PCM1: Lung Exam

=Objectives=

=Definitions=
 * egophony:
 * pleural effusion

=Interpretation of Clinical Findings=
 * pleural effusion
 * pericardial rub


 * tactile fremitus
 * the palpable vibration of the chest wall that results from speech or other verbalizations


 * Vesicular breath sounds
 * low-pitched, low-intensity sounds heard over healthy lung tissue.
 * ~ 3:1 inspiratory-to-expiratory ratio (timing)


 * Bronchovesicular sounds
 * heard over the major bronchi and are typically moderate in pitch and intensity. abnormal if they are heard over the peripheral lung tissue.
 * 1:1 inspiratory-to-expiratory ratio (timing)


 * bronchial breath sounds
 * The sounds highest in pitch and intensity which are ordinarily heard only over the trachea, abnormal if they are heard over the peripheral lung tissue.


 * hyperresonance
 * sound on percussion associated with hyperinflation (asthma, emphysema) or pneumothorax

Define adventitious breath sounds and their significance

 * crepitus
 * pathological sign. a crackly or crinkly sensation, can be both palpated and heard-a gentle, bubbly feeling. It indicates air in the subcutaneous tissue from a rupture somewhere in the respiratory system or by infection with a gas-producing organism


 * pleural friction rub
 * dry, rubbing or gratin sound, usually caused by inflammation. heard in both inspiration and expiration


 * crackles
 * discrete, abnormal sounds typically heard during inspiration. further descriptors distinguish between fine vs. coarse, low pitched vs. high pitched.


 * rhonchi
 * continuous, deep, rumbling noises caused by passage or air through an airway obstructed by thick secretions. Sometimes palpable.  Tend to disappear after coughing whereas crackles do not.


 * whispered pectoriloquy
 * when the physician intelligibly hear a patient whisper while listening with the stethoscope. suggestive of a consolidation because sound passes more easily through solids than air.

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=Examination Order=