Additional details of examination maneuvers and their origins may be found in the Historical section. The physiologic basis of vocal sounds may be found in the Pathophysiology section. No single maneuver is both highly sensitive and specific in detection of pneumonia therefore, usually several maneuvers are performed to increase the accuracy. Several of the techniques for auscultation and percussion are classical parts of the physical examination with little data about predictive value or reproducibility. In this setting the following maneuvers have historically been used in making the diagnosis of pneumonia and may be of interest. Lung injury in patients can be revealed by abnormal findings based on chest CT. The clinical likelihood of pneumonia increases when focal abnormalities such as crackles or asymmetry between lung fields are present. Assessment of lung and heart states is critical when evaluating the health condition of patients with pneumonia. Note: If the above exam is normal, no further maneuvers are likely to contribute to the diagnosis of lung pathology.
Assess for crackles in the lateral decubitus position (LDP).Assess for excursion depth during inspiration. Stridor is one of the adventitious (abnormal) lung sounds that you may hear during a respiratory assessment.The inspiration and expiration sound’s pitch, quality. Start at the top and work your way to the bottom of the chest while comparing sides (watch the video for the technique) When listening note the following: A full inspiration and expiration cycle. Auscultate for presence of crackles, wheezes and rub, alternating between left and right lung. The Basics of Lung Auscultation: Listen to both the anterior and posterior sides of the chest.
Since the complete pulmonary physical examination takes approximately ten minutes, for time-efficiency it is helpful to perform a screening exam, expanding techniques employed in a sequential fashion as indicated clinically: Screening Exam Techniques These are techniques of auscultation and percussion: We believe that the lung-sound data produced by our device will help to teach physical diagnosis.There are many physical examination maneuvers described for evaluation of lung sounds. Computerized lung sound analysis can provide objective evidence supporting the diagnosis of pneumonia. Our lung sound analyzer found significant differences between lung sounds in patients with pneumonia and in asymptomatic controls. Adventitious sounds were more common in pneumonia patients (inspiratory crackles 81% vs 28%, expiratory crackles 65% vs 9%, rhonchi 19% vs 0%).
The sensitivities in the 2 groups were 0.90 and 0.78, and the specificities were 0.94 and 0.88, respectively. Treatment depends on the cause and severity of pneumonia. The flu, COVID-19 and pneumococcal disease are common causes of pneumonia. It makes it difficult to breathe and can cause a fever and cough with yellow, green or bloody mucus. The positive predictive value of a score higher than 6 was 0.94 in the learning sample and 0.87 in the test sample. Pneumonia is inflammation and fluid in your lungs caused by a bacterial, viral or fungal infection. It can be heard when there is an airway obstruction such as when you listen to a patie. The acoustic pneumonia score averaged 13 in the learning sample and 11 in the test sample of pneumonia patients. This is the sound of wheezing when auscultating breath or lung sounds. Automated quantification and characterization of the lung sounds commonly recognized to be associated with pneumonia were used to generate an "acoustic pneumonia score." These were examined in the learning sample and then prospectively tested in 50 patients and 50 controls. To determine whether objectively detected lung sounds were significantly different in patients with pneumonia than those in asymptomatic subjects, and to quantify the pneumonia findings for teaching purposes.Īt a community teaching hospital we used a multi-channel lung sound analyzer to examine a learning sample of 50 patients diagnosed with pneumonia and 50 control subjects.