N125 Exam 3 Review Questions and
100% Correct Answers
when auscultating the lungs and consolidation (e.g., pneumonia) or compression (e.g.,
fluid in the intrapleural space) yields a dense lung area that enhances the
transmission of sound from the bronchi.
increased breath sounds occur
when auscultating the lungs and airway obstruction from acute asthma or chronic
emphysema sound is a wheeze; like High-pitched, musical squeaking sounds that
sound polyphonic (multiple notes as in a musical chord)
increased breath sounds occur
Crackles
discontinuous popping sounds heard over inspiration
occur with restrictive disease: pneumonia, heart failure, and interstitial fibrosis
obstructive disease: chronic bronchitis, asthma, and emphysema
wheezes
continuous musical sounds heard mainly over expiration.
stridor
High-pitched, monophonic, inspiratory, crowing sound; louder in neck than over
chest wall
Costal Angle
,The right and left costal margins form an angle where they meet at the xiphoid
process. Usually 90 degrees or less, this angle increases when the rib cage is chronically
overinflated, as in emphysema.
fremitus
a palpable vibration. Sounds generated from the larynx are transmitted through patent
bronchi and the lung parenchyma to the chest wall, where you feel them as vibrations.
fremitus know where to find it or where you're looking for it
-most prominent between the scapulae and around the sternum, sites where the
major bronchi are closest to the chest wall.
-feels greater over a thin chest wall than over an obese or heavily muscular one where
thick tissue damps the vibration.
fremitus assessment
Begin palpating over the lung apices in the supraclavicular areas (Fig. 19.22). Compare
vibrations from one side to the other as the person repeats "ninety-nine." Avoid
palpating over female breast tissue because breast tissue normally damps the sound.
Bronchovesicular breath sound
-pitch: moderate, -amplitude: moderate -duration: inspirations =expiration
-quality: mixed, -normal location: Over major bronchi where fewer alveoli are
-located: posterior, between scapulae especially on right; anterior, around
upper sternum in 1st and 2nd intercostal space
BRONCHIAL (TRACHEAL) breath sound
-pitch: high, -amplitude: loud
-duration: inspiration <expiration
, -quality:Harsh, hollow tubular, normal
-location:Trachea and larynx
VESICULAR breath sound
-pitch: low
-amplitude:soft
- duration: inspiration >expiration
-quality:Rustling, like the sound of the wind in the trees
- normal location: Over peripheral lung fields where air flows through smaller
bronchioles and alveoli
proper way to assess lungs when progressing from one site to another
-The person is sitting, leaning forward slightly, with arms resting comfortably across the
lap. Instruct the person to breathe through the mouth, a little bit deeper than usual,
but to stop if he or she begins to feel dizzy.
*Be careful to monitor the breathing throughout the examination, and offer times for
the person to rest and breathe normally.*
-Clean the flat diaphragm endpiece of the stethoscope and hold it firmly on the
person's chest wall.
-Listen to at least one full respiration in each location. Side-to-side comparison is
most important.
-While standing behind the person, listen to the following lung areas: posterior from
the apices at C7 to the bases (around T10) and laterally from the axilla down to the 7th
or 8th rib
Atelectatic crackles
-Sound like fine crackles but do not last and are not pathologic; disappear after the first
few breaths;
100% Correct Answers
when auscultating the lungs and consolidation (e.g., pneumonia) or compression (e.g.,
fluid in the intrapleural space) yields a dense lung area that enhances the
transmission of sound from the bronchi.
increased breath sounds occur
when auscultating the lungs and airway obstruction from acute asthma or chronic
emphysema sound is a wheeze; like High-pitched, musical squeaking sounds that
sound polyphonic (multiple notes as in a musical chord)
increased breath sounds occur
Crackles
discontinuous popping sounds heard over inspiration
occur with restrictive disease: pneumonia, heart failure, and interstitial fibrosis
obstructive disease: chronic bronchitis, asthma, and emphysema
wheezes
continuous musical sounds heard mainly over expiration.
stridor
High-pitched, monophonic, inspiratory, crowing sound; louder in neck than over
chest wall
Costal Angle
,The right and left costal margins form an angle where they meet at the xiphoid
process. Usually 90 degrees or less, this angle increases when the rib cage is chronically
overinflated, as in emphysema.
fremitus
a palpable vibration. Sounds generated from the larynx are transmitted through patent
bronchi and the lung parenchyma to the chest wall, where you feel them as vibrations.
fremitus know where to find it or where you're looking for it
-most prominent between the scapulae and around the sternum, sites where the
major bronchi are closest to the chest wall.
-feels greater over a thin chest wall than over an obese or heavily muscular one where
thick tissue damps the vibration.
fremitus assessment
Begin palpating over the lung apices in the supraclavicular areas (Fig. 19.22). Compare
vibrations from one side to the other as the person repeats "ninety-nine." Avoid
palpating over female breast tissue because breast tissue normally damps the sound.
Bronchovesicular breath sound
-pitch: moderate, -amplitude: moderate -duration: inspirations =expiration
-quality: mixed, -normal location: Over major bronchi where fewer alveoli are
-located: posterior, between scapulae especially on right; anterior, around
upper sternum in 1st and 2nd intercostal space
BRONCHIAL (TRACHEAL) breath sound
-pitch: high, -amplitude: loud
-duration: inspiration <expiration
, -quality:Harsh, hollow tubular, normal
-location:Trachea and larynx
VESICULAR breath sound
-pitch: low
-amplitude:soft
- duration: inspiration >expiration
-quality:Rustling, like the sound of the wind in the trees
- normal location: Over peripheral lung fields where air flows through smaller
bronchioles and alveoli
proper way to assess lungs when progressing from one site to another
-The person is sitting, leaning forward slightly, with arms resting comfortably across the
lap. Instruct the person to breathe through the mouth, a little bit deeper than usual,
but to stop if he or she begins to feel dizzy.
*Be careful to monitor the breathing throughout the examination, and offer times for
the person to rest and breathe normally.*
-Clean the flat diaphragm endpiece of the stethoscope and hold it firmly on the
person's chest wall.
-Listen to at least one full respiration in each location. Side-to-side comparison is
most important.
-While standing behind the person, listen to the following lung areas: posterior from
the apices at C7 to the bases (around T10) and laterally from the axilla down to the 7th
or 8th rib
Atelectatic crackles
-Sound like fine crackles but do not last and are not pathologic; disappear after the first
few breaths;
