Question

(2) Vital Signs/Auscultations: (a) Indicate some situations/conditions when listening to both anterior and posterior breath sounds might be difficult or impossible? (b) at what intercostal space do you find the border between the lungs and diaphragm on exhalation and inhalation? (c) Describe possible sounds heard on percussion during exhalation and inhalation (d) Describe possible diaphragm sounds on percussion during exhalation and inhalation

Answer 1

Auscultation is the process of listening to the breath sounds with the use of a sthescope.

a.Absent or decreased breath sounds can seen in

1.Pneumonia: Pneumonia is air or fluid in and around the lung. In Pneumonia bubbling noises are made by the movement of fluid in the tiny air sac of the lung.Lack of breath sounds in certain areas of the lung and mean air is not entering the area of the lung.

2.Pleural effusion In pleural effusion auscultation produce a muffled sound.Breath sound is decreased because ventilation to hemithorax is decreased

3.Emphysema: Auscultation of patients with emphysema produce diminished breath sound.

4.Heart failure: In heart failure diminished breath sounds are heard.It is due to the decreased ability of heart to fill and empty which in turn increase pressure around the lung.

5.Chronic obstructive pulmonary disease: It's respiratory illness that cause breathlessness ,cough sputum and shortness of breath.

6.Asthma:It is a chronic respiratory conditions that cause difficulty in breathing due to the inflammation of the wheezing is a whistling sound in your chest when you inhale and seen in Asthmatic patient.

b.When you exhale the external intercostal muscle relax and internal intercostal muscle contract,pulling ribcage downwards.The diaphragm relaxes and moves upwards

When you inhale,the internal intercostal muscles relax and external intercostal muscles contract pulling the ribcage upwards and outwards.The diaphragm contracts and moves downward.

c.Percussion plays a important role in examination . Percussion sounds can be normal,full or hyperresonant.Flat or dull percussive sounds indicate abnormal lung density.Hyperresonance on percussion indicate air is present in lung tissue.

d. Diaphragmatic excursion is the movement of the thoracic diaphragm during breathing.Normal diaphragmatic excursion is 5-6 cm.Normally lungs produce resonant sound which is a low pitched,hollow sound.During disease diaphragm sounds can be dull,flat , or hyperresonance.