Lung sounds - Learning Issue: Lung sounds Completed by:...

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Learning Issue: Lung sounds Completed by: Michael Holmes TABLE 17-2. -- Classic Physical Findings in Some Common Pulmonary Disorders Disorder Inspection Palpation Percussion Auscultation Bronchial asthma (acute attack) Hyperinflation; use of accessory muscles Impaired expansion; decreased fremitus Hyperresonance; low diaphragm Prolonged expiration: inspiratory and expiratory wheezes Pneumothorax (complete) Lag on affected side Absent fremitus Hyperresonant or tympanitic Absent breath sounds Pleural effusion (large) Lag on affected side Decreased fremitus; trachea and heart shifted away from affected side Dullness or flatness Absent breath sounds Atelectasis (lobar obstruction) Lag on affected side Decreased fremitus; trachea and heart shifted toward affected side Dullness or flatness Absent breath sounds Consolidation (pneumonia) Possible lag or splinting Increased fremitus on affected side Dullness Bronchial breath sounds; bronchophony; pectoriloquy; crackles Modified from Hinshaw HC, Murray JF (eds): Diseases of the Chest (4th ed). Philadelphia: WB Saunders, 1980, p 23. Adventitious Sounds Two generic categories of adventitious sounds have been documented by high-speed recording techniques, and each of these has two subdivisions: discontinuous sounds, including fine crackles and coarse crackles, and continuous sounds, including wheezes and rhonchi. Discontinuous Sounds (Crackles) Crackles, still often referred to as “rales” in the United States and “crepitations” in Great Britain, consist of a series of short explosive nonmusical sounds that punctuate the underlying breath sound; fine crackles are softer, shorter in duration, and higher in pitch than coarse crackles. There is general agreement that the brief recurrent detonations that characterize fine crackles are caused
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Lung sounds - Learning Issue: Lung sounds Completed by:...

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