[BLANK_AUDIO] Hi, we're here today to talk about accessing the respiratory system. You've had a lecture with Dr. Stanger about respiratory anatomy and physiology, you've had a demonstration with Amanda of the respiratory vital sign of respiration rate. And today we're going to talk about assessing the breath sounds. So, that's a little bit beyond Vital Signs, but something that'll be really beneficial to understand what's going on when a healthcare provider is listening to your breath sounds. So, what is it that we're listening for when we're listening to the breath sounds? What are we trying to assess? >> I think we're trying to assess the quality of the sounds, whether they're normal or abnormal. Right. So we want to hear if we're hearing a normal breath sound, or what's called an adventitious breath sound, which is an abnormal breath sound. And there's several different types of abnormal breath sounds that might indicate different things, so we'll talk a little later more about some examples of those. There's the right lung and the left lung, so let's talk a little bit more about the anatomy. Can you explain to me the differences between the right and the left lung? >> Yeah. The left lung has two lobes, an upper lobe and a lower lobe. And the right lung had three lobes, an upper, middle and lower lobe. >> Right! Great, so in the left lung you have the upper lobe and the lower lobe. And when you're listening, if we were to listen from the anterior, or front of the chest. Here would be the upper portion and here would be the lower lobe portion. On the right side, again, it's divided, as you said, into three sections. You have the upper lobe, the middle lobe and the lower lobe. So if you were listening, from the front you would hear mostly upper lobe in this section, middle lobe in this section and lower lobe, more on this side and posteriorly. So now, let's turn our mannequin around. Because we'll actually be able to, listen to some of the different breath sounds, both normal and abnormal. [BLANK_AUDIO] So, when a provider, does a assessment of breathing. They're using their stethoscope to auscultate, or listen to the breath sounds. And you have someone take a deep breath as you move your stethoscope around the individual's posterior chest cavity. So, just to demonstrate, in a very thorough assessment, you would listen in multiple locations. So, you would do somewhat like a ladder pattern, and you would start here, and move across and then down. And across, down, and across, down, and across, and then you would get some of the outer, portions of the lungs as well. So there's multiple locations. Now. That's a very thorough assessment. Depending on the purpose for the exam, the healthcare provider may choose not to listen if every single on of those locations. So, however, if they were to hear something abnormal in one particular spot they would be much more likely to listen longer more carefully and in more places. To ensure that they they can figure out what's going on with that person's lungs. So, let's start Naomi, maybe by having you take a listen, our mannequin can actually demonstrate some of the sounds, so. As you listen I'll have you listen first to what normal breath sounds would sound like. [SOUND] Great. Were you able to hear well? >> Yeah. >> Okay. so, let's talk a little bit more about some of the abnormal sounds that we might hear. Can you guys name any? >> Crackles or wheezing. >> Right. [COUGH] Crackles, which is also called rales is something that you might hear if somebody had a case of pneumonia, or pulmonary edema, where they fluid collecting in their lungs, so it really sounds like a crackle, or a little pop. And you would hear it where fluid is collecting, or where there's some sort of consolidation. Like you would have with pneumonia. You also mentioned wheezing. Do either of you know when, what condition you might hear wheezing with? >> Is that associated with Asthma? >> Asthma is a very common reason that you might hear wheezing in the lungs. So again, if your provider were listening, and they thought they heard one of these sounds, they would, you know, do a very thorough assessment to listen. And, we can actually demonstrate some of those sounds now. So, do you want to, listen? >> Sure. [BLANK_AUDIO] >> First, we'll listen to, crackles. >> [SOUND] Yeah, that sounds different. >> Yeah. And now let's do a demonstration of wheezing.Do you want to go ahead? >> Sure. >> Go ahead. [SOUND] You got it? >> Sounds very weird. >> Yeah. [LAUGH]. So this just a basic demonstration of what we're listening to and what's going on when a healthcare provider listens with a stethoscope to the lungs. So that's our demonstration today. Just a brief demonstration of, a respiratory assessment by listened to the breath sounds.
