auscultation: listening to breath sounds with a stethoscope
TRANSCRIPT
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Auscultation: Listening to breath sounds with a stethoscope
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Normal Breath Sounds and Their Locations
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Abnormal Breath Sounds: Diminished or Absent
Increased distance between aerated lung and chest wall:
Pneumothorax, Pleural effusion, Atelectasis, Obesity around thorax
Decreased or absent airflowAirflow obstruction (eg asthma), Hyperinflation (COPD), Malpositioned ET Tube
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Abnormal Breath Sounds: Bronchial or Bronchovesicular in abnormal part of the lung
Lung has become more solid and less aerated in these areasConsolidation, eg, pneumonia, or Atelectasis
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Abnormal Breath Sounds: Adventitious Sounds
Wheeze – continuous musical sounds heard mostly during expiration
May be also heard on inspiration
Caused by a sudden change in airway caliber
Edema, spasm, secretions, foreign body
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Abnormal Breath Sounds: Adventitious Sounds
Crackles – discontinuous sound heard mostly on inspirationCaused by small airways and alveoli popping open or from secretions in very large airways
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Lets all listen in
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Condition Chest Excursion
Fremitus Percussion
BreathSounds
Atelectasis
Pneumothorax
Pleural Effusion
COPD
Pulmonary Consolidation
Fibrosis
Pulmonary Edema
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Chest Physical Exam: Case Study
A patient is admitted with fever and cough. Auscultation reveals bronchial breath sounds in the lower chest posteriorly and normal vesicular breath sounds in the restof the lower thorax.
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Chest Physical Exam: Case Study
A patient is scheduled for inguinal herniasurgery. Observation reveals increased APdiameter and use of accessory muscles forbreathing. Auscultation yields diminishedbreath sounds in the upper and middle chest and absent breath sounds in the lower chest.
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Chest Physical Exam: Case Study
A 12 year patient in the ER with respiratory distress has bilateral wheezes throughout bothlung fields and prolonged expiration. A-P diameter of the chest is increased.
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Chest Physical Exam: Case Study
A ventilator patient suddenly becomes diaphoreticand tachycardic. The pressure limit alarm on theventilator is sounding on every breath. Auscultationshows absent breath sounds on the left and percussion yields hyperresonance on the left.