1.

Wheeze
a. On expiration hear a whistling sound
b. On inspiration the force of the chest pulls the small airways open and there is no
problem but on expiration the airways collapse, the chest force is gone so the
caliber of airways if smaller
c. High pitched musical adventitious sound
i. Why? Air passing through a narrow tunnel at high velocity ie bernoulis
principle
d. On expiration: mild obstruction
e. On inspiration and expiration: more severe
2. Subcutaneous emphysema
a. Due to displacement of chest tube
b. NB If trachea fills with air cant breath
3. Vocal horseness differential
a. Steroid use
b. Malignancy

Resp Rotation Lung Sounds

1. Lung sounds
a. Crackles
i. Mostly heard during inspiration because the alveoli “snap open”, its harder
for the alveoli open when they are restricted eg ILD/fibrosis
ii. Represents abrupt opening
iii. collapsed alveoli due to fluid or exudate
iv. DD?

b. wheeze
i. Wheezes are whistling-type noises produced during expiration (and
sometimes inspiration) when air is forced through airways narrowed
by bronchoconstriction, secretions, and/or associated mucosal
edema
2. Sounds
a. Wheeze: expiratory
b. Stridor inspiratory
3. Asthma
a. Trigger avoidance
b. Environmental factors
c. Ensuring they are using the inhaler correctly
d. Insure they are compliance
e. Drugs
i. ADAVIR