MECHANISM OF NORMAL BREATH SOUNDS

Normal breath sounds originate from the larynx. When the sound leaves the larynx it travels down the trachea and then divides when the airway divides. Some sound must be transmitted through the lung parenchyma but most travels down the airway. Eventually the sound travels along airways of different lengths and therefore becomes out of phase. Next it arrives in the respiratory bronchioles and alveoli and then gets transmitted through the chest wall to your stethoscope. The fat layer filters out much of the high frequency sound (above 4 kHz). The resulting sounds are much softer (because the sound has effectively been diluted throughout the whole of the lungs). There is no gap between inspiration and expiration (because all of the sound has become out of phase and therefore filled in the gap. Finally, the first third of expiration is now the only part that is audible because the latter two-thirds are much quieter.

REFERENCE : CHAMBERLAIN'S symptoms and signs of clinical medicine, 13th edition

 ILO CLASSIFICATION TO DESCRIBE PNEUMOCONIOTIC OPACITIES

ILO TERM                  OPACITY WIDTH                              OPACITY TYPE

P                                   < 1.5mm                                               Small rounded

Q                                  1.5 - 3 mm                                            Small rounded

R                                   > 3 - 10 mm                                         Small rounded

S                                   < 1.5mm                                               Linear/ Irregular

T                                   1.5 - 3 mm                                            Linear/ Irregular

U                                   > 3 - 10 mm                                         Linear/ Irregular

A                                   > 10 - 50 mm                                        Large

B                                   > 50 mm - RUZ                                    Large

C                                    > RUZ                                                  Large

Cardinal symptoms

 1. COUGH

Aggravating factors:

Pollution, Pollen, Posture

Drugs, Diurnal, Dry air

Food

Cold weather, Common cold

Exercise

Relieving Factors:

Using cough suppressants or expectorants

Drinking warm fluids 

Humidified air or steam inhalation

Avoiding triggers 

Rest

2. SPUTUM

Aggravating Factors:

Respiratory infections (e.g., bronchitis, pneumonia)

Exposure to cold air or smoke

Allergic reactions

COPD, asthma

Physical activity 

Relieving Factors:

Hydration 

Expectorants 

steam inhalation

Deep breathing exercises

3. HEMOPTYSIS 

Aggravating Factors:

Trauma or injury to the respiratory tract

Relieving Factors:

Treating the underlying condition 

Cough suppressants 

Oxygen therapy 

Positioning the person to reduce coughing or to prevent aspiration

4. CHEST PAIN

Aggravating Factors:

Deep breathing, coughing, sneezing (if pleuritic)

Physical exertion (if cardiac in nature)

Stress or anxiety

Movement or pressure on the chest area

acid reflux

Relieving Factors:

Rest 

Pain medication

Positioning (e.g., lying on one side for pleuritic pain)

Relaxation or stress-reduction techniques

Oxygen therapy

5. BREATHLESSNESS

Aggravating Factors:

Physical exertion or exercise

Exposure to cold air or allergens

Respiratory infections

Anxiety or panic attacks

Relieving Factors:

Rest or reducing physical activity

Oxygen therapy 

Bronchodilators 

Calm breathing techniques 

Elevating the head or upper body in severe cases

6. WHEEZE

Aggravating Factors:

Exposure to allergens or irritants (e.g., smoke, dust, pollen)

Respiratory infections 

Exercise or physical activity 

Cold air or sudden weather changes

Anxiety or panic attacks

Relieving Factors:

Bronchodilators 

Avoidance of triggers

Breathing exercises 

Inhaling steam

Rest and calm environment