MED1 SGD

REVIEW ON LUNG SOUNDS

PART 1
Tactile Fremitus = Palpation
Breath Sounds = Auscultation
Mediastinal Shift = Palpation

PART 2
Decreased sound transmission (D breath sound)
Dull on percussion

Tip: Correlate percussion and voice transmission

I = Lagging of the right side

Palp = Decreased voice transmission
Perc = Dull; presence of consolidation
A=

Pleural effusion

Substernal chest pain

Sudden onset = rules out pneumonia

Pneumothorax on the right side

The shifting to the left side of the midline structures
(trachea and apex beat)

Emphysema to Pneumothorax

PART 3

Tracheal breath sounds at the bases = signify

increased sound transmission

Another term: Tubular breath sounds

Loud, harsh and high-pitched

More than 400 Hz
Particularly peripheral posterior lung bases

Obese, young, nighttime awakenings = signs of

obstructive sleep apnea or asthma

Findings: Expiratory Wheeze

Bronchial breath sounds

Wheeze
● Fluttering of the airway
● High-pitched sounds

Findings: Inspiratory Fine Crackles

Bronchial Breath Sounds

Crackles
● Low-pitched
● Sudden opening of airways = ~VELCRO

Findings: Rhonchi

Low pitched sound

Both expiration (mostly) and inspiration
Musical/bubbly, resembles snoring

Differentiation
Rhonchi = central/larger airway constriction
Wheeze = musical; smaller airway constriction