Control questions

1. What is auscultation? What types of auscultation do you know?

2. What types of the normal breath sounds do you know? Their properties and differences.

3. How the vesicular breath sound is changed in pathology? Diagnostic importance of the quantitative changes.

4. What are qualitative changes of vesicular breath sound, their diagnostic importance?

5. What is pathological bronchial breath sound, its diagnostic importance?

6. What is a stridor, its formation, diagnostic importance?

7. What are bronchophony and whispered pectoriloquy? Their diagnostic importance.

Practical tasks

1. Auscultation of the lungs

2. Assessment normal lung sounds.

3. Assessment changes of the lung sounds

4. Recognizing and assessing bronchophony and whispered pectoriloquy

Situation tasks

Task 1

21-year-old male patient complains on attacks of breathlessness. He occupied the forced position with fixed shoulder girdle, his skin is cyanotic. At auscultation you hear louder than normal vesicular breathe sound during inhalation and long exhalation. You suppose acute asthma attack.

1. How the vesicular breath sound change is named?

2. Why do the changes happen?

3. How the percussion sound is changed at the patient?

Task 2

59-year-old female patient complains of dyspnea, cough and left side chest pain. The symptoms appeared after hard work and overcooling 3 days before. At the visual inspection skin is pale and cyanotic, respiratory rate is 32 and left part of the chest is left behind from right. At percussion you find dull sound over lower lobe of the left lung. At auscultation you hear loud and rough breath sound during inhalation and exhalation, like sound “H” over the lower lobe of the left lung. X-ray examination has revealed lobar infiltration.

1. How the breath sound is named?

2. What is mechanism of their origin?

3. What position may patient occupy in the bed? Why?

Task 3

34-year-old female was admitted to pulmonology department with high fever (39°C), cough with mucus sputum. During examination patient’s general condition is moderate severe, at auscultation - vesicular breath sound calmer over right upper lobe than left.

1. How the vesicular breath sound change is named?

2. Why do the changes happen?

3. How the percussion sound is changed at the patient?

Task 4

67-year-old male patient notes increasing dyspnea, cough with purulent sputum production during last week after overcooling. Patient condition is moderate severe. He sits fixing the shoulder girdle. His exhalation is longer than inhalation. Skin is cyanotic. At auscultation vesicular sound is louder than normal with light metallic tone.

4. How the vesicular breath sound change is named?

5. Why do the changes happen?

6. How the percussion sound is changed at the patient?