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36 Cards in this Set
- Front
- Back
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High pitch, Loud amplitude, inspiration
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Bronchial (Tracheal)
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inspiration=expiration; moderate pitch; moderate amplitude; mixed sounds; heard over major bronchi where there are less alveoli (i.e.; between scapulae, around upper sternum;
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Bronchovesicular
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inspiration>expiration; low pitch; soft amplitude; rustling sound; heard over the peripheral lung fields where air flows through smaller bronchioles and alveoli
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Vesicular
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difficulty breathing when supine; state number of pillows needed to achieve comfort
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Orthopnea
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awakening from sleep with SOB and needing to be upright to achieve comfort
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Paroxysmal nocturnal dyspnea
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discontinuous, high-pitched, short crackling, popping sounds heard during inspiration; not cleared by coughing
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Fine crackles
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Clinical Example - Occurs with restrictive disease; pneumonia, heart failure, interstitial fibrosis
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Late inspiratory crackles
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Clinical Example - Occurs with chronic bronchitis, asthma and emphysema
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Early inspiratory crackles
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Clinical example- Fine crackles appear with change from sitting to supine position
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Posturally induced crackles
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Loud, low-pitched, bubbling and gurgling sounds; start in early inspiration; may be present in expiration; (sounds like opening a velcro fastener)
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Coarse crackles
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Clinical Example- Occurs in pulmonary edema, pneumonia, pulmonary fibrosis, terminally ill with depressed cough
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Coarse crackles
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sounds like fine crackles; do not last; not pathologic; disappear after first few breaths
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Atelectatic crackles
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Clinical example- In aging adults, in bedridden persons, or in persons just aroused from sleep
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Atelectatic crackles
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superficial sound; coarse and low pitched; grating quality; sounds just like crackles but close to the ear; two pieces of leather being rubbed together
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Pleural friction rub
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Clinical example- Pleuritis, accompanied by pain with breathing
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Pleural Friction rub
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These are discrete, crackling sounds
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Discontinuous Sounds
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These are connected, musical sounds
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Continuous Sounds
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High-pitched, musical speaking sounds that sound polyphonic; predominate in expiration but may occur in both expiration and inspiration
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High-pitched (sibilant) Wheeze
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Clinical example- diffuse airway obstruction from acute asthma or chronic emphysema
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High-pitched (sibilant) Wheeze
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Low-pitched; monophonic, single note, musical snoring, moaning sounds; heard throughout the cycle; more prominent in expiration; may clear somewhat by coughing
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Low-pitched (sonorous rhonchi) Wheeze
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Clinical example- Bronchitis, single bronchus obstruction from airway tumor
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Low-pitched (sonorous rhonchi) Wheeze
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high-pitched, monophonic, inspiratory, crowing sound; louder in neck than chest wall
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Stridor
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Clinical example- occurs in croup, acute epiglottitis in children, and foreign inhalation; may be life threatening
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Stridor
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collapsed shrunken section of alveoli or entire lung; results in 1) airway obstruction, alveolar air beyond is gradually absorbed by pulmonary capillaries, alveolar walls cave in; 2) compression on the lung; and 3) lack of surfactant (hyaline membrane disease)
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Atelectasis (collapse)
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pump failure with increasing pressure of cardiac overload causing pulmonary congestion or increased amount of blood present in pulmonary capillaries; dependent air sacs are deflated; pulmonary capillaries are engorged; bronchial mucosa may be swollen
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Heart failure
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Inspection: increased respiratory rate, SOB on exertion, orthopnea, paroxysmal nocturnal dyspnea, nocturia, ankle edema, pallor; Palpation: moist, clammy skin; fremitus normal; Percussion: resonant; Auscultation: normal vesicular; hear sounds include S3 gallop; Adventitious sounds: crackles at lung bases. |
Signs of heart failure
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RBC’s and WBC’s pass from blood to alveoli, alveoli progressively fill with bacteria, solid cellular debris, fluid and blood cells, decreases surface area of respiratory membrane; causes hypoxemia;
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Lobar pneumonia
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Excessive mucus secretion; inflammation of bronchi with partial obstruction by secretions or constrictions; acute or chronic;
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Bronchitis
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destruction of pulmonary connective tissue (elastin, collagen); permanent enlargement of air sacs; increased airway resistance, especially on expiration producing hyperinflated lung and an increase in lung volume (cigarette smoking 80-90% cases)
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Emphysema
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allergic hypersensitivity to inhaled allergens, irritants, microbes, stress or exercise, producing bronchospasm and inflammation, edema in bronchiole walls, secretion of viscous mucus to airways; symptoms include: wheezing, dyspnea, chest tightness;
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Asthma
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collection of excess fluid in intrapleural space with compression of overlying lung tissue; may contain watery, capillary fluid (transudative), protein (exudative), purulent matter (empyemic), blood (hemothorax), or milky lymphatic fluid (chylothorax);
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Pleural effusion (fluid) or thickening
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free air in pleural space causing partial or complete lung collapse; air neutralized the usual negative pressure that is present; can be 1) spontaneous (air enters space through puncture lung wall); 2) traumatic (air enters through opening or injury in chest wall); and 3) tension (trapped air in space increases, compressing lung);
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Pneumothorax
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virulent form of pneumonia; protozoal infection associated with AIDS; common in US but harmless to most people, except immunocompromised; cysts form in alveolar spaces, thickening their walls;
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Pneumonia
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inhalation of tubercle bacilli into alveolar wall; initial acute inflammatory response, then scar tissue forms, lesions calcify, reactivation of previously healed lesions, bacilli multiply; subjective: initially asymptomatic; weight loss; anorexia; easily fatigued; low grade afternoon fever; night sweats;
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Tuberculosis
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undissolved material originating in the legs/pelvis, detach and travel through venous system returning blood to R heart, which occludes pulmonary vessels; 99% arise from DVT; pulmonary occlusion results in ischemia of lung tissue, increased pulmonary artery pressure, decreased cardiac output and hypoxia; subjective: chest pain, worse on deep inspiration, dyspnea;
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Pulmonary embolism
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acute pulmonary insult damages alveolar capillary membrane leading to increased permeability of pulmonary capillaries and alveolar epithelium and pulmonary edema;
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Acute respiratory distress syndrome (ARDS)
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