Post by Brian G on Oct 2, 2014 18:49:25 GMT
Yeah, I hear you breathing...now what?
Paraphrasing what Dr. Ridgeway explained today (thank you so much)...
When you are listening for:
-normal breath sounds
and
-abnormal breath sounds
You aren't doing these tasks separately. Each time you place the stethoscope and listen to a breath, you are using clues from two different directions to tell you if something is wrong or not.
The first clue is what it sounds like-the pitch and loudness-and where you are hearing it.
Normal breath sounds
As air comes in through your mouth and down, it first passes through the trachea, or bronchial tube. Remember playing with the wrapping paper tube when you were a kid-talking through the tube? It's got that loud hum feel. This is the bronchial sound,
As the air continues, it splits out into the smaller and smaller bronchi and bronchioles. It is taking more paths, more spread out, so it sounds a little softer. This is the bronchovesicular sound. You hear it where your windpipe makes the "Y".
Finally, the air reaches the alveoli where all those oxygen molecules meet the blood at the alveoli and do the diffusion dance. Think of the gently flowing brook with the water flowing softly and quietly. This is the vesicular sound. Think of the lung fields as the alveoli-everything else in the lung besides the pipes.
The second clue (or the third really after pitch and location) is how long you hear air going in, and how long you hear it going out. For a normal, healthy person, when you listen at the bronchial area, the exhalation part sounds longer than the inhalation part. This is described as a 1 to 2 ratio-the inhalation is half as long as the exhalation. In my mind I see the inhale as being behind the game.
As you move down, the game evens out, inhalation has caught up. Now the ratio is more equal-1 to 1.
By the lung field area-the vesicular sounds-inhalation is gaining the upper hand. The ratio is 5 to 2.
Okay...what?
You listen to how loud it is, where you hear it, and the proportion of inhalation and exhalation, not just listening for what sounds right, but what sounds normal but in the wrong place. For example, a loud exhaling breath sound that is easy to auscultate when you have the stethoscope low in the back towards the side is all out of place. This is the lung field, the vesicular area. It should be a gentle brook.
Kinda makes sense to me at least.
Brian
Paraphrasing what Dr. Ridgeway explained today (thank you so much)...
When you are listening for:
-normal breath sounds
and
-abnormal breath sounds
You aren't doing these tasks separately. Each time you place the stethoscope and listen to a breath, you are using clues from two different directions to tell you if something is wrong or not.
The first clue is what it sounds like-the pitch and loudness-and where you are hearing it.
Normal breath sounds
As air comes in through your mouth and down, it first passes through the trachea, or bronchial tube. Remember playing with the wrapping paper tube when you were a kid-talking through the tube? It's got that loud hum feel. This is the bronchial sound,
As the air continues, it splits out into the smaller and smaller bronchi and bronchioles. It is taking more paths, more spread out, so it sounds a little softer. This is the bronchovesicular sound. You hear it where your windpipe makes the "Y".
Finally, the air reaches the alveoli where all those oxygen molecules meet the blood at the alveoli and do the diffusion dance. Think of the gently flowing brook with the water flowing softly and quietly. This is the vesicular sound. Think of the lung fields as the alveoli-everything else in the lung besides the pipes.
The second clue (or the third really after pitch and location) is how long you hear air going in, and how long you hear it going out. For a normal, healthy person, when you listen at the bronchial area, the exhalation part sounds longer than the inhalation part. This is described as a 1 to 2 ratio-the inhalation is half as long as the exhalation. In my mind I see the inhale as being behind the game.
As you move down, the game evens out, inhalation has caught up. Now the ratio is more equal-1 to 1.
By the lung field area-the vesicular sounds-inhalation is gaining the upper hand. The ratio is 5 to 2.
Okay...what?
You listen to how loud it is, where you hear it, and the proportion of inhalation and exhalation, not just listening for what sounds right, but what sounds normal but in the wrong place. For example, a loud exhaling breath sound that is easy to auscultate when you have the stethoscope low in the back towards the side is all out of place. This is the lung field, the vesicular area. It should be a gentle brook.
Kinda makes sense to me at least.
Brian