Whispering to a Goat??
Ergophony and Whispering Pectoriloquy.
In this short mini-series, we look at the basics of auscultation of lung sounds.
Few things are cooler than listening to a sick patient's chest and hearing the classic sounds that highly suggest a specific diagnosis.
Pneumonia (lobar consolidation), is one such diagnosis. With alveoli collapsed and congested under the strain of pus, and other inflammatory debris, the way sound is transmitted becomes characteristically different. If reading about this for the first time, you will be itching to give this a go.
Ergophony
Assume Mr Chester in bed 6 has a diagnosis of Right middle lobe pneumonia. He is admitted on the ward for IV antibiotics and supplemental oxygen. As part of your routine assessment, you auscultate his lung sounds.
You ask Mr Chester to repeat the letter E, over and over while you listen the the resonance of his voice, through your stethoscope, at different locations on his chest. Across his left chest you hear the familiar sound of him chanting "Eeeee, Eeeee,Eeeee...." Over and over.
But as you place your stethoscope over the consolidated region of his right chest, the sound changes to a muffled "Aaaahhh, Aaaahhh, Aaaahhh..." sound. It sounds to you like the bleat of a goat or sheep. This is called Ergophony and literally means "voice of the goat". It is caused by changes to the sound waves as they travel through different densities of lung. When transmitted through pus filled dense pneumonia lobes, the Eeee resonates to Aaahhh.
Whispering Pectoriloquy
Say it out loud :
"Peck - tor- rill- oh- Kwee"
Apart from being a cracking scrabble word, this funky phenomenon is another one that can be heard in patients with pneumonia.
Normally if I listen to your lung fields with my stethoscope while you are whispering, I wont hear your words. The light air filled matrix of your ventilating lung filters out whispered sounds, rendering them inaudible on auscultation of a normal chest. However, when Mr Chester has pneumonia and an area of consolidation, sound is transmitted well through more dense tissue.
Start by asking your patient to sit upright and chant through the alphabet or count to 100 but only whispering. As you listen to the healthy areas of his chest you'll not hear his whispers, but when the stethoscope is placed over pneumonia consolidation of lung masses, you will hear the whispered words through your stethoscope. This is called whispering pectoriloquy, and is a symptom of consolidation.
Well that is it for part 4 of our breath sounds . Stay tuned for part 5 where we discuss some other adventitious noises.
If you missed our other KYJs in this series click them here.
Www.knowingyourjargon.blogspot.com
Please comment on and share these. I'd love to see you at one of my nursing seminars. They can be found on our ECT4Health web page.
As a sign of gratitude for how my husband was saved from Pneumonia , i decided to reach out to those still suffering from this.
ReplyDeleteMy husband was diagnosed of Pneumonia in 2013 and it was really tough and heartbreaking for me because he was my all and the symptoms were terrible, he always have headaches , and he always complain of sore throat . we tried various therapies prescribed by our neurologist but none could cure him. I searched for a cure and i saw a testimony by someone who was cured and so many other with similar body problem, and he left the contact of the doctor who had the cure to Pneumonia . I never imagined Pneumonia has a natural cure not until i contacted him and he assured me my husband will be fine. I got the herbal medication he recommended and my husband used it and in one months he was fully okay even up till this moment he is so full of life. Pneumonia has a cure and it is a herbal cure contact the doctor for more info on drwilliams098675@gmail.com on how to get the medication. Thanks admin for such an informative blog.