While performing auscultation on a 2-month-old child, the therapist hears wheezes equal in pitch across all regions of the chest; however, they seem loudest in the vicinity of the sternum. From which of the following anatomic structures is the wheezing likely originating?

Question

Quizplus · Accepted Answer

Tracheal narrowing produces either expiratory or biphasic (inspiratory and expiratory) wheezing. The degree and flexibility of the airway narrowing will determine the severity of the wheeze. Because the trachea serves as the final conduit for the removal of secretions, lesions in this area may result in pooling of mucus with rhonchi audible during auscultation. The abnormalities are heard radiating throughout the chest but are best appreciated over the sternal area. It is often difficult to discern where the wheezes or rhonchi originate in a small child. Wheezes or rhonchi that remain equal in pitch across all regions of the chest but are heard loudest around the sternum most likely have originated in the trachea. Larger bronchial lesions produce similar manifestations but are more localized to the side of the lesion.

While Performing Auscultation on a 2-Month-Old Child, the Therapist Hears