Author Question: During auscultation of a patient's chest, you hear coarse crackles throughout both inspiration and ... (Read 59 times)

j.rubin · **on:** Jul 16, 2018

During auscultation of a patient's chest, you hear coarse crackles throughout both inspiration and expiration. These sounds clear when the patient coughs. Which of the following is the most likely cause of these adventitious sounds?

a. Opening of closed smaller airways or al-veoli
b. Opening of collapsed large, proximal air-ways
c. Variable obstruction to flow in the upper airway
d. Movement of excessive secretions in the airways

Question 2

Which of the following changes in the characteristics of wheezing indicate improvement in air-way obstruction following bronchodilator therapy?

a. Lower pitch, shorter duration
b. Higher pitch, shorter duration
c. Lower pitch, longer duration
d. Higher pitch, longer duration

JYan · **Reply #1 on:** Jul 16, 2018

Answer to Question 1

ANS: D
Excessive mucus in the airways causes crackles that are usually coarse (low pitched) and heard during inspiration and expiration. These crackles often clear when the patient coughs or when the upper airway is suctioned.

Answer to Question 2

ANS: A
It is useful to monitor the pitch and duration of wheezing. Improved expiratory flow is associat-ed with a decrease in the pitch and length of the wheezing. For example, if high-pitched wheez-ing is present during the entire expiratory time before treatment but becomes lower pitched and occurs only late in exhalation after therapy, the pitch and duration of the wheeze have dimin-ished. This suggests that the degree of airway obstruction has decreased.