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49 Cards in this Set
- Front
- Back
Resonant Percussion Note is produced when
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Percussing over normal lung tissue
= distribution of air & tissue |
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Hyperresonant Percussion Note is produced when
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Ther is an abnormal increase in the amount of air in the lungs
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A Dull percussion note is produced when
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a solid or liquid substance has replaced some of the normal air in the lungs
>proportion of tissue or fluid than of air |
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A flat percussion note is produced when
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airless tissue
contains a > proportion of tissue than of air |
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A tympanic percussion note is produced when
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percussing over an enclosed, air-filled chamber or cavity
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Lung disorders or diseases in which a hyperresonant sound is heard upon percussion
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small pneumothorax, lung hyperinflation due to emphysema or acute asthma attack. Area above pleural effusion
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Lung disorders or diseases in which a dull sound is heard upon percussion
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pneumonia, atelectasis, pulmonary edema, lung tumors, pleural effusion, pleural thickening or fibrosis and pulmonary fibrosis
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Lung disorders or diseases in which a flat note is heard upon percussion
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massive pleural effusions, pneumonectomy and massive atelectasis
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Lung disorders or diseases in which a tympanic note is heard upon percussion
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tension pneumothorax, large pulmonary cavity, and emphysematous bullae under tension
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Describe a resonant sound
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low in pitch and has a "muffled drum" sound
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Describe a hyperresonant sound
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low pitch and has a "hollow drum" sound
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Describe a dull percussion note
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moderately high pitched and has a "dull thud" sound
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Describe a flat percussion note
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relatively high pitched and has a "soft thud" sound
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Describe a tympanic percussion note
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usually highest in pitch when compared to other percussion notes and has a pure musical sound
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Four classifications of normal breath sounds
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1. vesicular
2. bronchial 3. bronchovesicular 4. tracheal |
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Vesicular Breath sounds
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low pitched, soft
I phase longer than E phase Heard over majority of lung periphery - excluding right apex |
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Bronchial Breath Sounds
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Higher pitched
Sounds like blowing through a tube; Loud E phase longer than I phase w/short pause between Heard over manubrium |
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Bronchovesicular Breath Sounds
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combination of vesicular and bronchial breath sounds w/out pause
I & E phases are about = |
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Tracheal Breath Sounds
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very harsh & high pitched
heard over trachea above clavicular notch E phase longer than I phase |
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Four common Adventitious Breath Sounds
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crackles
wheezes ronchi rubs |
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Crackles
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described as coarse or fine
produced by sudden opening of alveoli or sections of the lung |
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Wheezes
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High pitched continuous sound
generated by air passing through a narrowed lumen |
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Rhonci
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low pitched continuous sounds
described as "wet" produced by fluids or secretions vibrating in the airways |
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Pleural Rub
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Sounds like creaking leather
occurs when the visceral & pleural membranes rub w/more friction then normal |
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Stridor
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loud, high pitched musical wheeze heard primarily over the larynx & trachea on I
Indicates partial obstruction of structures |
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Grunting
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expiratory sound made by closing the glottis over the trachea during E, which increases P to help keep alveoli from collapsing
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Describe normal voice sounds
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if underlying tissue is normal (air-filled) the sound heard will be muffled and indistinct
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Reduction of voice sounds occurs when
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excessive amt. of air in lungs and/or pleural space
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Louder & clearer voice sounds are a result of:
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normally air-filled lung structures are filled with a liquid or solid
(there must be a patent airway to conduct the sounds) |
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Bronchophony
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an increase in the intensity and clarity of the spoken words
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Egophony
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word "E" yields a nasally sounding "A"
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Whispered Pectoriloquy
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an increase in the intensity and the clarity of whispered voice sounds
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clearly transmitted voice sounds indicate
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that the normally air filled lung structures have been replaced w/a solid or a liquid substance
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Diminished lung sounds can be due to:
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1. partial loss of ventilating tissue
2. hyperinflated lung tissue 3. abnormality that reduces sound transmission 4. Absence of functioning structures |
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What is tactile fremitus
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the feeling of vibrations on the chest wall with the hand
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What are the three forms of tactile fremitus?
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1. vocal fremitus
2. pleural rub fremitus 3. rhonchal fremitus |
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Decreased or absent vocal fremitus indicates
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that there is an increase in the amount of air in the lungs
collapsed or obstructed airways also prevent the transmission of sound |
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Increased vocal fremitus indicates
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an increased density of the lung (liquid or solid mediums)
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Plerual Rub Fremitus
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feel a grating sensation
indicates that the pleural surface is inflamed or roughened by disease. |
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Rhonchal Fremitus
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vibrations felt on chest wall when secretions are in the airways
can often clear w/a productive cough |
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Diseases/disorders associated w/a partial loss of ventilating lung tissue
resulting in decreased/absent lung sounds |
pneumonia
partial airway obstruction atelectasis |
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Abnormalities that reduce sound transmission
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pleural effusion
pleural thickening pneumothorax |
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Conditions that can lead to absent lung sounds
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pneumonectomy
atelectasis pneumothorax pleural effusion severe pleural fibrosis empyema diaphragmatic paralysis |
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airway narrowing accompanied by wheezing may occur from:
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1. Mediator release of bronchoactive substances (Asthma, Carcinoid Tumor)
2. Excess fluid in the lungs or edematous airways (Cardiogenic or Noncardiogenic pulmonary edema; 3. Airway inflammation & mucus secretion. (pneumonia, bronchitis, Bronchiolitis, Bronchiectasis, Asthma) 4. Partial Airway Obstruction (large lung tumor, foreign object, mucus plug) |
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Crackles are indicative of
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airway collapse
alveolar collapse fluid or mucous in airways fluid or mucous in alveoli |
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Diseases or disorders that may present with Fine Crackles
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high pitched - on I
atelectasis, interstitial fibrosis, early pulmonary edema, early left ventricular failure, CHF, interstitial pneumonia |
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Characteristics of Fine Crackles
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high pitched cracling or popping noises on I
caused by seperation of alveolar walls that are mildly adhered to each other due to fluid or mucus w/in the alveoli; Also result from sudden "popping open" of alveoli that collapsed on previous E. |
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Medium Crackles Characteristics
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medium pitched w/a wet moist quality, usually occur early to mid I but may occure throughout E.
Result of fluid/mucus filled bronchial or bronchiolar walls that are separated by the passage of air during lung expansion. |
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Coarse Crackles Characteristics
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low pitched w/a loud bubbly quality
Result of air bubbling through fluid or mucus in the larger, more proximal airways |