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Respiratory Exam
 
 

Listening for Breath Sounds

 
 
 
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Overview

Breath sounds are normally heard on auscultating the chest, and their intensity and character can be used to assess for the presence of pulmonary pathology.
  • How to Assess

  • Ask the patient to take deep breaths in and out through their mouth. Auscultate from left to right, noting symmetry of breath sounds.
Auscultate the chest anteriorly and posteriorly, as well as in the axillae and supraclavicular fossae.
  • Types of Breath Sounds

  • Vesicular breath sounds - soft, non-musical, heard in inspiration and early expirationNormal breath sounds
  • Bronchial breath sounds - hollow sounds similar to those normally heard over the tracheaConsolidation or fibrosis

Reduced Breath Sounds

  • Listen For

  • Reduced intensity of breath sounds, either focally or generally over the chest. 
  • Causes of Decreased Breath Sounds

  • Shallow breathing - e.g. due to anxiety or CNS depression
  • Obstruction - foreign body, tumour, asthma, COPD
  • Pleural effusion
  • Pneumothorax
  • Obesity

Bronchial Sounds

  • Listen for

  • Hollow breath sounds, similar to those normally heard over the trachea.
  • Significance

  • Created by a patent airway surrounded by consolidated or otherwise hyperdense lung tissue.
  • Causes of Bronchial Breath Sounds

  • Pneumonia
  • Atelectasis (e.g. an area above a pleural effusion)
  • Pulmonary fibrosis
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