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51 Cards in this Set
- Front
- Back
How does vesicular breathing sound?
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Swishing noise, blowing air with letter "f"
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Vesicular breathing originate from?
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Inspiration air --> Narrower bronchioles --> Wide alveolar sacs --> Eddies (whirl)
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When do we hear vesicular breathing?
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Only inspiration
--> During expiration air goes from wide alevoli to narrow bronchioles --> No sound |
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Ratio of normal insp/exp RR?
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3:1
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What does tubular breathing sound like? (bronchial)
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A throaty "kh"
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Tubular breathing comes from?
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Air through larynx & bronchial tree
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Ratio of insp/exp in tubular breathing?
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Longer expiratory
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Physiological tubular breathing may be heard where?
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1. Over larynx & trachea
2. C7 vertebra 3. Th4 vertebra to the right (R bronchus nearby) 4. In axillae |
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Increased vesicular breathing may be a sign of?
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Increased air hunger
- Kussmaul´s acidotic breathing Unilateral hyperventilation Lobar pneumonia Pneumothorax Pleural effusion |
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Decreased vesicular breathing may be a sign of?
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Obesity (physiological)
- Decreased breathing motion (pain,pleurisy) - Pleuropulmonary adhesions - Effusion, pneumothorax - Emphysema - Obstructive atelectasis |
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Inaudible breathing may be a sign of?
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Large pneumothorax
Big pleural effusion Atelectases |
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Vesicular breathing with prolonged expiration may be heard in?
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Bronchial asthma
Bronchiolitis Spasm, swelling, presence of secretion Emphysema (due to loss of alveoli&elasticity) |
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What is pleurisy?
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Inflammation of pleurae, less lubrication
--> Lead to pain in breathing (pneumonia) |
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Bronchial breathing is not a normal finding - when is it heard?
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When vesicular / alveolar areas are compromised, but bronchial tree is unobstructed
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Airless alveoli is heard when?
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1. Filled with path. material
2. Compressed from outside |
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What is amphoric breathing?
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Tubular breathing heard over a large pulmonary cavity - communicating with bronchus
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What is compressive breathing?
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Intermediate b/w vesicular & tubular breathing
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When and where can we hear compressive breathing?
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Upper border of large pleural effusions
- Caused by pressure of pleural fluid upon adj. lung tissue --> Expiration |
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Rales is heard in the presence of?
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1. Liquid / semiliquid in alveoli, bronchioli, bronchi
2. Bronchospasm |
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Rales is also called?
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Adventitious sounds
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Rales are divided into?
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Dry rales
Moist rales |
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High and low pith dry rales?
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High: Whistles
Low: Rhonci (like snoring - secretion in bronchial airways) |
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Char. of moist rales according to bubble size?
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1. Crackling - small
2. Crepitant - medium 3. Gurgling - large (rhonci) |
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Dry rales appear when?
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Medium/large bronchi are filled with thick or viscous exudate adhering to bronchial wall
--> Spasm of bronchi may contribute |
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Dry rales are heard in which disorders?
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- Chronic bronchitis
- Bronchial asthma |
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Dry rales are heard in which breathing phase?
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Both insp&exp
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Moist rales also is called?
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Crackles, creptiations
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Crackles may be divided into... according to their intensity?
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Accentuated & unaccentuated - according to their intensity
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How is an accentuated rale?
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Clear, close to the ear
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How is an unaccentuated rale?
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Flat, coming from a distance
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Why does accentuated rales sound "closer"?
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Cause inflitration of the lung transmit sound better than tissue filled with air
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Moist crackles are found in?
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Pneumonia - acc.
Bronchopneumonia Bronchiectasis |
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A flood of crackling & crepitant is found in?
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Pulmonary edema
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Continuous acc. moist rales over lower lobes may indicate?
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Bronchiectasis
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Can moist&dry rales coexist?
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Yes
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What is bronchiectasis?
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Abnormal widening of bronchi
--> Increased risk of infection |
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When is physiological inspiratory creptiations heard?
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During shallow breathing, like after surgery during first breaths - when alveoli expand and air rushes in. Dissapear quickly
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When is pathological inspiratory creptiations heard?
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Early & late stages of pneumonia:
Crepitus indux Crepitus redux Exudate stick alveoli walls together - when air enters crepitation is heard |
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What can we sometimes hear in pulmonary infarction & over tuberculous infiltrate?
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Crepiration after coughing
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Sounds heard sometimes in idiopathic pulmonary fibrosis?
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Popping sound resembling tearing of parchment paper (during inhalation)
A very dry crackling |
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What is stridor?
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Wheezing sound in narrowing of the large airways
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What is the pleural friction rub?
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A sound resembling frozen snow caused by friction of inflamed and roughened pleural layers
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Where is pleural friction rub best heard?
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In axilla & below scapular angle
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What can better the pleural friction rub?
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Continuous deep breathing
--> NOT coughing! |
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What is bronchophony?
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Placing ear or stethoscope over chest when patient speak words (like fremitus)
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How does bronchophony of a healthy lung sounds?
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Unclear words
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How does bronchophony over a infiltrated dense lung sound?
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Clear words
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Increased bronchophony is found in?
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Pneumonia
Infarction |
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Decreased bronchophony is found in?
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Pleural exudate
Pneumothorax Obstructive atelectasis Over massive pleural thickenings |
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What is pectoriloquy?
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Exaggerated bronchophony. Then we use the whisper voice, which is only heard over trachea & main bronchi, but poorly.
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If pectoriloquy is heard over lung tissue it means?
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Infiltrative process in the lung
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