Respiratory Concept Lab

  Respiratory Concept Lab When your patient breathes, air rushes through the nasal passages & trachea, the bronchi, & into the lungs where it’s absorbed by the alveoli. Healthcare professionals listen to these sounds through a stethoscope – a process called auscultation. Once you know how to listen to these sounds, they can give you diagnostic information about your patient’s respiratory system.           Normal Lung Sounds Bronchial o You can hear bronchial sounds above the manubrium, over the trachea. o Bronchial sounds are: Harsh High-pitched Loud Bronchovesicular o These sounds are heard over the main bronchi. o These sounds are: Medium in loudness Medium in pitch Vesicular o These sounds are heard over the lower bronchi, the bronchioles, & the lobes. o The left lung has two lobes. The right has three lobes. o Vesicular sounds are: Softest Lowest in pitch   Abnormal Lung Sounds Decreased Breath Sounds o Normal lung sounds are usually easy to hear with a stethoscope. Occasionally you will hear sounds that are decreased in intensity, or even absent. o Decreased breath sounds occur in airway disease or obstruction, diaphragm paralysis, or impairment of sound transmission through the chest wall. o Worsening symptoms may lead to absent breath sounds. Absent lung sounds usually indicate that no air is moving in the lung tissue. Increased Breath Sounds o Location of breath sounds matters! o A “normal sound” is not normal if it is in the wrong place. o A common abnormal finding is hearing bronchial or bronchovesicular sounds, which are louder and harsher, in peripheral lung tissues where vesicular sounds are normally heard. This occurs when underlying lung tissue is filled with liquid or solid material, rather than air.                         Adventitious Sounds o When you auscultate, you might hear abnormal sounds in additions to the normal lung sounds. These additional abnormal sounds are called adventitious sounds. o Crackles (Fine) Fine crackles, as the name indicates, are high-pitched crackling sounds that occur when inhaled air meets deflated alveoli, causing them to pop open. Short popping sounds High-pitched Location: usually bases of lower lobes TIP: Fine crackles sound like the noise created by rolling a strand of hair between your thumb & index finger. The existence of fine crackles in a vesicular region is a likely indicator of pneumonia – an inflammatory condition of the lung usually caused by an infection. Pneumonia is a major cause of death among all age groups, resulting in 4 million deaths (7%) of the world’s total death) yearly. o Crackles (Coarse) Coarse crackles are loud, low-pitched bubbling sounds that are caused when air meets secretions in the large airways. Short crackling sounds Low-pitched Location: Trachea & large bronchi TIP: Coarse crackles sound like separating a Velcro fastener. o Rhonchi Rhonchi are continuous, low-pitched snoring sounds caused by airway obstruction from thick secretions, muscular constriction, or masses. Long snoring sounds Low-pitched Location: Bronchi TIP: Rhonchi can sound like snoring or moaning. o Wheezes Wheezes are continuous, high-pitched musical sounds that are created by the narrowing of airways from swelling, secretions, or masses. Long musical sounds High-pitched Location: all lung fields o Stridor Stridor is a loud, continuous, high-pitched crowing sound that is caused by upper airway obstruction. This is the most serious of the adventitious sounds & it requires immediate attention.     Long crowing sounds High-pitched Location: trachea TIP: Stridor is usually audible without a stethoscope.