Simple Nursing: Breath Sounds Made Easy

Presenter: David Woodruff

• Editor of Critical Care Nursing Made Incredibly Easy
• Goal: Simplify understanding of abnormal breath sounds

Introduction

• Importance of proper reporting of breath sounds in nursing
• Focus on five common abnormal breath sounds:
  • Wheezing
  • Ronchi
  • Rales (Crackles)
  • Stridor
  • Pleural friction rub
• Understanding anatomy and physiology to determine sound origins

Anatomy and Physiology

• Upper Airway: Nose, mouth, tongue, trachea
  • Snoring occurs due to closure by soft palate
  • Stridor caused by upper airway obstructions
• Lower Airway: Bronchi, lungs, bronchioles, alveoli
  • Different sounds based on location
  • More air movement in upper airways, making sounds louder

Abnormal Breath Sounds

Wheezing

• Narrowing of airways, similar to whistling
• Causes: Bronchoconstriction, secretions, asthma, COPD, infections, pulmonary embolism, aspiration
• Sound: High-pitched, continuous, worsens on expiration

Ronchi

• Harsh, bubbly sound
• Causes: Secretions or foreign bodies in the airway
• Sound: Low-pitched bubbling/rattling, continuous on inspiration and expiration

Rales (Fine Crackles)

• Fluid accumulation in distal airways or alveoli
• Causes: Pulmonary edema, pneumonia, atelectasis
• Sound: Brief, discontinuous popping/crackling, heard at end of inspiration

Stridor

• Upper airway obstruction
• Causes: Epiglottitis, pertussis, aspiration, croup
• Sound: Loud, high-pitched whistling, worse on inspiration

Pleural Friction Rub

• Inflammation of the pleura
• Causes: Pleural effusions, empyemas, hemothorax
• Sound: Symmetrical, continuous, "leather creaking", localized

Differentiating Breath Sounds

• Wheezing vs. Ronchi: Wheezing high-pitched, Ronchi low-pitched
• Fine Crackles vs. Coarse Crackles: Fine (Rales) at end of inspiration; Coarse (Ronchi) continuous
• Pleural Friction Rub: Symmetrical, often localized, doesn't change with cough

Conclusion

• Key distinctions and characteristics of each abnormal breath sound
• Listening techniques and understanding location-based sound differences

Thank you for joining "Breath Sounds Made Easy" with David Woodruff.