Physical Diagnosis Block 2

Continuous whistling sounds heard as air rushes through narrowed airways. Often high pitched, reflecting air movement through smaller airways or bronchioles, they are musical in nature. This description perfectly matches the symptoms of wheezing, which is the correct answer.

Egophany refers to the abnormal transmission of sound from the lungs to the chest wall and stethoscope. It is a characteristic finding in cases of lung consolidation, where the lung tissue becomes solid due to conditions like pneumonia. In lung consolidation, the air-filled spaces in the lungs are replaced with fluid or inflammatory material, which acts as a better conductor of sound. This allows sounds produced in the bronchi to travel directly to the chest wall and can be heard more clearly through a stethoscope. Therefore, the statement is true.

The given correct answer is "Low-pitched wheeze, Rhonchi". This suggests that the sound described in the question is a low-pitched wheeze and rhonchi. A low-pitched wheeze is a sound that occurs when air rushes through narrowed, wider caliber bronchi, indicating secretions in the large airways. Rhonchi are also similar to snoring and can be heard when there are secretions in the large airways. Therefore, the presence of a low-pitched wheeze and rhonchi suggests the presence of secretions in the large airways.

Auscultation involves listening to 4-6 areas posteriorly and 1-2 areas anteriorly and laterally

A vesicular breath sound refers to the normal sound heard during breathing. It is a low-pitched, soft, and gentle sound that is heard over most of the lung fields. This sound indicates that the air is flowing freely through the airways and the lungs are functioning properly. Therefore, the correct answer is "Normal."

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Fremitus refers to the palpable vibrations that can be felt through the chest when a patient speaks, particularly when they say "Ninety nine". These vibrations are transmitted through the bronchopulmonary tree, which includes the bronchi and lungs. Fremitus can be assessed by placing hands on the patient's chest while they speak and feeling for the vibrations. It can provide important information about the condition of the lungs and airways, such as the presence of fluid or consolidation.

Bronchovesicular breath sounds are characterized by a mix of normal and abnormal sounds. These sounds are heard during auscultation of the lungs and are produced by the air moving through the larger airways. Normally, bronchovesicular breath sounds are heard in specific areas of the lungs, such as over the main bronchi. However, if these sounds are heard in abnormal locations or if they are altered in intensity or pitch, it may indicate an underlying respiratory condition. Therefore, the correct answer states that bronchovesicular breath sounds are mixed normal and abnormal.

Bronchophony refers to the increased loudness and clarity of breath sounds heard during auscultation. This can occur in conditions such as consolidation of lung tissue, where sound waves are transmitted more efficiently. It is characterized by a clearer and louder transmission of spoken words, indicating an abnormality in the lung. Therefore, bronchophony is the correct term to describe louder, clearer breath sounds.

Vesicular breath sounds are heard during inspiration. During this phase of breathing, the diaphragm contracts and moves downward, causing the lungs to expand. As the lungs expand, air is drawn in through the airways, creating a gentle and rustling sound known as vesicular breath sounds. These sounds are typically heard over most of the lung fields and are considered normal in healthy individuals.

When a patient whispers "one, two, three" the whispered voice is faint and indistinct, if heard at all. Louder, whispered sounds are called whispered pectoriloquy. The millions of alveoli that normally baffle and break up whispered sounds into indistinguishable noises are not able to do so when the lung is consolidated, and the character of the sounds is clearly distinguishable by the stethoscope

Fremitus is decreased or absent when the voice is soft or when the transmission of vibrations from the larynx to the surface of the chest is impeded. Causes include obstructed bronchus, COPD, separation of pleural surfaces by fluid (pleural effusion), fibrosis (thickening), air (pneumothorax), infiltrating tumor or thick chest wall

Generalized hyperresonance may be heard over the hyperinflated lungs of emphysema or asthma, but is not a reliable sign for them.

Bronchial breath sounds are abnormal 'breathy' sounds. Normally, breath sounds heard over the bronchial tree are louder and higher pitched than over the lung periphery. However, if these sounds become more audible and have a harsh, blowing quality, it indicates an abnormality. This can occur in conditions such as bronchial obstruction, consolidation of lung tissue, or lung fibrosis. The abnormal 'breathy' sounds suggest a disruption in the normal airflow through the bronchial tree, leading to altered breath sounds.

A lung percussion sound would be dull when fluid or solid tissue replaces the air-containing lung. This can occur in conditions such as lobar pneumonia, hemothorax, or tumor. In these cases, the normal resonance of the lung is replaced by a dull sound due to the presence of fluid or solid tissue, which hinders the transmission of sound waves. This can be detected during a physical examination by tapping on the chest and listening for the resulting sound.

A normal, air-filled lung would cause percussion to give a resonance sound because when the lung is filled with air, it creates a hollow space that allows sound waves to vibrate and resonate. This resonance sound is characteristic of a healthy lung and indicates that there is no obstruction or abnormality present.

Vesicular breath sounds are soft and low pitched, heard through inspiration, and fade away about 1/3 of the way through expiration. They resemble the quiet sound of a breeze rustling the leaves of a tree and represent air blowing through the small airways. These characteristics are normal and indicate normal lung function. They are not abnormal or indicative of pneumonia.

Differences in pitch and intensity are often more easily detected during expiration.

Bronchial breath sounds are louder and higher in pitch, with a short silence between inspiratory and expiratory sounds, expiratory sounds last longer than inspiratory sounds