obesity (physiological)

- Decreased breathing motion (pain,pleurisy)
- Pleuropulmonary adhesions
- Effusion, pneumothorax
- Emphysema
- Obstructive atelectasis
Inaudible breathing may be a sign of?
Large pneumothorax
Big pleural effusion
Atelectases
Vesicular breathing with prolonged expiration may be heard in?
Bronchial asthma
Bronchiolitis

Spasm, swelling, presence of secretion
Emphysema (due to loss of alveoli&elasticity)
What is pleurisy?
Inflammation of pleurae, less lubrication
--> Lead to pain in breathing (pneumonia)
Bronchial breathing is not a normal finding - when is it heard?
When vesicular / alveolar areas are compromised, but bronchial tree is unobstructed
Airless alveoli is heard when?
1. Filled with path. material
2. Compressed from outside
What is amphoric breathing?
Tubular breathing heard over a large pulmonary cavity - communicating with bronchus
What is compressive breathing?
Intermediate b/w vesicular & tubular breathing
When and where can we hear compressive breathing?
Upper border of large pleural effusions
- Caused by pressure of pleural fluid upon adj. lung tissue

--> Expiration
Rales is heard in the presence of?
1. Liquid / semiliquid in alveoli, bronchioli, bronchi
2. Bronchospasm
Rales is also called?
Adventitious sounds
Rales are divided into?
Dry rales
Moist rales
High and low pith dry rales?
High: Whistles
Low: Rhonci (like snoring - secretion in bronchial airways)
Char. of moist rales according to bubble size?
1. Crackling - small
2. Crepitant - medium
3. Gurgling - large (rhonci)
Dry rales appear when?
Medium/large bronchi are filled with thick or viscous exudate adhering to bronchial wall

--> Spasm of bronchi may contribute
Dry rales are heard in which disorders?
- Chronic bronchitis
- Bronchial asthma
Dry rales are heard in which breathing phase?
Both insp&exp
Moist rales also is called?
Crackles, creptiations
Crackles may be divided into... according to their intensity?
Accentuated & unaccentuated - according to their intensity
How is an accentuated rale?
Clear, close to the ear
How is an unaccentuated rale?
Flat, coming from a distance
Why does accentuated rales sound "closer"?
Cause inflitration of the lung transmit sound better than tissue filled with air
Moist crackles are found in?
Pneumonia - acc.
Bronchopneumonia
Bronchiectasis
A flood of crackling & crepitant is found in?
Pulmonary edema
Continuous acc. moist rales over lower lobes may indicate?
Bronchiectasis
Can moist&dry rales coexist?
Yes
What is bronchiectasis?
Abnormal widening of bronchi

--> Increased risk of infection
When is physiological inspiratory creptiations heard?
During shallow breathing, like after surgery during first breaths - when alveoli expand and air rushes in. Dissapear quickly
When is pathological inspiratory creptiations heard?
Early & late stages of pneumonia:

Crepitus indux
Crepitus redux

Exudate stick alveoli walls together - when air enters crepitation is heard
What can we sometimes hear in pulmonary infarction & over tuberculous infiltrate?
Crepiration after coughing
Sounds heard sometimes in idiopathic pulmonary fibrosis?
Popping sound resembling tearing of parchment paper (during inhalation)

A very dry crackling
What is stridor?
Wheezing sound in narrowing of the large airways
What is the pleural friction rub?
A sound resembling frozen snow caused by friction of inflamed and roughened pleural layers
Where is pleural friction rub best heard?
In axilla & below scapular angle
What can better the pleural friction rub?
Continuous deep breathing
--> NOT coughing!
What is bronchophony?
Placing ear or stethoscope over chest when patient speak words (like fremitus)
How does bronchophony of a healthy lung sounds?
Unclear words
How does bronchophony over a infiltrated dense lung sound?
Clear words
Increased bronchophony is found in?
Pneumonia
Infarction
Decreased bronchophony is found in?
Pleural exudate
Pneumothorax
Obstructive atelectasis
Over massive pleural thickenings
What is pectoriloquy?
Exaggerated bronchophony. Then we use the whisper voice, which is only heard over trachea & main bronchi, but poorly.
If pectoriloquy is heard over lung tissue it means?
Infiltrative process in the lung