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Old 02-06-2012
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Default HELP! I don't understand Respiratory terminology!

hey guys,

I've been pushing this off for months now but it has come time to really hit it head on and figure out what the heck some of these descriptions in respiratory questions mean. I don't think any source does a good job at simply defining or explaining what these mean so i've always been lost and just ignored them but i'm starting to realize they are the key giveaways when it comes to solving respiratory questions.

Could you please tell me what the following mean/indication:
- rhonchi
- crackles
- wheezing
- breath sounds
- dullness
- fullness
etc etc

Thank you!
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  #2  
Old 02-07-2012
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Quote:
Originally Posted by khushi.chahal View Post
hey guys,

I've been pushing this off for months now but it has come time to really hit it head on and figure out what the heck some of these descriptions in respiratory questions mean. I don't think any source does a good job at simply defining or explaining what these mean so i've always been lost and just ignored them but i'm starting to realize they are the key giveaways when it comes to solving respiratory questions.

Could you please tell me what the following mean/indication:
- rhonchi
- crackles
- wheezing
- breath sounds
- dullness
- fullness
etc etc

Thank you!
Sorry I can't explain that for some reason.. But did you try listening to the sounds on youtube (may be)? Sounds are best heard than explained.
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Old 02-07-2012
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wheezing in the stem means asthma in the answer choices, until proven otherwise ;-)
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Old 02-07-2012
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Originally Posted by suka View Post
Sorry I can't explain that for some reason.. But did you try listening to the sounds on youtube (may be)? Sounds are best heard than explained.
i don't mean what they sound like. i mean when they mention these key words in the question stem, what are they hinting at? what does crackles for example.
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Old 02-07-2012
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Quote:
Originally Posted by DocSikorski View Post
wheezing in the stem means asthma in the answer choices, until proven otherwise ;-)
awesome, thanks! thats one down.
what about these other keywords?
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Old 02-07-2012
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Quote:
Originally Posted by khushi.chahal View Post
hey guys,

I've been pushing this off for months now but it has come time to really hit it head on and figure out what the heck some of these descriptions in respiratory questions mean. I don't think any source does a good job at simply defining or explaining what these mean so i've always been lost and just ignored them but i'm starting to realize they are the key giveaways when it comes to solving respiratory questions.

Could you please tell me what the following mean/indication:
- rhonchi
- crackles
- wheezing
- breath sounds
- dullness
- fullness
etc etc

Thank you!
Crackles...short explosive clicking like sounds...when in early inspiration common in COPD...when loud and coarse it may be because of bronchiectasis...when its late in inspiration and fine in quality, then its due to interstitial lung disease

Rhonchi...represent larger airway version of wheeze, hutchison's book says its a poorly defined wheeze. So wont hint at any particular pathology.

Wheezing...due to airway narrowing...when its diffused over the chest, its asthma...when is localized over a specific area of chest, its due to narrowing of a single bronchus by a FB or a tumor.

Dullness...observed when purcussing over a lung which has either consolidation of lung parenchyma by pneumonia, pulm edema etc. or when pleural cavity is filled up by fluid like effusion, hemothorax etc
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Old 02-08-2012
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Bates' Physical Examination and History-Taking Book

Percussion Notes:

Flatness - Large pleural effusion
Dullness - Lobar pnuemonia
Resonance - Normal lung, simple chronic bronchitis
Hyperresonance - Emphysema, pneumothorax
Tympany - Large pneumothorax

Side comments (by me):
Flatness/Dullness are interchangeable. They indicate fluid in the lung. Dullness is usually used.
Hyperresonance/Tympany are also interchangeable. They indicate "extra" air in the lung. Hyperresonance is usually used.

Physical Findings in Selected Chest Disorders (Derived from a table in the same book as above):
Chronic bronchitis - none, or wheezes, rhonchi, crackles
Left heart failure (early) - late inspiratory crackles; possible wheezes
Consolidation - late inspiratory crackles
Atelectasis - usually absent breath sounds
Pleural effusion - decreased to absent breath sounds
Pneumothorax - decreased to absent breath sounds, possible pleural rub
COPD - decreased to absent breath sounds; no other lung sounds, unless with
bronchitis also
Asthma - wheezes

For Transmitted Voice Sounds (Same book as above) in the lungs:
Found in lobar pneumonia and toward the top of a large pleural effusion -
Bronchophony - spoken words louder, clearer
Egophony - spoken "ee" heard as "ay"
Whispered pectoriloquy - whispered words are louder and clearer

Side comments (by me):
You don't have to memorize them, this generalization helps:
anything that reduces the diameter (asthma, lung tumor) - wheezes
anything that causes to have fluid in the alveoli (pneumonia/left heart failure) - crackles/rales
rhonchi - just generally harsh breath sounds that don't point to a specific pathology
fluid outside the alveoli or in the pleura - absent breath sounds
collapsed lung or anything in between the lung and chest - absent breath sounds
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Old 02-08-2012
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awesome! thank you guys SO MUCH.
i'm going to give these comments a good read now and burn them into memory.

thanks again!!
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Old 09-05-2016
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RALES vs. RHONCHI:
https://www.youtube.com/watch?v=RZlLUmMbbGU
this is really high yield for Step 1. Knowing the difference helps you immensely on question stems
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