Wake Pulm Ccl 1

Front 1

Normal Lungs
(Percussion)
(Trachea)
(Tactile Fremitus)

Back 1

Percussion: Resonant

Trachea: Midline

Tactile Fremitus: Normal

Front 2

Chronic Bronchitis
(Percussion)
(Trachea)
(Tactile Fremitus)

Back 2

Percussion: Resonant

Trachea: Midline

Tactile Fremitus: Normal

Front 3

Left Sided Heart Failure
(Percussion)
(Trachea)
(Tactile Fremitus)

Back 3

Percussion: Resonant

Trachea: Midline

Tactile Fremitus: Normal

Front 4

Consolidation
(Percussion)
(Trachea)
(Tactile Fremitus)

Back 4

Percussion:DULL over the airless area

Trachea: Midline

Tactile Fremitus: Increased over the involved area, with bronchophony, egophany, and whisphered pectoriloquy

Front 5

Atelectasis
(Percussion)
(Trachea)
(Tactile Fremitus)

Back 5

Percussion: DULL over the airless area

Trachea: may be shifted toward the INVOLVED SIDE

Tactile Fremitus: Usually absent when the bronchial plug persists.

In exceptions (right upper lobe atelectasis) may be increased.

Front 6

Pleural Effusion
(Percussion)
(Trachea)
(Tactile Fremitus)

Back 6

Percussion: DULL to FLAT over the fluid

Trachea: Shifted toward the OPPOSITE side in a large effusion

Tactile Fremitus: Decreased to absent, but may be increased toward the top of a large effusion

Front 7

Pneumothorax
(Percussion)
(Trachea)
(Tactile Fremitus)

Back 7

Percussion: HYPERRESONANT or TYMPANITIC over the pleural air

Trachea: Shifted toward the OPPOSITE side, if much air

Tactile Fremitus: Decreased to absent over the pleural area

Front 8

COPD
(Percussion)
(Trachea)
(Tactile Fremitus)

Back 8

Percussion: diffusely HYPERRESONANT

Trachea: Midline

Tactile Fremitus: Decreased

Front 9

Asthma
(Percussion)
(Trachea)
(Tactile Fremitus)

Back 9

Percussion: RESONANT to diffusely HYPERRESONANT

Trachea: Midline

Tactile Fremitus: Decreased

Front 10

Pleural Effusion
(Breath Sounds)
(Adventitious Sounds)

Back 10

Breath Sounds: Decreased to absent, but bronchial breath sounds may be heard near top of large effusion

Adventitious Sounds: None, except a possible pleural rub

Front 11

Pneumothorax
(Breath Sounds)
(Adventitious Sounds)

Back 11

Breath Sounds: Decreased to absent over the pleural air

Adventitious Sounds: None, except a possible pleural rub

Front 12

COPD
(Breath Sounds)
(Adventitious Sounds)

Back 12

Breath Sounds: Decreased to absent

Adventitious Sounds: None, or the crackles, wheezes, and ronchi of associated chronic bronchitis

Front 13

Asthma
(Breath Sounds)
(Adventitious Sounds)

Back 13

Breath Sounds: Often obscured by wheezes

Adventitious Sounds: Wheezes, possibly crackles

Front 14

Normal Lungs
(Breath Sounds)
(Adventitious Sounds)

Back 14

Breath Sounds: Vesicular, except perhaps bronchovesicular over the large bronchi and bronchial over the trachea

Adventitious Sounds: None, except perhaps a few transient inspiratory crackles at the bases of the lungs

Front 15

Chronic Bronchitis
(Breath Sounds)
(Adventitious Sounds)

Back 15

Breath Sounds: Vesicular (normal)

Adventitious Sounds: None; or scattered coarse crackles in early inspiration and perhaps expiration; or wheezes or rhonchi

Front 16

Left-Sided Heart Failure
(Breath Sounds)
(Adventitious Sounds)

Back 16

Breath Sounds: Vesicular

Adventitious Sounds: Late inspiratory crackles in the dependent portions of the lungs; possibly wheezes

Front 17

Consolidation
(Breath Sounds)
(Adventitious Sounds)

Back 17

Breath Sounds: Bronchial over the involved area

Adventitious Sounds: Later inspiratory crackles over the involved area

Front 18

Atelectasis
(Breath Sounds)
(Adventitious Sounds)

Back 18

Breath Sounds: Usually absent when bronchial plug persists. Exceptions include right upper lobe atelectasis, where adjacent tracheal sounds may be transmitted.

Adventitious Sounds: None