Thorough Examination of respiratory system

1. ANATOMY OF LUNGS

2. GRAPHIC REPRESENTATION

3. CHEST LANDMARKS

4. NORMAL BREATH SOUNDS
• TRACHEAL SOUNDS
• BRONCHIAL SOUNDS
• BRONCHOVESICULAR SOUNDS
• VESICULAR SOUNDS

5. TRACHEAL SOUNDS
• High-pitched loud breath sound.
• Heard over Trachea.
• Sounds are heard equally during inspiration and expiration.

6. BRONCHOVESICULAR SOUNDS
• Moderate pitch
• Can be heard over the upper portion of the lungs around the 1st and 2nd intercoastal
spaces.
• Breath sound will have a pause between inspiration and expiration.

7. VESICULAR SOUNDS
• Low -pitched sound and have a soft quality.
• Can be heard from the beginning of inspiration to almost the end of expiration.
• Not any pause in between the breath sound.

8. BRONCHIAL
• Heigh-pitched sounds.
• Expiration period is longer than inspiration period.
• Can be heard best next to trachea.

9. ABNORMAL BREATH SOUNDS
• STRIDOR( IN INFANTS)
• CRACKLES.
• WHEEZE
• RONCHI.
• PLEURAL RUB

10. STRIDOR
• Found specially in ‘ Infants’.
• Heigh-pitched inspiratory stridor.
• Noisy breathing, whistling sounds produced due to partially blocked airways.

11. CRACKLES(RALES)
• Sounds like air flowing through liquid.
• It can be Fine and Coarse Crackles.
• Usually heard during Inspiration. E.g. Bronchiectasis

12. WHEEZE
• Air flowing through constricted airways.
• Heigh-pitched musical sound.
• It is continuous and heard on inspiration and expiration.
• Bilateral in nature usually. E.g. Asthma

13. RONCHI
• Low – pitched sounds and Heigh pitched both.
• Heigh pitched are heard over the ‘smaller bronchi’.
• Low –pitched are heard over ‘larger bronchi’.
• Hard to distinguished between Ronchi and Crackles, if after coughing it disappear it
is Ronchi.

14. PLEURAL RUBS
• Inflammation of the pleural spaces causes friction.
• Not produced inside the airways, also friction rubs are dry, rubbing causes Crackling
sound.
• Can be heard during inspiration and expiration.

15. VIDEO
• https://youtu.be/kv3B81mWc1E?t=237

16. THANK YOU……