Ab Thorax Week 5

When you ask the patient to say "99" and the sound is louder, clearer and more distinct than normal.

bronchophony

When you ask the patient to whisper "99" and the sound is louder, clearer and more distinct than normal.

pectoriloquy

What does the abnormal finding for both bronchophony and pectoriloquy suggests?

consolidation

Which transmitted voice sound is the most sensitive physical diagnostic test for this condition of consolidation?

pectoriloquy

If these abnormal voice sounds (bronchophony and pectoriloquy) are auscultated, you would expect tactile fremitus over those areas to be _________.

increased

When you ask the patient to say "ee" and the sound is heard as "ay", with a nasal quality to the sound.

egophony

Egophony is primarily heard over ____________________.

meniscus of pleural effusion

An example of tracheal displacement ipsilateral (toward lesion) would be?

atelectasis with bronchial plug

Examples of tracheal displacement contralateral (away from lesion) would be?

large pneumothorax; tumor; large pleural effusion

The normal respiratory rate in infants is _________ than in adults. Up to (_______ BPM).

faster; 44 BPM

Breathing that is deep due to metabolic acidosis that may be fast, normal in rate or slow.

kussmaul

Periods of deep breathing alternate with periods of apnea is known as?

cheyne-stokes

According to Bates, Cheyne-Stokes may occasionally be seen in what demographic?

sleeping children

What are other causes of Cheyne-Stokes?

heart failure; uremia; drugs; brain damage

Breaths may be shallow or deep and stop for short periods caused by brain damage at the medullary level.

ataxic (Biot's)

This breathing is caused by prolonged expiration due to narrowed airways.

obstructive

Obstructive breathing is caused by what three things?

asthma, COPD, bronchitis

While occasional sighs are normal, Sighing Respiration may suggest _________, which is a common cause of _________ and __________.

hyperventilation syndrome; dizziness; dyspnea

Gurgling rale is produced when air passes through large amounts of pulmonary secretion sin the _________, as it occurs in patients who are________. This type of rake is sometimes called the "_____________"

trachea; moribund; death rattle

What are two conditions that may cause the pleura to become inflamed?

infection and pulmonary infarction

The sound produced by inflamed pleurae is called...

pleural friction rub

Pleural friction rub is similar to the sound of chest hair moving under the stethoscope. Pressing the stethoscope more firmly against the chest wall will cause the sound of the chest hair to _________ but the inflamed pleural sound to ________.

decrease; increase

T/F: The sound of inflamed pleura may diminish after a few respiratory cycles.

T

What is the splashing sound called that is heard upon shaking a patient who has both air and fluid in the pleural cavity?

succussion splash

The presence of air under the skin that can produce a popping sound. When the air pockets are pushed back and forth is called?

subcutaneous emphysema

Grating sound produced when the two ends of a fractured rib are rubbed together is called ________________.

bone crepitus

*CHART

Chronic Bronchitis

Percussion:

Trachea:

Breath Sounds:

Adventitious Sounds:

Fremitus:

Voice Sounds:

resonant

midline

normal

wheezes; rhonchi; crackles

normal

normal

*CHART

Consolidation

Percussion:

Trachea:

Breath Sounds:

Adventitious Sounds:

Fremitus:

Voice Sounds:

dull

midline

bronchovesicular; bronchial

late inspiratory crackles

increased

pectoriloquy; bronchophony

*CHART

Atelectasis w/ Bronchial Plug

Percussion:

Trachea:

Breath Sounds:

Adventitious Sounds:

Fremitus:

Voice Sounds:

dull

ipsilateral deviation

absent

absent

decreased

absent

*CHART

Pleural Effusion

Percussion:

Trachea:

Breath Sounds:

Adventitious Sounds:

Fremitus:

Voice Sounds:

small: dull; large: flat

small: midline; large: contralateral deviation

over effusion: absent; above effusion: bronchial

none

decreased over effusion

egophony @ meniscus

*CHART

Pneumothorax

Percussion:

Trachea:

Breath Sounds:

Adventitious Sounds:

Fremitus:

Voice Sounds:

hyper-resonant

small: midline; large: contralateral deviation

decreased OR absent

none

decreased

decreased OR absent

*CHART

Emphysema

Percussion:

Trachea:

Breath Sounds:

Adventitious Sounds:

Fremitus:

Voice Sounds:

hyper-resonant

midline

diminished vesicular

wheezes

decreased

decreased