Lung sounds PPA

Five Classes of Sounds Normal Mild Acute Moderate Acute Severe Acute Chronic

Normal What is our definition of a “normal” Little to no pathophysiological signs No permanent lung tissue damage Antibiotic therapy may not be justified

Normal Note the lack of any pathophysiological symptoms of sickness.

Normal - Lungs

Normal - Histopathology

Normal - Spectrogram The spectrogram of the sound shows little change during respiratory phases.

Normal - Spectrogram The spectrogram of the sound shows little change during respiratory phases.

Mild Acute What is our definition of “mild acute” Early pathophysiological symptoms Weight gaining ability starting to be compromised Antibiotic therapy is necessary with expectations of excellent response from cost effective medications

Mild Acute

Mild Acute - Spectrogram

Mild Acute - Spectrogram

Moderate Acute What is our definition of “moderate acute” Some pathophysiological symptoms Weight gaining ability compromised Aggressive antibiotic therapy necessary for full recovery with no permanent damage

Moderate Acute Again, note the lack of any pathophysiological symptoms of sickness.

Moderate Acute - Lungs The lung tissue is beginning to show signs of damage [note fluid buildup in front of heart]

Moderate Acute - Histopathology The histopathology microgram shows some thickening of the interstitial areas- pre-pneumonic stage

Moderate Acute - Spectrogram The spectrogram for the mild shows good air movement for each respiratory phase. Each peak represents a respiratory phase where airway obstructions cause noise to be made.

Moderate Acute - Spectrogram The spectrogram for the mild shows good air movement for each respiratory phase (black line). Each peak represents a respiratory phase where airway obstructions cause noise to be made (brown line).

Severe Acute What is our definition of “severe acute” Pathophysiological signs definitely visible Lung tissue quickly deteriorating Weight gaining ability severely hampered (not permanent) Immediate, aggressive antibiotic therapy necessary just to minimize permanent damage

Severe Acute Some pathophysiological symptoms are appearing (runny nose), eye discharge, depression

Severe Acute - Lungs Severe damage is beginning to show on the exterior of the lungs. Note the dark regions above the apical lobe.

Severe Acute – Trachea Mucus within the trachea.

Severe Acute – Lungs Cross section of the apical lobe, notice the consolidation beginning to occur as well as the inflamed state of the tissue.

Severe Acute – Lungs Severe damage done by the infection.

Severe Acute - Histopathology Histopathology microgram shows white cells coming in to fight infection with air sac and small airways filled

Severe Acute - Histopathology Histopathology microgram showing same response- higher magnification

Severe Acute - Spectrogram Spectrogram shows signs of reduced air movement (brown line) as well as the first signs of consolidation (orange boxes).

Severe Acute - Spectrogram Spectrogram shows signs of reduced air movement (brown line) as well as the first signs of consolidation (orange boxes).

Chronic What is our definition of “chronic”? Advanced pathophysiology Permanent lung tissue damage is present Treatment will only affect new infections Weight gaining ability permanently diminished

Chronic Obvious pathophysiological signs of severe infection.

Chronic - Lungs Obvious signs of severe lung tissue damage.

Chronic - Lungs Dark purple regions indicate permanent lung tissue consolidation.

Chronic - Histopathology Dark purple regions indicate permanent lung tissue consolidation.

Chronic - Lungs Spectrogram reflects permanent consolidation of lung tissue with near constant level of noise throughout respiratory phases.

Chronic - Lungs Spectrogram reflects permanent consolidation of lung tissue with near constant elevated level of noise throughout respiratory phases (brown line).

Outward comparison Normal Mild Acute Moderate Acute Severe Acute Chronic

Lung tissue comparison Normal Mild Acute Moderate Acute Severe Acute Chronic

Histopathology comparison Normal Mild Acute Moderate Acute Severe Acute Chronic

Spectrogram comparison Normal Mild Acute Moderate Acute Severe Acute Chronic